Kim Delbaere1, Stuart T Smith, Stephen R Lord. 1. Falls and Balance Research Group, Neuroscience Research Australia, Barker Street, Randwick, Sydney, NSW 2031, Australia. k.delbaere@neura.edu.au
Abstract
BACKGROUND: Fear of falling scales typically have a strong floor effect in active people and use short phrases to state overall context of fear-related activities. We developed the Iconographical Falls Efficacy Scale (Icon-FES), which includes more demanding activities and uses pictures to provide more complete environmental contexts. METHODS: Two-hundred and fifty community-dwelling older people (70-90 years) were assessed on the Icon-FES in conjunction with the Falls Efficacy Scale International (FES-I). RESULTS: Overall structure and measurement properties of the 30-item Icon-FES (evaluated with item-response theory) were good. It measured a single factor with 2 dimensions assessing fear about less and more demanding daily activities. It had high internal consistency (Cronbach's alpha = 0.96) and excellent test-retest reliability. The Icon-FES distribution was considerably closer to normal compared with FES-I, indicating absence of floor and ceiling effects. Construct validity of the Icon-FES was supported by its relation with FES-I and its ability to discriminate between groups relating to demographic characteristics and fall risk factors. A shortened 10-item Icon-FES showed similar psychometric properties to the 30-item Icon-FES. CONCLUSIONS: The Icon-FES is an innovative way of assessing fear of falling using pictures to describe a range of activities and situations. This initial validation study showed that the Icon-FES has excellent psychometric properties and showed close continuity with the FES-I. Main advantages of the Icon-FES over the FES-I are its normal distribution and its ability to assess fear of falling in high functioning older people.
BACKGROUND: Fear of falling scales typically have a strong floor effect in active people and use short phrases to state overall context of fear-related activities. We developed the Iconographical Falls Efficacy Scale (Icon-FES), which includes more demanding activities and uses pictures to provide more complete environmental contexts. METHODS: Two-hundred and fifty community-dwelling older people (70-90 years) were assessed on the Icon-FES in conjunction with the Falls Efficacy Scale International (FES-I). RESULTS: Overall structure and measurement properties of the 30-item Icon-FES (evaluated with item-response theory) were good. It measured a single factor with 2 dimensions assessing fear about less and more demanding daily activities. It had high internal consistency (Cronbach's alpha = 0.96) and excellent test-retest reliability. The Icon-FES distribution was considerably closer to normal compared with FES-I, indicating absence of floor and ceiling effects. Construct validity of the Icon-FES was supported by its relation with FES-I and its ability to discriminate between groups relating to demographic characteristics and fall risk factors. A shortened 10-item Icon-FES showed similar psychometric properties to the 30-item Icon-FES. CONCLUSIONS: The Icon-FES is an innovative way of assessing fear of falling using pictures to describe a range of activities and situations. This initial validation study showed that the Icon-FES has excellent psychometric properties and showed close continuity with the FES-I. Main advantages of the Icon-FES over the FES-I are its normal distribution and its ability to assess fear of falling in high functioning older people.
Authors: Tanja A C Dorresteijn; G A Rixt Zijlstra; Kim Delbaere; Erik van Rossum; Johan W S Vlaeyen; Gertrudis I J M Kempen Journal: BMC Health Serv Res Date: 2011-09-20 Impact factor: 2.655
Authors: Daniel Schoene; Stephen R Lord; Kim Delbaere; Connie Severino; Thomas A Davies; Stuart T Smith Journal: PLoS One Date: 2013-03-05 Impact factor: 3.240
Authors: K Delbaere; T Valenzuela; A Woodbury; T Davies; J Yeong; D Steffens; L Miles; L Pickett; G A R Zijlstra; L Clemson; J C T Close; K Howard; S R Lord Journal: BMJ Open Date: 2015-10-22 Impact factor: 2.692
Authors: Daniel Schoene; Trinidad Valenzuela; Barbara Toson; Kim Delbaere; Connie Severino; Jaime Garcia; Thomas A Davies; Frances Russell; Stuart T Smith; Stephen R Lord Journal: PLoS One Date: 2015-12-16 Impact factor: 3.240