Vu Tuong-Vi, Mackenzie Lynette
Occupational Therapy, Specialist Mental Health Services for Older People, Braeside Hospital, Prairiewood, NSW, Australia.
Aust Occup Ther J. 2012 Jun;59(3):235-42. doi: 10.1111/j.1440-1630.2012.01012.x. Epub 2012 May 21.
BACKGROUND/AIM: The Home Falls and Accidents Screening Tool was developed to assist health professionals to identify falls risk among community-dwelling older people arising from their home environment. The aim of this study was to evaluate the Home Falls and Accidents Screening Tool by examining its inter-rater and test-retest reliability.
Community-dwelling older people, over the age of 65 (n = 31) were recruited from the caseload of nine occupational therapists across three area health services in Sydney and the Hunter region. A total of 31 home visits were conducted by the researcher and an occupational therapist to independently administer the Home Falls and Accidents Screening Tool. Follow-up visits were then conducted within a two-week period by one of the raters to re-administer the Home Falls and Accidents Screening Tool. Reliability was evaluated using percentage agreement, intra-class correlations and kappa coefficients.
The intra-class correlation coefficient for the Home Falls and Accidents Screening Tool overall score was 0.82 (95% CI, 0.66-0.91) for inter-rater reliability and 0.77 (95% CI, 0.57-0.88) for test-retest reliability, indicating a good level of reliability for the tool. 'Undefined stair edges' was the only item that demonstrated poor inter-rater reliability (kappa = 0.37). All items except 'loose mats' (kappa = 0.19) reached acceptable or excellent levels of test-retest reliability with kappa scores greater than 0.40.
The Home Falls and Accidents Screening Tool demonstrated consistency across raters and across different time periods. Further studies into the reliability of the Home Falls and Accidents Screening Tool would benefit from sampling raters from varying professional backgrounds and older people with higher levels of function.
背景/目的：家庭跌倒与事故筛查工具旨在帮助卫生专业人员识别社区居住老年人因家庭环境而产生的跌倒风险。本研究的目的是通过检查其评分者间信度和重测信度来评估家庭跌倒与事故筛查工具。
从悉尼和亨特地区三个区域卫生服务机构的九名职业治疗师的病例中招募了31名65岁以上的社区居住老年人。研究人员和一名职业治疗师共进行了31次家访，以独立管理家庭跌倒与事故筛查工具。然后，其中一名评分者在两周内进行随访，重新管理家庭跌倒与事故筛查工具。使用百分比一致性、组内相关性和kappa系数评估信度。
家庭跌倒与事故筛查工具总分的组内相关系数，评分者间信度为0.82（95%CI，0.66 - 0.91），重测信度为0.77（95%CI，0.57 - 0.88），表明该工具具有良好的信度水平。“未定义的楼梯边缘”是唯一显示评分者间信度较差的项目（kappa = 0.37）。除“松散的地垫”（kappa = 0.19）外，所有项目的重测信度均达到可接受或优秀水平，kappa分数大于0.40。
家庭跌倒与事故筛查工具在评分者之间和不同时间段内表现出一致性。对家庭跌倒与事故筛查工具信度的进一步研究将受益于从不同专业背景的评分者和功能水平较高的老年人中进行抽样。
