Falls And Hospitalized Cancer Patients

FALLS AND HOSPITALIZED CANCER PATIENTSby REBECCA ALLAN-GIBBS, MSN, RN, CNS-BC, AOCNSMay 2014Advisor: Dr. Patricia Jarosz, PhD, RNMajor: NursingDegree: Doctor of PhilosophyProblem: Many hospital fall prevention studies have shown that having a diagnosis of cancerplaces patients at higher risk for falls/falls with injury when compared to other hospitalizedgroups of patients. Few studies have focused solely on cancer patients at risk for falls in thehospital setting. Specifically, this study used Dorothea Orem’s theory of self-care (Orem,2001), and Albert Bandura’s (2001), social cognitive theory to determine if factors such as age,gender, health state, healthcare system factors, self-care agency, and self-care impact falls.Design: case-control with prospective design component. Sample: retrospective, n=104; (74controls, 30 cases); prospective, n=32 Findings: Statistically significant variables that were associated with a fall and included in the logistic regression model were: a diagnosis of lungcancer, diuretics, antiepileptics, and length of stay. Conclusions: The model as a whole explained between 27% (Cox and Snell R square) and 38.6% (Nagelkerke R squared) of thevariance in falls, and classified 80.8% of cases. The strongest predictor of falls was lung cancer,recording an odds ratio of 3.87. This indicated that participants who had lung cancer were 3.87times more likely to fall. The prospective group of participants did not fall. In the prospective sample, depression scores were low, fatigue scores were moderate, performance status on