Access Type

Open Access Dissertation

Date of Award

January 2013

Degree Type


Degree Name




First Advisor

Ramona A. Benkert


Background: Worldwide, falls among older adults lead to significant physical, psychological, and social problems. Studies have described fall prevalence, risk factors, and the impact of falls in Thailand. Although fall prevention requires significant self-care abilities, insufficient knowledge exists about how to prevent falls in Thai community settings or the predictors of fall prevention behaviors among Thai Older adults.

Purpose: Orem's Self-Care Theory was used: 1) to examine the relationships among the basic conditioning factors (BCFs) of age, gender, falls, comorbidity, mental and physical health status, self-care agency (i.e., self-efficacy), and fall prevention self-care behaviors and 2) to determine the predictors of self-efficacy and fall prevention behaviors.

Methods: Using a cross-sectional design, a convenience sample of 200 older adults living in the Saraburi province of Thailand was recruited. Eight reliable and valid Thai-translated instruments were completed through face-to-face interviews. Moreover, older adults were requested to perform walking speed test. Descriptive, correlational, and multiple regression analyses were performed.

Results: Age, number of falls, and depression were negatively correlated with fall and general self-efficacy (FSE and GSE; p < 0.01), whereas walk-speed and the SF-12 physical component score were positively correlated with FSE and GSE (p < 0.01). Multiple regression analyses revealed that a higher number of falls, more comorbidities, higher depression and global mental health scores, and slower walk-speeds predicted 43% (F(5, 194) = 29.67, p < 0.0001) of the variance in FSE, whereas older age, an increased number of falls, and higher depression scores predicted 29% (F(4, 195) = 20.14, p < 0.0001) of the variance in GSE. Controlling for BCFs, neither FSE nor GSE predicted fall prevention behaviors. Only the BCFs of female gender, lower depression and walk-speed, and higher number of comorbidities, fear of falling and SF-12 physical and mental component scores predicted 30% (p < 0.0001) of the variance in fall prevention behaviors.

Conclusion: Fall prevention behaviors among Thai older adults are multifaceted and are predicted by several variables. Unexpectedly, neither of the self-care agency variables predicted fall prevention behaviors. The results provide new knowledge about the predictors of fall prevention behaviors and may be used to develop effective programs for selected community-dwelling older adults in Thailand (e.g., older women with lower walk speed, more comorbidities, etc.). Future research is needed to evaluate the link between other self-care agency predictors of fall prevention behaviors.

Included in

Nursing Commons