Psychometric properties of the German version of the Fear of Falling Questionnaire-revised (FFQ-R) in a sample of older adults after hip or pelvic fracture

Assessment tools of the fear of falling: A scoping review

AIM

To comprehensively evaluate and synthesize fear of falling assessment tools and their psychometric properties.

METHODS

The literature in PubMed, Web of Science Core Collection, Cochrane Library, Embase, Google Scholar, CNKI, Wanfang, VIP, and CBM was systematically searched, and the search period was from the establishment of the database to September 1, 2023, and updated on September 1, 2024.

RESULTS

A total of 104 documents covering 19 assessment tools were included. Of the 19 instruments, the Falls Efficacy Scale-International was the most widely used and had been tested for reliability and validity in different countries and populations. A total of 18 studies focused on tool development and validation, and the remaining 86 were related to tool validation.

CONCLUSION

Scientific and reliable assessment instruments for FOF are an important part of future targeted intervention research. The future research direction of tools should be based on local demographic characteristics and qualitative interview results, combined with objective quantitative indicators measured by professional instruments.

Falls risk perception measures in hospital: a COSMIN systematic review

Falls prevention in hospital continues to be a research priority because of the poor health outcomes and financial burdens that can arise. Recently updated World Guidelines for Falls Prevention and Management strongly recommend evaluating patients' concerns about falling as part of a multifactorial assessment. The aim of this systematic review was to evaluate the quality of falls risk perception measures for adults in a hospital setting. This review was conducted using the Consensus-based Standards for the selection of health Measurement Instruments guidelines and provides a comprehensive summary of these instruments, including psychometric properties, feasibility and clinical recommendations for their use. The review followed a prospectively registered protocol, in which a total of ten databases were searched between the years 2002 and 2022. Studies were included if the instruments measured falls risk perception and/or other psychological falls constructs, if they were conducted in a hospital setting and if the target population contained hospital inpatients. A total of 18 studies met the inclusion criteria, encompassing 20 falls risk perception measures. These falls risk perception instruments were grouped into five falls-related constructs: Balance Confidence, Falls Efficacy/Concern, Fear of Falling, Self-Awareness and Behaviour/Intention. Two of the patient reported outcome measures (PROMs) received Class A recommendations (Falls Risk Perception Questionnaire and the Spinal Cord Injury-Falls Concern Scale); however, this rating is only applicable for the populations/context described in the studies. Thirteen PROMs received Class B recommendations, solidifying the need for further validation studies of these PROMs.

Psychometric Properties of the Turkish Version of the Fear of Falling Questionnaire-Revised (FFQ-R) in Nursing Home Residents with Mild Cognitive Decline

BACKGROUND

The aim of the study was to investigate the validity and reliability of the Turkish version of the Fear of Falling Questionnaire-Revised (FFQ-R) in older adults with mild cognitive impairment (MCI) living in a nursing home.

METHODS

The study was conducted with 107 (69 women) older adults. The participants were evaluated with the FFQ-R, the Falls Efficacy Scale (FES), the Mini-Mental State Examination (MMSE), the Barthel Index and Montgomery-Åsberg Depression Rating Scale (MADRS)". FFQ-R was refilled one month later for retesting.

RESULTS

Cronbach's alpha value of the FFQ-R was 0.971. The global internal consistency was excellent (>0.80). Intraclass correlation coefficient of the FFQ-R was 0.962 (95% CI: 0.92-0.98), indicating excellent test-retest reliability. The Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) values of the FFQ-R was 0.80 and 2.21, respectively. The correlation between the total score of FFQ-R and the FES was excellent (r = 0.963, p < .001). The relationship between FFQ-R and MMSE was excellent (r = -0.821, p < .001). Besides, there was a moderate correlation between the FFQ-R with Barthel Index (r = -0.648, p < .001) and FFR-Q with MADRS (r = 0.568, p < .001).

CONCLUSION

Turkish version of the FFQ-R is a valid and reliable tool to assess the fear of falling in nursing home residents.

Validation of the Perform-FES: a new fear of falling scale for hospitalized geriatric patients

Background

Fear of falling is highly prevalent in older adults and associated with numerous negative health events. The main objective of this study was to validate a scale to assess fear of falling, based on performance in real situation (Perform-FES), in a hospitalized geriatric population.

Methods

In this cross-sectional study, 55 patients (mean age: 85.3 years; 58% women) hospitalized in a geriatric hospital in Geneva (Switzerland) were enrolled. The Perform-FES scale was administered to all patients in conjunction with four other fear of falling scales. We determined the floor and ceiling effects, internal consistency, reliability, construct validity, and discriminative power of the Perform-FES scale.

Results

The Perform-FES scale did not demonstrate any significant floor or ceiling effect. It had a good internal consistency (Cronbach’s alpha = 0.78) and an excellent reliability (intraclass correlation coefficient = 0.94). Regarding convergent validity, good correlations were shown between the score obtained on the Perform-FES scale and those obtained on other fear of falling scales. Also, the Perform-FES scale was able to discriminate patients with severe functional impairments (area under the ROC curve = 0.81) and had significantly better discriminating performance than other fear of falling scales.

Conclusion

Findings suggest that the Perform-FES scale has good psychometric properties and may be a relevant tool to assess fear of falling in a geriatric hospitalized population. Future research should focus in particular on assessing the sensitivity to change and the predictive value of this scale in longitudinal studies, and its validity in other populations.