A Mixed-Methods Study on the Current Status and Influencing Factors of Fear of Falling in Elderly Patients with Frailty

Anxiu WANG; Xiaohong SHEN; Wenjie MA; Sichao WU; Hongjian ZHOU; Yaopeng YANG

Article Contents

Article Navigation > Journal of Kunming Medical University > 2026 > Accepted Manuscript

Anxiu WANG, Xiaohong SHEN, Wenjie MA, Sichao WU, Hongjian ZHOU, Yaopeng YANG. A Mixed-Methods Study on the Current Status and Influencing Factors of Fear of Falling in Elderly Patients with Frailty[J]. Journal of Kunming Medical University.

Citation:

PDF( 692 KB)

A Mixed-Methods Study on the Current Status and Influencing Factors of Fear of Falling in Elderly Patients with Frailty

1.
School of Nursing，Kunming Medical University，Kunming Yunnan 650500
2.
Department of Geriatrics
3.
Department of Emergency Medicine ，Sixth Affiliated Hospital of Kunming Medical University，Yuxi Yunnan 653100，China

Received Date: 2025-11-21

Abstract

Abstract

Objective To explore the current status of fear of falling in elderly patients with debilitating diseases and analyze its influencing factors. Methods An explanatory mixed-methods design was adopted. Using convenience sampling, a total of 335 elderly debilitated patients hospitalized in the department of geriatrics a tertiary hospital in Yunnan Province from January 2025 to October 2025 were enrolled as participants. Data were collected using a general Information Questionnaire, the Morse Balance Scale, the Self-Rating Anxiety Scale, the Self-Rating Depression Scale and the Modified Fear of Falling Questionnaire. Multiple linear regression analysis was used to identify the influencing factors of Fear of Falling in elderly debilitated patients. Semi-structured interviews were conducted with 16 elderly debilitated patients by purposive sampling and the interview data were analyzed qualitatively. Results The mean score of fear of falling in frail elderly patients was 42.88 ± 3. 65. The mean scores of anxiety and depression were 41.17 ± 10. 83 and 44.21 ± 8. 92 respectively. Multiple linear regression showed that gender, monthly income, age, emotional status, weekly exercise frequency, number of disease types, Morse score and daily sleep duration were the main influencing factors of fear of falling in elderly debilitated patients （P < 0.05）. The qualitative study refined four themes: the dual challenges of physical frailty and disease onset, self-suggestion caused by the fall experience; lack of a safe and comfortable external environment; and incomplete understanding of information. The integrated results show that the quantitative and qualitative findings mutually validated and supplemented each other. Conclusion The level of fear of falling in elderly debilitated patients is moderately high, influenced by both individual and environmental factors. Healthcare providers should implement targeted nursing interventions for this population.
- Fear of falling,
- Frail elderly,
- Influencing factors,
- Mixed-methods study

FullText(HTML)

References(34)

