Examining the relationship between patients who have undergone brain surgery and their fear of falling and pain, cognitive status, functional mobility, anxiety, and depression: Fear of falling in patients who have undergone brain surgery

Hale Turhan Damar; Özlem Bilik; Aklime Sarıkaya; Altun Baksi; Şirin Akyıl

doi:10.28982/josam.7398

Authors

Hale Turhan Damar Elderly Care Program, Health Services Vocational School, İzmir Demokrasi University, Izmir, Turkey https://orcid.org/0000-0002-1218-5319
Özlem Bilik Department of Surgical Nursing, Faculty of Nursing, Dokuz Eylül University, Izmir, Turkey https://orcid.org/0000-0002-8372-8974
Aklime Sarıkaya Nursing Department, Faculty of Health Sciences, Istanbul Aydin University, Istanbul, Turkey https://orcid.org/0000-0002-7576-801X
Altun Baksi Department of Nursing, Faculty of Health Sciences, Suleyman Demirel University, Isparta, Turkey https://orcid.org/0000-0001-8267-2254
Şirin Akyıl Dokuz Eylül University Hospital, Izmir, Turkey https://orcid.org/0000-0002-8687-1872

DOI:

https://doi.org/10.28982/josam.7398

Keywords:

fear of falling, brain surgery, pain, cognitive status, functional mobility, anxiety, depression

Abstract

Background/Aim: Patients who have undergone brain surgery are at risk of falling. Fear of falling causes an increase in the risk of falling and a decrease in movement and daily life activities. However, no previous research has investigated the fear of falling experienced by patients who have undergone brain surgery or the factors that affect it. This study aims to examine the relationship between fear of falling and pain, cognitive status, functional mobility, anxiety, depression, and socio-demographic and clinical characteristics in patients who have undergone brain surgery.

Methods: This cross-sectional study included 115 patients who had undergone brain surgery. The data were collected via a Patient Information Form, the Fear of Falling Scale, the Visual Analogue Scale, the Mini-Mental State Examination, the Itaki Fall Risk Scale, the Hospital Anxiety and Depression Scale, the Glasgow Coma Scale and the Timed Up and Go Test. IBM SPSS 22.0 software was used for descriptive statistics, correlation, and stepwise multiple linear regression analyses.

Results: Of the 115 patients, 73.1% were afraid of falling. Multiple linear regression analysis of the fear of falling in patients who had undergone brain surgery reveals that age (β=0.217, P=0.004), number of postoperative mobilizations (β=-0.141, P=0.031), a reported history of falling (β=0.155, P=0.032), the Timed Up and Go Test (β=0.372, P<0.001), and anxiety (β=0.358, P<0.001) were significant predictors of fear of falling. These variables explained 63% of the common variance.

Conclusion: Age, number of mobilizations, falling experience, functional mobility, and anxiety level can affect the fear of falling in patients after brain surgery. To mitigate this fear, it is important to plan care with reference to these variables from the time of the brain surgery until the patient is discharged. In addition, there is a need for further studies on falling and the fear of falling after brain surgery.

Downloads

Download data is not yet available.

References

Denkinger MD, Lukas A, Nikolaus T, Hauer K. Factors associated with fear of falling and associated activity restriction in community-dwelling older adults: A systematic review. Am J Geriatr Psychiatry. 2015;23(1):72–86. doi: 10.1016/j.jagp.2014.03.002. DOI: https://doi.org/10.1016/j.jagp.2014.03.002

Turhan Damar H, Bilik O, Karayurt O, Ursavas FE. Factors related to older patients’ fear of falling during the first mobilization after total knee replacement and total hip replacement. Geriatr Nurs (Minneap). 2018;39(4):382-7. doi: 10.1016/j.gerinurse.2017.12.003 DOI: https://doi.org/10.1016/j.gerinurse.2017.12.003

Doré AL, Yvonne MG, Mercer VS, Shi XA, Renner JB, Joanne MJ, et al. Lower limb osteoarthritis and the risk of falls in a community-based longitudinal study of adults with and without osteoarthritis. Arthritis Care Res (Hoboken). 2015;67(5):633–9. doi:10.1002/acr.22499. DOI: https://doi.org/10.1002/acr.22499

