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Questionnaire
The following questions were included in the questionnaire to
gain data for preventing patient falls in the hospital. The
questionnaire was established in two portions, one potion
includes the demographic factors of the patient, and the other
includes questions regarding patient falls.
Demographics
8
1.
2. Name:
3. Age
· Under 12 years old
· 18-34 years old
· 35-49 years old
· 50 years or older
4. Gender
· Male
· Female
· Others
5. Education level
· Basic
· High School
· University
Questions
6. How important or unimportant of an issue do you think falls
are for the health of patients?
· Very important
· Not very important
· Don't know
7. How concerned or not concerned are you about falling over?
· Very concerned
· Not very concerned
· Don't know
8. Have you had a fall in the last 12 months?
· Yes
· No
9. Have you ever attended a 'Strictly No Falling' program?
· Yes
· No
10. How satisfied or unsatisfied are you with the cost of No
falling measures or program service by the hospital.
· Very satisfied
· Neither satisfied nor dissatisfied
· Very dissatisfied
11. Have you attended a 'Strictly No Falling' program that had
any of the following impacts on you?
· Prevented a fall
· Reduced the number of falls
· Increased the number of falls
· Other impacts
· No impact
12.
13. Have you ever preferred to find information about falls
prevention?
· Yes
· No
14. I take a medicine that sometimes makes me feel light-
headed or more tired than usual.
· Yes
· No
15. Ever felt dizzy while standing up after taking medicine.
· Yes
· No
16. I use a walker to get around safely.
· Yes
· No
17. Do your doctors and nurse practitioners guide you regarding
how to prevent falls?
· Yes
· No

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Questionnaire the following questions were included in the questi

  • 1. Questionnaire The following questions were included in the questionnaire to gain data for preventing patient falls in the hospital. The questionnaire was established in two portions, one potion includes the demographic factors of the patient, and the other includes questions regarding patient falls. Demographics 8 1. 2. Name: 3. Age · Under 12 years old · 18-34 years old · 35-49 years old · 50 years or older 4. Gender · Male · Female · Others 5. Education level · Basic · High School · University Questions 6. How important or unimportant of an issue do you think falls are for the health of patients? · Very important · Not very important · Don't know 7. How concerned or not concerned are you about falling over? · Very concerned
  • 2. · Not very concerned · Don't know 8. Have you had a fall in the last 12 months? · Yes · No 9. Have you ever attended a 'Strictly No Falling' program? · Yes · No 10. How satisfied or unsatisfied are you with the cost of No falling measures or program service by the hospital. · Very satisfied · Neither satisfied nor dissatisfied · Very dissatisfied 11. Have you attended a 'Strictly No Falling' program that had any of the following impacts on you? · Prevented a fall · Reduced the number of falls · Increased the number of falls · Other impacts · No impact 12. 13. Have you ever preferred to find information about falls prevention? · Yes · No 14. I take a medicine that sometimes makes me feel light- headed or more tired than usual. · Yes · No 15. Ever felt dizzy while standing up after taking medicine. · Yes · No 16. I use a walker to get around safely. · Yes · No
  • 3. 17. Do your doctors and nurse practitioners guide you regarding how to prevent falls? · Yes · No