Critical Appraisal of a Systematic Review: Preventing Falls Among Older People with Mental Health Problems

Running head: CRITICAL APPRAISAL
CRITICAL APPRAISAL OF A SYSTEMATIC REVIEW
Name of the Student
Name of the university
Author’s note

CRITICAL APPRAISAL1
Title: Critical appraisal of systematics review: Preventing falls among older people with
mental health problems: a systematic review
Paper for the appraisal: Bunn, F., Dickinson, A., Simpson, C., Narayanan, V., Humphrey, D.,
Griffiths, C., ... & Victor, C. (2014). Preventing falls among older people with mental health
problems: a systematic review. BMC nursing, 13(1), 4.
INTRODUCTION
Falls can be considered to be one of the main causes of morbidity and mortality in elderly
adults. The fall risk is further aggravated by any cognitive issues. There are standing reviews that
have suggested on people having cognitive impairment are susceptible to falls due to improper
gait, the effect of various antidepressant medicines and other comorbidities. Falls are being
found to affect the rehabilitation, both the physical as well as the mental function, increase the
rate or hospital readmission, delaying treatment and increasing the length of stays in the hospital
department (Hendrie et al., 2013). Falls in older people is also are related to greater cost in
comparison to the common population of older people. Hence, adoption of suitable fall
prevention strategies by the nursing professionals is important.
This papers will provide a critical appraisal of the paper “Preventing falls among older
people with mental health problems: a systematic review”.
REVIEW QUESTION
What interventions are effective in preventing and managing falls among older people with
mental health conditions?
Population studies: Older adults with mental health problems
Interventions: Interventions to prevent falls

CRITICAL APPRAISAL2
C: Older adults without any cognitive impairment.
O: To reduce falls
Fall is regarded as the most commonly reported incident concerning elderly patients.
Hence the target population chosen for this paper are elderly patients, who are more prone to
falls. The interventions are effective approaches for prevention of falls among older adults, with
mental illness in comparison to the ones who do not have such mental illness. The anticipated
outcome of this review aims to assess the efficiency of fall prevention interventions for older
people having a mental illness.
The title of this paper signifies that the paper is about the prevention of falls among older
adults. Although the title gives us an idea of the target population, no clue has been given about
any interventions. A research question needs to be clear and focused. A good research question
would be able to condense the main idea of the study. Both the research question and the title
should contain less words that define the content and objective of the research paper. They
should be practicable, thought-provoking, ethical and pertinent to the scientific knowledge and
future research. The title in this paper although gives a clear idea of the research design, that has
been adopted.
LITERATURE REVIEW/ SEARCH
A literature review is an accumulation of information derived from credible sources like
journal articles, books, and thesis based on a particular topic. It provides an overview of the main
findings and the concepts and developments of a research problem or a question from
contemporary research sources (Grewal et al., 2016). A good literature review does not the only
summarise the sources, but analyze, interpret and critically evaluate various literature, synthesize

CRITICAL APPRAISAL3
the sources for highlighting the patterns, conflicts, and the gaps. It helps to show the current
knowledge about a central research question. The literature review of this paper is not supported
by an adequate number of papers, however, the paper could point out that although several types
of research have been conducted in hospital settings, rehabilitation centres, and homes, no
research has been done about the prevention of falls in the mental health patients. Furthermore, it
had also pointed out that there is a lack of evidence-based interventions to prevent falls among
older patients in hospital settings. To write a credible literature review, it is necessary to choose
papers relevant to the content, appropriate keywords need to be selected to search electronic
databases (Garg, 2016). The paper had used proper keywords and expanders and limiter to
restrict the search. Application of proper inclusion criteria helps to identify the study population
reliably and consistently. They act as the cofounders for the outcome parameter (Patino &
Ferreira, 2018). Those variables that are not related to the research question affects the external
validity of the result (Patino & Ferreira, 2018). Appropriate databases have been used for the
literature search, for example, CENTRAL, NHS, CINAHL, PsychInfo and other lateral search
techniques. Web-based search engines identify appropriate materials related to the research
topic.
An appropriate study design is important for the intervention outcome in terms of the best
possible and the most reliable estimate. A study design is normally based on the objective, the
therapeutic area, the comparison between treatment, the outcome and phase of the trial. This
paper has chosen to carry out a systematic review by using the methodology that has been
engaged by review team in the reviews that have been done previously and in agreement to the
guidelines provided by the Cochrane collaboration (Zeng et al., 2015). This systematic review
has included RCTs and controlled assessments of the interventions for fall prevention for people