Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 2 , Pages 291-296, February 2008

Validation of an Adapted Falls Efficacy Scale in Older Rehabilitation Patients

  • Christophe J. Büla, MD

      Affiliations

    • Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
    • Corresponding Author InformationReprint requests to Christophe J. Büla, MD, CUTR Sylvana, Ch de Sylvana 10, 1066 Epalinges, Switzerland
    • ,
  • Estelle Martin, PhD

      Affiliations

    • Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
    • ,
  • Stéphane Rochat, MD

      Affiliations

    • Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
    • ,
  • Chantal Piot-Ziegler, PhD

      Affiliations

    • Health Psychology, Institute of Psychology, University of Lausanne, Lausanne, Switzerland.

Abstract 

Büla CJ, Martin E, Rochat S, Piot-Ziegler C. Validation of an adapted Falls Efficacy Scale in older rehabilitation patients.

Objective

To determine the psychometric properties of an adapted version of the Falls Efficacy Scale (FES) in older rehabilitation patients.

Design

Cross-sectional survey.

Setting

Postacute rehabilitation facility in Switzerland.

Participants

Seventy elderly persons aged 65 years and older receiving postacute, inpatient rehabilitation.

Interventions

Not applicable.

Main Outcome Measures

FES questions asked about subject’s confidence (range, 0 [none]–10 [full]) in performing 12 activities of daily living (ADLs) without falling. Construct validity was assessed using correlation with measures of physical (basic ADLs [BADLs]), cognitive (Mini-Mental State Examination [MMSE]), affective (15-item Geriatric Depression Scale [GDS]), and mobility (Performance Oriented Mobility Assessment [POMA]) performance. Predictive validity was assessed using the length of rehabilitation stay as the outcome. To determine test-retest reliability, FES administration was repeated in a random subsample (n=20) within 72 hours.

Results

FES scores ranged from 10 to 120 (mean, 88.7±26.5). Internal consistency was optimal (Cronbach α=.90), and item-to-total correlations were all significant, ranging from .56 (toilet use) to .82 (reaching into closets). Test-retest reliability was high (intraclass correlation coefficient, .97; 95% confidence interval, .95−.99; P<.001). Subjects reporting a fall in the previous year had lower FES scores than nonfallers (85.0±25.2 vs 94.4±27.9, P=.054). The FES correlated with POMA (Spearman ρ=.40, P<.001), MMSE (ρ=.37, P=.001), BADL (ρ=.43, P<.001), and GDS (ρ=−.53, P<.001) scores. These relationships remained significant in multivariable analysis for BADLs and GDS, confirming FES construct validity. There was a significant inverse relationship between FES score and the length of rehabilitation stay, independent of sociodemographic, functional, cognitive, and fall status.

Conclusions

This adapted FES is reliable and valid in older patients undergoing postacute rehabilitation. The independent association between poor falls efficacy and increased length of stay has not been previously described and needs further investigations.

Key Words: Accidental falls, Fear, Rehabilitation

 

 Supported in part by the Swiss National Scientific Foundation (grant no. 3252BO-100416) and the Leenaards Foundation.

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(07)01693-0

doi:10.1016/j.apmr.2007.08.152

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 2 , Pages 291-296, February 2008

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