From fall experiences to patient-reported data in community fall-risk screening: a multiperspective qualitative study

Falls are an important public health problem among community-dwelling older adults. Patient-reported fall experiences are important for community fall-risk screening, but how these experiences become screening data remains poorly understood.

We conducted a multiperspective qualitative study in community health centres and surrounding communities in Xi'an, China. Community-dwelling older adults, family caregivers and primary healthcare workers were recruited using purposive and maximum-variation sampling. Semi-structured interviews were analysed using reflexive thematic analysis and cross-group comparison.

A total of 47 participants were interviewed, including 23 community-dwelling older adults, 11 family caregivers and 13 primary healthcare workers. We identified a 6-link process through which fall experiences became patient-reported data: renaming, recalling, weighing before expression, reprocessing within the family, community inquiry and data completion and reshaping through feedback. These links were explained by three themes and nine subthemes. Fall experiences were filtered through everyday definitions, normalisation of near-falls and ageing and memory reconstruction based on life anchors and consequences. Reporting willingness was negotiated through autonomy, identity, family relationships, fear of troubling others and service expectations. Once information entered community screening, oral accounts were summarised in structured records, interpreted through professional judgement and further reshaped by feedback from services.

Patient-reported fall data are shaped by more than recall alone. They are also influenced by interpretation, family interaction, screening practices, documentation and feedback. Screening may be improved through understandable questions, documentation of near-falls and uncertainty and clearer links between reported information and follow-up services.