Montero-Odasso M, Verghese J, Beauchet O, Hausdorff JM. Gait and cognition: A complementary approach to understanding brain function and the risk of falling. J Am Geriatr Soc. 2012;60(11):2127–36. doi:10.1111/j.1532-5415.2012.04209.x DOI: https://doi.org/10.1111/j.1532-5415.2012.04209.x

Kushner DS, Amidei C. Rehabilitation of motor dysfunction in primary brain tumor patients. Neuro-Oncology Pract. 2015;2(4):185–91. doi:10.1093/nop/npv019 DOI: https://doi.org/10.1093/nop/npv019

Dicle A, Simsek AB, Vahaplar A. Investigation of symptoms severity, symptoms clustering and status of interference in the life of patients with primary brain tumors. Int J Basic Clin Stud. 2014;3(1):40–54.

Çelik GO, Zıngal H. Beyin cerrahisi kliniğinde yatan hastaların düşme risklerinin ve alınan önlemlerin belirlenmesi. İzmir Katip Çelebi Üniversitesi Sağlık Bilim Fakültesi Derg. 2016;1(1):7–11.

Uemura K, Shimada H, Makizako H, Doi T, Tsutsumimoto K, Lee S, et al. Effects of mild cognitive impairment on the development of fear of falling in older adults: A prospective cohort study. J Am Med Dir Assoc. 2015;16(12):1104.e9-1104.e13. doi: 10.1016/j.jamda.2015.09.014. DOI: https://doi.org/10.1016/j.jamda.2015.09.014

Uemura K, Shimada H, Makizako H, Doi T, Tsutsumimoto K, Yoshida D, et al. Effects of mild and global cognitive impairment on the prevalence of fear of falling in community-dwelling older adults. Maturitas. 2014;78:62–6. doi: 10.1016/j.maturitas.2014.02.018. DOI: https://doi.org/10.1016/j.maturitas.2014.02.018

Uemura K, Shimada H, Makizako H, Yoshida D, Doi T, Tsutsumimoto K, et al. A lower prevalence of self-reported fear of falling is associated with memory decline among older adults. Gerontology. 2012;58(5):413–8. doi: 10.1159/000336988 DOI: https://doi.org/10.1159/000336988

Borges SDM, Radanovic M, Forlenza OV. Fear of falling and falls in older adults with mild cognitive impairment and Alzheimer's disease. Aging, Neuropsychol Cogn. 2015;22(3):312–21. doi: 10.1080/13825585.2014.933770. DOI: https://doi.org/10.1080/13825585.2014.933770

Young WR, Williams MA. How fear of falling can increase fall-risk in older adults: Applying psychological theory to practical observations. Gait and Posture. 2015;41(1):7–12. doi: 10.1016/j.gaitpost.2014.09.006. DOI: https://doi.org/10.1016/j.gaitpost.2014.09.006

Pena BS, Cristina Quatrini Carvalho Passos Guimarães H, Lima Lopes J, Santiago Guandalini L, Taminato M, Aparecida Barbosa D, et al. Fear of falling and risk of falling: a systematic review and meta-analysis. Acta Paul Enferm. 2019;32(4):456–63. doi: 10.1590/1982-0194201900062 DOI: https://doi.org/10.1590/1982-0194201900062

Ayoubi F, Launay CP, Annweiler C, Beauchet O. Fear of falling and gait variability in older adults: A systematic review and meta-analysis. J Am Med Dir Assoc. 2015;16(1):14–9. doi: 10.1016/j.jamda.2014.06.020. DOI: https://doi.org/10.1016/j.jamda.2014.06.020

Vo THM, Nakamura K, Seino K, Nguyen HTL, Van Vo T. Fear of falling and cognitive impairment in elderly with different social support levels: Findings from a community survey in Central Vietnam. BMC Geriatr. 2020;20(141):1–11. doi: 10.1186/s12877-020-01533-8 DOI: https://doi.org/10.1186/s12877-020-01533-8