References

[1]	杨舸. 我国“十四五”时期的人口变动及重大“转变”[J]. 北京工业大学学报(社会科学版), 2021, 21(1): 17-29. doi: 10.12120/bjutskxb202101017
[2]	吴淑婷, 徐伟豪, 林展翼. 老年心血管疾病患者衰弱干预最新研究进展[J]. 中华老年心脑血管病杂志, 2025, 27(8): 1110-1113.
[3]	耿圆圆, 张薇, 周鼒, 等. 老年人衰弱的心理社会因素流行病学研究进展[J]. 中国老年学杂志, 2021, 41(8): 1752-1756.
[4]	周越, 潘宇帆, 戴雨, 等. 基于COSMIN指南对中文版老年人跌倒恐惧评估工具的系统评价[J]. 中国循证医学杂志, 2024, 24(11): 1305-1311.
[5]	O’Caoimh R, Costello M, Small C, et al. Comparison of frailty screening instruments in the emergency department[J]. Int J Environ Res Public Health, 2019, 16(19): 3626. doi: 10.3390/ijerph16193626
[6]	Sawa R, Doi T, Tsutsumimoto K, et al. Overlapping status of frailty and fear of falling: An elevated risk of incident disability in community-dwelling older adults[J]. Aging Clin Exp Res, 2023, 35(9): 1937-1944. doi: 10.1007/s40520-023-02474-z
[7]	许琳, 严立群, 吴争艳. 老年骨质疏松性椎体压缩骨折患者认知衰弱现状及其与跌倒恐惧的关系[J]. 护理实践与研究, 2022, 19(18): 2741-2745.
[8]	Knoop V, Costenoble A, Vella Azzopardi R, et al. The operationalization of fatigue in frailty scales: A systematic review[J]. Ageing Res Rev, 2019, 53: 100911. doi: 10.1016/j.arr.2019.100911
[9]	方积乾, 陆盈. 现代医学统计学[M]. 北京: 人民卫生出版社, 2002.
[10]	Bower E S, Wetherell J L, Merz C C, et al. A new measure of fear of falling: Psychometric properties of the fear of falling questionnaire revised (FFQ-R)[J]. Int Psychogeriatr, 2015, 27(7): 1121-1133. doi: 10.1017/S1041610214001434
[11]	王蕾, 王颖, 鲁志卉, 等. 修订版跌倒恐惧问卷的汉化及信效度研究[J]. 护理研究, 2022, 36(7): 1134-1138.
[12]	Zung W W K. A rating instrument for anxiety disorders[J]. Psychosomatics, 1971, 12(6): 371-379. doi: 10.1016/S0033-3182(71)71479-0
[13]	Zung W W K. A self-rating depression scale[J]. Arch Gen Psychiatry, 1965, 12(1): 63. doi: 10.1007/springerreference_184638
[14]	Morse J M, Black C, Oberle K, et al. A prospective study to identify the fall-prone patient[J]. Soc Sci Med, 1989, 28(1): 81-86. doi: 10.1016/0277-9536(89)90309-2
[15]	林嘉琪, 吴桂丽. Morse跌倒风险评估量表的临床应用研究进展[J]. 护理学报, 2018, 25(13): 42-45. doi: 10.16460/j.issn1008-9969.2018.13.042
[16]	de Souza L F, Canever J B, de Souza Moreira B, et al. Association between fear of falling and frailty in community-dwelling older adults: A systematic review[J]. Clin Interv Aging, 2022, 17: 129-140. doi: 10.2147/CIA.S328423
[17]	Makino K, Lee S, Bae S, et al. Prospective associations of physical frailty with future falls and fear of falling: A 48-month cohort study[J]. Phys Ther, 2021, 101(6): pzab059. doi: 10.1093/ptj/pzab059
[18]	Birhanie G, Melese H, Solomon G, et al. Fear of falling and associated factors among older people living in Bahir Dar City, Amhara, Ethiopia- a cross-sectional study[J]. BMC Geriatr, 2021, 21(1): 586. doi: 10.1186/s12877-021-02534-x
[19]	Merchant R A, Chen M Z, Wong B L L, et al. Relationship between fear of falling, fear-related activity restriction, frailty, and sarcopenia[J]. J Am Geriatr Soc, 2020, 68(11): 2602-2608. doi: 10.1111/jgs.16719
[20]	Kumar A, Carpenter H, Morris R, et al. Which factors are associated with fear of falling in community-dwelling older people?[J]. Age Ageing, 2014, 43(1): 76-84. doi: 10.1093/ageing/aft154
[21]	Su Q, Gao Y, Zhang J, et al. Prevalence of fear of falling and its association with physical function and fall history among senior citizens living in rural areas of China[J]. Front Public Health, 2021, 9: 766959. doi: 10.3389/fpubh.2021.766959
[22]	Chen T Y, Lee S, Hsu K W, et al. Poor sleep health predicts the onset of a fear of falling among community-dwelling older adults[J]. Sleep Health, 2024, 10(1): 137-143. doi: 10.1016/j.sleh.2023.10.007
[23]	Kakazu V A, Pinto R Z, Dokkedal-Silva V, et al. Does poor sleep quality and excessive daytime sleepiness influence fear of falling among older adults? A cross-sectional study[J]. Sleep Biol Rhythms, 2022, 20(2): 287-295. doi: 10.1007/s41105-021-00368-z
[24]	Makino K, Makizako H, Doi T, et al. Fear of falling and gait parameters in older adults with and without fall history[J]. Geriatr Gerontol Int, 2017, 17(12): 2455-2459. doi: 10.1111/ggi.13102
[25]	De Roza J G, Ng D W L, Mathew B K, et al. Factors influencing fear of falling in community-dwelling older adults in Singapore: A cross-sectional study[J]. BMC Geriatr, 2022, 22(1): 186. doi: 10.1186/s12877-022-02883-1
[26]	邵梦琪, 谢中垚, 霍霞, 等. 基于扎根理论的老年人跌倒恐惧发生机制模型的构建[J]. 护理研究, 2025, 39(8): 1233-1240. doi: 10.12102/j.issn.1009-6493.2025.08.001
[27]	Xiong W, Wang D, Ren W, et al. The global prevalence of and risk factors for fear of falling among older adults: A systematic review and meta-analysis[J]. BMC Geriatr, 2024, 24(1): 321. doi: 10.1186/s12877-024-04882-w
[28]	郭亚芬, 周建伟, 陈秋蕾. 68例住院患者跌倒伤害的影响因素分析[J]. 当代护士(上旬刊), 2021, 28(4): 45-48. doi: 10.19791/j.cnki.1006-6411.2021.04.016
[29]	荆海燕, 梁碧娟, 罗玉奇, 等. 老年衰弱前期患者跌倒风险预防及管理的研究进展[J]. 中国老年保健医学, 2024, 22(6): 124-127.
[30]	Arias-Fernández L, Caballero F F, Yévenes-Briones H, et al. Association between multimorbidity and risk of falls and fear of falling among older adults: The mediation effect of physical function, use of sleeping pills, and pain relievers[J]. J Am Med Dir Assoc, 2024, 25(10): 105201. doi: 10.1016/j.jamda.2024.105201
[31]	陶圆佳, 程宇琪, 晏和智, 等. 老年抑郁障碍患者认知损害的影响因素[J]. 昆明医科大学学报, 2024, 45(6): 94-99. doi: 10.12259/j.issn.2095-610X.S20240612
[32]	Sheng Y, Wang C, Wang Y, et al. An umbrella review of physical-activity therapy and cognitive behavioral therapy in reducing fear of falling among community-dwelling older adults: Insights on intervention intensity and duration[J]. Front Public Health, 2025, 12: 1498451. doi: 10.3389/fpubh.2024.1498451
[33]	Drummond F M M, Lourenço R A, de Souza Lopes C. Incidence, persistence and risk factors of fear of falling in older adults: Cohort study (2008-2013) in Rio de Janeiro, Brazil[J]. Rev Saude Publica, 2020, 54: 56. doi: 10.11606/s1518-8787.2020054001939
[34]	刘玉文, 张丽梅, 王永丽, 等. 老年多学科团队服务对共病伴营养不良老年患者的疗效分析[J]. 昆明医科大学学报, 2024, 45(12): 81-87. doi: 10.12259/j.issn.2095-610X.S20241211

