Patterns of fall-risk perception and response among nursing home residents: A qualitative study

Despite guideline-recommended multicomponent programs, fall-prevention efforts in nursing homes often show variable uptake because residents differ in their perceptions of fall risk and their responses to preventive support. Standardized approaches may therefore fail to account for differences in how residents appraise fall risk and cope with prevention-related challenges, making it difficult to tailor strategies to different resident profiles. User personas, defined as profiles that integrate salient characteristics across key dimensions, offer a practical way to capture this heterogeneity and inform more tailored, person-centered fall-prevention strategies in institutional care.

To characterize nursing home residents' fall-risk perceptions and prevention-related responses, construct representative user personas, and inform more personalized fall-prevention strategies.

We conducted semi-structured interviews with 30 nursing home residents using purposive sampling to ensure variation in demographic characteristics, fall experience, and functional status. Data were analyzed using qualitative content analysis. Personas were developed by identifying recurring patterns of salient individual characteristics, followed by cross-case comparison and refinement through team discussion and consensus.

Five key dimensions shaping fall-risk perception and prevention-related responses were identified: physical function, risk perception, self-efficacy, psychological appraisal, and coping style. Based on these dimensions, four distinct user personas were developed: the overconfident risk-takers, the anxious limiters, the compliant dependents, and the active self-managers.

Fall-risk perception and prevention-related responses among nursing home residents are heterogeneous and shaped by interacting functional and psychosocial factors. Persona-informed fall prevention may support more tailored communication and support strategies that better fit residents' differing needs and response patterns. Future research should assess whether persona-based assessment and intervention approaches can improve both safety and resident-centered outcomes.