Reliability, Construct Validity, and Clinical Feasibility of the Activities-Specific Fall Caution Scale for Residential Living Seniors

Abstract 

Blanchard RA, Myers AM, Pearce NJ. Reliability, construct validity, and clinical feasibility of the Activities-specific Fall Caution Scale for residential living seniors.

Objective

To examine the reliability, validity, and feasibility of the Activities-specific Fall Caution (AFC) Scale.

Design

Cross-sectional studies with test-retest and interrater reliability.

Setting

Residential care facilities in Ontario, Canada: 10 in study 1 and 6 in study 2.

Participants

Convenience samples of 101 and 31 residents.

Interventions

Not applicable.

Main Outcome Measures

In study 1, the AFC Scale was readministered to 44 residents, 64 were assessed using the Berg Balance Scale, Timed Up & Go, and Self-Paced Walk Test, and the Nursing Home Life-Space Diameter was completed for 80 residents. In study 2, staff administered the AFC Scale to 31 residents on 2 occasions.

Results

In study 1, test-retest reliability (intraclass correlation coefficient [ICC]) was .87 (95% confidence interval, .78−.93). AFC scores were associated with physical performance and mobility patterns (P<.001) and able to discriminate on the basis of gait aid use (P<.001), balance disorders (P<.05), and transfer assistance and walk speed (P<.01). Comparatively, general fear of falling showed weaker associations and a sex bias. In study 2, staff administration was fairly consistent (ICC=.71) and similar associations emerged for AFC scores.

Conclusions

The AFC Scale shows good reproducibility, convergent and discriminative validity, and is feasible for clinical as well as research use.

Key Words: Fear, Rehabilitation, Reliability and validity, Risk assessment