Jan H M Visschedijk1,2, Caroline B Terwee3, Monique A A Caljouw1, Monica Spruit-van Eijk1, Romke van Balen1, Wilco P Achterberg1. 1. a Department of Public Health and Primary Care , Leiden University Medical Centre , Leiden , The Netherlands . 2. b Zorggroep Solis , Deventer , The Netherlands , and. 3. c Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research , VU University Medical Center , Amsterdam , The Netherlands.
Abstract
PURPOSE: To assess the measurement properties of the Falls Efficacy Scale-International (FES-I) in patients after a hip fracture aged ≥ 65 years. METHODS: In a sample of 100 patients, we examined the structural validity, internal consistency and construct validity. For the structural validity a confirmatory factor analysis was carried out. For construct validity predetermined hypotheses were tested. In a second sample of 21 older patients the inter-rater reliability was evaluated. RESULTS: The factor analysis yielded strong evidence that the FES-I is uni-dimensional in patients with a hip fracture; the Cronbach's alpha was 0.94. When testing the reliability, the intra-class correlation coefficient was 0.72, while the Standard Error of Measurement was 6.4 and the Smallest Detectable Change was 17.7 (on a scale from 16 to 64). The Spearman correlation of the FES-I with the one-item fear of falling instrument was high (r = 0.68). The correlation was moderate with instruments measuring functional performance constructs and low with instruments measuring psychological constructs. CONCLUSIONS: Reliability and structural validity of the FES-I in patients after a hip fracture are good. The construct validity appears more closely related to functional performance constructs than to psychological constructs, suggesting that the concept measured by the FES-I may not capture all aspects of fear of falling. IMPLICATIONS FOR REHABILITATION: The Falls Efficacy Scale-International (FES-I), which is commonly used to measure fear of falling in community-dwelling older persons, can also be used to assess fear of falling in patients after a hip fracture. The reliability and the structural validity of the FES-I for these hip patients are good, whereas the construct validity of the FES-I is not optimal. The FES-I may not capture all aspects of fear of falling and may be more closely related to functional performance than to psychological concepts such as anxiety.
PURPOSE: To assess the measurement properties of the Falls Efficacy Scale-International (FES-I) in patients after a hip fracture aged ≥ 65 years. METHODS: In a sample of 100 patients, we examined the structural validity, internal consistency and construct validity. For the structural validity a confirmatory factor analysis was carried out. For construct validity predetermined hypotheses were tested. In a second sample of 21 older patients the inter-rater reliability was evaluated. RESULTS: The factor analysis yielded strong evidence that the FES-I is uni-dimensional in patients with a hip fracture; the Cronbach's alpha was 0.94. When testing the reliability, the intra-class correlation coefficient was 0.72, while the Standard Error of Measurement was 6.4 and the Smallest Detectable Change was 17.7 (on a scale from 16 to 64). The Spearman correlation of the FES-I with the one-item fear of falling instrument was high (r = 0.68). The correlation was moderate with instruments measuring functional performance constructs and low with instruments measuring psychological constructs. CONCLUSIONS: Reliability and structural validity of the FES-I in patients after a hip fracture are good. The construct validity appears more closely related to functional performance constructs than to psychological constructs, suggesting that the concept measured by the FES-I may not capture all aspects of fear of falling. IMPLICATIONS FOR REHABILITATION: The Falls Efficacy Scale-International (FES-I), which is commonly used to measure fear of falling in community-dwelling older persons, can also be used to assess fear of falling in patients after a hip fracture. The reliability and the structural validity of the FES-I for these hip patients are good, whereas the construct validity of the FES-I is not optimal. The FES-I may not capture all aspects of fear of falling and may be more closely related to functional performance than to psychological concepts such as anxiety.
Entities:
Keywords:
Falls Efficacy Scale-International; fear of falling; hip fractures; measurement properties
Authors: Maaike N Scheffers-Barnhoorn; Jolanda C M van Haastregt; Jos M G A Schols; Gertrudis I J M Kempen; Romke van Balen; Jan H M Visschedijk; Wilbert B van den Hout; Eve M Dumas; Wilco P Achterberg; Monica van Eijk Journal: BMC Geriatr Date: 2017-03-20 Impact factor: 3.921
Authors: Margriet C Pol; Gerben Ter Riet; Margo van Hartingsveldt; Ben Kröse; Sophia E de Rooij; Bianca M Buurman Journal: BMC Health Serv Res Date: 2017-01-03 Impact factor: 2.655
Authors: Maaike N Scheffers-Barnhoorn; Monica van Eijk; Jos M G A Schols; Romke van Balen; Gertrudis I J M Kempen; Wilco P Achterberg; Jolanda C M van Haastregt Journal: BMC Geriatr Date: 2021-04-01 Impact factor: 3.921