Chang Yaw-Wen, Chang Ying-Hsue, Pan Yu-Ling, Kao Tung-Wei, Kao Senyeong
Division of Geriatric Medicine, Tri-Service General Hospital Graduate Institute of Medical Science Department of Nursing Department of Family Medicine, Tri-Service General Hospital School of Public Health Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan.
Medicine (Baltimore). 2017 Aug;96(31):e7693. doi: 10.1097/MD.0000000000007693.
A comprehensive fall risk assessment can provide information for effective prevention and intervention measures and reduce falls among hospitalized elderly people. The purpose of this study was to develop a Chinese version of an inpatient fall risk assessment tool and evaluate its validity and reliability.This study employed the Falls Risk for Hospitalised Older People (FRHOP) assessment to construct a FRHOP-Taiwan Version (Tw-FRHOP) through forward, synthesized, and backward translation. A face validation was conducted by 5 clinical nurses and a content validation was conducted by 5 specialists using the content validity index (CVI) to validate the proposed model. Thirty hospitalized older adults in an internal care unit were selected for an interrater reliability assessment, conducted separately by specialists in 4 disciplines (i.e., nurses, physicians, occupational therapists, and physiotherapists) by using Cohen kappa statistic and intraclass correlation coefficients (ICCs). Specifically, the assessment rating developed in the Tw-FRHOP was compared with the Morse Fall Scale (MFS), St. Thomas Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY), and the Hendrich II Fall Risk Model (HIIFRM) for criterion validation.According to the analysis results, the CVI was 0.94, and the indexes of criterion-related validity for the FRHOP-Taiwan Version, MFS, STRATIFY, and HIIFRM were 0.49, 0.63, and 0.54 (all P < .001), respectively. In addition, after interrater reliability testing was conducted, the results indicated that the index of response consistency in each discipline was 86.7% to 100%, and the values of Cohen kappa were 0.651 to 1.000. The ICCs of the discipline-related subscale were 0.97 to 1.00.The Tw-FRHOP is a multidisciplinary comprehensive fall risk assessment that can serve as a satisfactorily valid and reliable reference tool for medical personnel with full professional training, as well as inpatient fall prevention interventions for multidisciplinary teams in hospitals.
全面的跌倒风险评估可为有效的预防和干预措施提供信息，并减少住院老年人的跌倒情况。本研究的目的是开发中文版的住院患者跌倒风险评估工具，并评估其有效性和可靠性。本研究采用住院老年人跌倒风险（FRHOP）评估，通过正向翻译、综合翻译和反向翻译构建了FRHOP-台湾版（Tw-FRHOP）。由5名临床护士进行了表面效度验证，并由5名专家使用内容效度指数（CVI）进行了内容效度验证，以验证所提出的模型。选取内科护理单元的30名住院老年人进行评分者间信度评估，由4个学科的专家（即护士、医生、职业治疗师和物理治疗师）分别使用Cohen卡方统计量和组内相关系数（ICC）进行评估。具体而言，将Tw-FRHOP中制定的评估等级与莫尔斯跌倒量表（MFS）、老年住院患者圣托马斯跌倒风险评估工具（STRATIFY）和亨德里克二世跌倒风险模型（HIIFRM）进行比较，以进行标准效度验证。根据分析结果，CVI为0.94，FRHOP-台湾版、MFS、STRATIFY和HIIFRM的标准关联效度指标分别为0.49、0.63和0.54（均P<0.001）。此外，在进行评分者间信度测试后，结果表明各学科的反应一致性指标为86.7%至100%，Cohen卡方值为0.651至1.000。各学科相关子量表的ICC为0.97至1.00。Tw-FRHOP是一种多学科的全面跌倒风险评估，可为经过全面专业培训的医务人员提供令人满意的有效且可靠的参考工具，也可为医院的多学科团队进行住院患者跌倒预防干预提供参考。
