{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:04:24Z","timestamp":1787162664755,"version":"build-2736575974"},"reference-count":42,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T00:00:00Z","timestamp":1667347200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000654","name":"Marie Curie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000654","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Falls are the third highest reported safety incident in Specialist Palliative Care in-patient settings and yet specific risk factors connected with falling and associated outcomes in this setting are poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To understand the key individualised risk factors leading to falls in specialist in-patient palliative care settings and understand the implications and outcomes for the patients who fall.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A realist synthesis of the literature, reported following the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) standards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources:<\/jats:title>\n                    <jats:p>An iterative literature search was conducted across three recognised health collections as well as grey literature from policy, practice and other relevant areas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Falls taking place within in-patient specialist palliative care settings can cause significant harm to patients. The risk factors for these patients are multifaceted and often interlinked with underpinning complex realist mechanisms including a history of falls, the age of the person, impact of complex medications, improving functional status and the presence of delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In-patients in specialist palliative care settings are at risk of falling and this is multifactorial with complex reasoning mechanisms underpinning the identified risks. There is a significant impact of a fall in this cohort of patients with many sustaining serious harm, delayed discharge and both physical and psychological impacts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692163221127808","type":"journal-article","created":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T06:32:28Z","timestamp":1667370748000},"page":"1469-1482","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Why patients in specialist palliative care in-patient settings are at high risk of falls and falls-related harm: A realist synthesis"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0275-1364","authenticated-orcid":false,"given":"Helen","family":"Louise Forrow","sequence":"first","affiliation":[{"name":"Northumbria University, Newcastle upon Tyne, UK"},{"name":"Marie Curie, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"Lhussier","sequence":"additional","affiliation":[{"name":"Northumbria University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Scott","sequence":"additional","affiliation":[{"name":"Northumbria University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Northumbria University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,11,2]]},"reference":[{"key":"bibr1-02692163221127808","doi-asserted-by":"publisher","DOI":"10.1177\/1049909120971825"},{"key":"bibr2-02692163221127808","doi-asserted-by":"publisher","DOI":"10.1177\/0269216318776846"},{"key":"bibr3-02692163221127808","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2014.05.014"},{"key":"bibr4-02692163221127808","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2015-001070"},{"key":"bibr5-02692163221127808","doi-asserted-by":"publisher","DOI":"10.1177\/1049909106298721"},{"key":"bibr6-02692163221127808","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2010.0140"},{"key":"bibr7-02692163221127808","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.14.1698"},{"key":"bibr8-02692163221127808","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2011-0326"},{"key":"bibr9-02692163221127808","doi-asserted-by":"publisher","DOI":"10.17265\/2159-5313\/2016.09.003"},{"key":"bibr10-02692163221127808","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a1720"},{"key":"bibr11-02692163221127808","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-018-0914-0"},{"key":"bibr12-02692163221127808","unstructured":"Pawson R, Tilley N. 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