Hoang OTT, Jullamate P, Piphatvanitcha N, Rosenberg E. Factors related to fear of falling among community-dwelling older adults. J Clin Nurs. 2017;26(1-2):68–76. doi: 10.1111/jocn.13337 DOI: https://doi.org/10.1111/jocn.13337

Barış VK, Seren İntepeler Ş, İleri S, Rastgel H. Evaluation of psychometric properties of ITAKI fall risk scale. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektron Derg. 2020;13(4):214–21. doi: 10.46483/deuhfed.732097 DOI: https://doi.org/10.46483/deuhfed.732097

Aydemir Ö. Hastane anksiyete depresyon ölçeği Türkçe formunun geçerlilik ve güvenilirliği. Türk Psikiyatr Derg. 1997;8:280–7.

Folstein MF, Robins LN, Helzer JE. The mini-mental state examination. Arch Gen Psychiatry. 1983;40(7):812. DOI: https://doi.org/10.1001/archpsyc.1983.01790060110016

Güngen C, Ertan T, Eker E, Yaşar R, Engin F. Reliability and validity of the standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish population. Turkish J Psychiatry. 2002;13(4):273–81.

Podsiadlo D, Richardson S. The Timed “Up & Go”: a test of basic functional mobility for frail elderly person. J Am Geriatr Soc. 1991;39(2):142–48. doi: 10.1111/j.1532-5415.1991.tb01616.x. DOI: https://doi.org/10.1111/j.1532-5415.1991.tb01616.x

Rivasi G, Kenny RA, Ungar A, Romero-Ortuno R. Predictors of incident fear of falling in community-dwelling older adults. J Am Med Dir Assoc. 2020;21(5):615–20. doi: 10.1016/j.jamda.2019.08.020. DOI: https://doi.org/10.1016/j.jamda.2019.08.020

Polat BSA, Yiğit Z, Köklü K, Köylü N, Sonkaya AR. A neurological approach to fear of falling in patients with stroke. Med Sci Discov. 2019;6(12):305–9. doi: 10.36472/msd.v6i12.320 DOI: https://doi.org/10.36472/msd.v6i12.320

Yolcu S, Akin S, Durna Z. The evaluation of mobility levels of postoperative patients and associated factors. Hemşirelikte Eğitm ve Araştırma Derg. 2016;13:129–38. doi: 10.5222/HEAD.2016.129 DOI: https://doi.org/10.5222/HEAD.2016.129

Wongyara N, Wongsawang N, Turner K, Kitreerawutiwong K, Heetaksorn C. Fear of falling in community-dwelling older adults. Clin Transl Sci. 2017;10(5):337–47. https://he02.tci-thaijo.org/index.php/Veridian-E-Journal/article/view/108367/85731

Gallagher D, Coen R, Kilroy D, Belinski K, Bruce I, Coakley D, et al. Anxiety and behavioural disturbance as markers of prodromal Alzheimer’s disease in patients with mild cognitive impairment. Int J Geriatr Psychiatry. 2011;26(2):166–72. doi: 10.1002/gps.2509. DOI: https://doi.org/10.1002/gps.2509

Robinovitch SN, Feldman F, Yang Y, Schonnop R, Leung PM, Sarraf T, et al. Video capture of the circumstances of falls in elderly people residing in long-term care: An observational study. Lancet. 2013;381(9860):47–54. doi: 10.1016/S0140-6736(12)61263-X. DOI: https://doi.org/10.1016/S0140-6736(12)61263-X

Kronborg L, Bandholm T, Palm H, Kehlet H, Kristensen MT. Physical activity in the acute ward following hip fracture surgery is associated with less fear of falling. J Aging Phys Act. 2016;24(4):525–32. doi: 10.1123/japa.2015-0071. DOI: https://doi.org/10.1123/japa.2015-0071

Komodikis G, Gannamani V, Neppala S, Li M, Merli GJ, Harrop JS. Usefulness of Timed Up and Go (TUG) Test for Prediction of Adverse Outcomes in Patients Undergoing Thoracolumbar Spine Surgery. Clin Neurosurg. 2020;86(3):E273–80. doi: 10.1093/neuros/nyz480. DOI: https://doi.org/10.1093/neuros/nyz480