Page 209 - Encyclopedia of Nursing Research

176 n FALLS

occur before the undernutrition. Although between the two (drewett, Blair, Emmett, &
the primary cause of FTT may never be fully Emond, 2004). However, it has been dem-
F understood, it is apparent that nutritional onstrated that school-aged children who
deficits are dependent on the environmental developed FTT in the first few months of
context in which they occur. infancy are shorter, weigh less, and have
Nurse researchers developed the eco- poorer intellectual outcomes than their
logical model describing parent/child inter- counterparts who did not experience FTT
actions, and the model is used to explain (Black, dubowitz, Krishnakumar, & Starr,
FTT (Barnard & Eyres, 1979; Lobo, Barnard, 2007; Corbett & drewett, 2004; Emond, Blair,
& Coombs, 1992). The ecological model Emmet, & drewett, 2007). This underscores
focuses on the three major interaction com- the importance of appropriate nutrition dur-
ponents of the parent/child relationship: ing infancy.
those of the child, the parent, and the envi- Because growth problems such as FTT
ronment. These interactions are synchro- in infancy place a child at significant risk for
nous and reciprocal. Barnard et al. (1989) developmental delays into toddlerhood and
emphasized the importance of the parent’s school age, it is important to investigate the
and child’s physical and emotional charac- interactional problems between parents and
teristics, as well as the supportive or non- their infants so that interventions aimed at
supportive nature of the environment in improving interactions can begin.
understanding the interactions.
researchers have examined parent/ Heidi V. Krowchuk
child interactions by means of direct, struc-
tured observations during feeding and other
situations, and have found that infants with
FTT demonstrate more difficult behavior, are Falls
less vocal, exhibit negative affect, and dis-
play more gaze aversion than infants who are
not failing to thrive (Harris, 2010; Lobo et al., Falls threaten the health, life, and indepen-
1992; Steward, 2001). Furthermore, parents of dence of older adults. Approximately one
FTT infants are less able to determine their third of older adults experience an unin-
infants’ needs, have shown a decreased abil- tentional fall to the ground (Adams, dey, &
ity to discriminate infant cues, and exhibit Vickerie, 2007). Nearly 32% of those with inju-
less social interactiveness with their infants ries require assistance with daily activities at
when compared with parents of healthy least 3 months after the fall (Schiller, Kramer,
infants (Harris, 2010; Steward, 2001). These & dey, 2007). Moreover, yearly health care
studies support that interference with the costs to treat falls are $19 billion (Stevens,
reciprocal process of the parent/child rela- Corso, Finkelstein, & Miller, 2006).
tionship disturbs the opportunity to attain Falls are preventable. The Nurse Quality
optimal growth and development. Forum has identified falls as a nurse-
Other researchers have examined post- sensitive outcome that is endorsed by the
natal factors, such as maternal breastfeed- Joint Commission for the Accreditation of
ing difficulties (e.g., infections, low milk Hospitals. Providing financial incentive to
supply), infant fussiness, and poor infant implement effective fall prevention pro-
suck, which contribute to undernutrition, grams, Medicare will not pay for hospital
and thus FTT (Emond, drewett, Blair, & expenses related to falls. The Centers for
Emmet, 2007). Maternal depression and disease Control has guidelines for the devel-
its’ link to FTT have also been investigated, opment and implementation of community-
and researchers have found no relationship based fall programs and a compendium of