Relative Articles(20)

Relative Articles

[1]	Qing LI, Wei GENG, Fengxi ZHANG, Dan ZHANG. Clinical Study on Predicting Pregnancy Outcomes through the Imbalance of Vaginal Microbiota and Levels of Inflammatory Factors in Pregnant Women. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20260114
[2]	Qianrong YANG, Xue CAO, Jiao YANG, Yanqiu ZHAO, Nan SHEN, Yajiao SUN. Status and Influencing Factors of Stigma in Lung Cancer Patients. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20250108
[3]	Zhongjie WANG, Yu XIA, Hongrui ZHAO, Xuelin XIANG, Huadan WANG, Min MA, Liping HE. Analysis of Self-assessed Health Changes and Influencing Factors among the Elderly People Based on CHARLS Database. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20250305
[4]	Shiyao YANG, Yanxia YANG, Haiyin YANG, Yong DONG, Jinhu MIAO, Yuexi ZHU, Qiongyao GUAN. A Systematic Evaluation of Incidence and Influencing Factors of Falls in Adult Cancer Patients. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20250512
[5]	Jiang ZHANG, Xijuan ZHAO, Jiang WU, Bingkun YANG, Ni YANG, Liping ZHOU. Analysis of Frailty Status and Influencing Factors in Lung Cancer Patients Undergoing Radiotherapy. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20250218
[6]	Jia TAN, Yixing ZOU, Xiaoying HAN, Guangming DING, Zhaohui LENG. Predictive Evaluation and Risk Factor Analysis of Delirium in Elderly Patients with Frailty Using FRAIL, CFS, and REFS. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20251215
[7]	Lifen WEN, Zhiqin GONG, Ping ZHANG, Manlu MEI, Zhihe TIAN, Yujuan DU. Investigation on Nutritional Status of the Elderly in Some Community in Kunming and Analysis of Its Influencing Factors. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20240618
[8]	Shumei QIU, Jingrui YANG, Xuecai QIU. The Risk and Influencing Factors of Vascular Dementia in Middle-aged and Elderly People in Kunming. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20240914
[9]	Xuesong HU, Wenbin DONG, Shifu LI, Liyue CHEN, Yingzhou MIAO, Bing SHEN, WenRui ZHOU, Shaoxing DONG. Frailty and Related Factors in Elderly Patients with Chronic Pain. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20241020
[10]	Xue-song HU, Li-yue CHEN, Shi-fu LI, Wen-bin DONG, Zi-qian HE, Shao-xin DONG, Shun-xiang LI. Influencing Factors Contributing to Insomnia Among Patients with Chronic Pain. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20210207
[11]	Xiu-qing WANG, Xin-tian LONG, Yong MAO, Jie CHEN, Jia ZHOU, Tian-shu CHU, Song-mei WANG, Cheng-huan SUN, Chun-mi LAI, Qian ZHANG. Prevalence and Determinants of Hypertension in Senior Nu Ethnic Group. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20210922
[12]	Xin-tian LONG, Jie CHEN, Yong MAO, Xiu-qing WANG, Shuang-yan LU, Hui-jie PU, Jia ZHOU, Cheng-huan SUN, Song-mei WANG, Ai-fang YE. Detection Rate and Determinants of Hypertension among Seniors in Anning City. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20211210
[13]	Ma Xiao Yan . The Depression Status and Influencing Factors for the Late Pregnancy Women. Journal of Kunming Medical University,
[14]	Liu Jun Ping . . Journal of Kunming Medical University,
[15]	Tao Yan Ping . . Journal of Kunming Medical University,
[16]	Yang Jian Yi . . Journal of Kunming Medical University,
[17]	Su Zhen Fang . . Journal of Kunming Medical University,
[18]	Su Zhen Fang . . Journal of Kunming Medical University,
[19]	Fu Zhong Yang . . Journal of Kunming Medical University,
[20]	He Li Ping . . Journal of Kunming Medical University,