Singapore Institute of Technology, Singapore, Singapore.
Queen Margaret University, Musselburgh, UK.
BMC Geriatr. 2021 Jan 7;21(1):21. doi: 10.1186/s12877-020-01960-7.
Falls efficacy is a widely-studied latent construct in community-dwelling older adults. Various self-reported instruments have been used to measure falls efficacy. In order to be informed of the choice of the best measurement instrument for a specific purpose, empirical evidence of the development and measurement properties of falls efficacy related instruments is needed.
The Consensus-based Standards for the Selection of Health Measurement Intruments (COSMIN) checklist was used to summarise evidence on the development, content validity, and structural validity of instruments measuring falls efficacy in community-dwelling older adults. Databases including MEDLINE, Web of Science, PsychINFO, SCOPUS, CINAHL were searched (May 2019). Records on the development of instruments and studies assessing content validity or structural validity of falls efficacy related scales were included. COSMIN methodology was used to guide the review of eligible studies and in the assessment of their methodological quality. Evidence of content validity: relevance, comprehensiveness and comprehensibility and unidimensionality for structural validity were synthesised. A modified GRADE approach was applied to evidence synthesis.
Thirty-five studies, of which 18 instruments had been identified, were included in the review. High-quality evidence showed that the Modified Falls Efficacy Scale (FES)-13 items (MFES-13) has sufficient relevance, yet insufficient comprehensiveness for measuring falls efficacy. Moderate quality evidence supported that the FES-10 has sufficient relevance, and MFES-14 has sufficient comprehensibility. Activities-specific Balance Confidence (ABC) Scale-Simplified (ABC-15) has sufficient relevance in measuring balance confidence supported by moderate-quality evidence. Low to very low-quality evidence underpinned the content validity of other instruments. High-quality evidence supported sufficient unidimensionality for eight instruments (FES-10, MFES-14, ABC-6, ABC-15, ABC-16, Iconographical FES (Icon-FES), FES-International (FES-I) and Perceived Ability to Prevent and Manage Fall Risks (PAPMFR)).
Content validity of instruments to measure falls efficacy is understudied. Structural validity is sufficient for a number of widely-used instruments. Measuring balance confidence is a subset of falls efficacy. Further work is needed to investigate a broader construct for falls efficacy.
跌倒效能是社区居住的老年人中广泛研究的潜在结构。已经使用了各种自我报告的工具来衡量跌倒效能。为了能够选择最适合特定目的的最佳测量工具，需要有关于与跌倒效能相关的工具的开发和测量特性的经验证据。
使用共识基础的健康测量仪器选择标准（COSMIN）清单总结了有关在社区居住的老年人中测量跌倒效能的工具的开发，内容有效性和结构有效性的证据。搜索了包括 MEDLINE、Web of Science、PsychINFO、SCOPUS、CINAHL 在内的数据库（2019 年 5 月）。包括有关仪器开发的记录以及评估与跌倒效能相关量表的内容有效性或结构有效性的研究。使用 COSMIN 方法指导合格研究的审查，并评估其方法学质量。内容有效性的证据：合成了结构有效性的相关性，全面性和可理解性以及单维性。应用改良的 GRADE 方法进行证据综合。
共有 35 项研究，其中确定了 18 种工具，被纳入了综述。高质量的证据表明，改良跌倒效能量表（FES）-13 项（MFES-13）具有足够的相关性，但在测量跌倒效能方面的全面性不足。中等质量的证据支持 FES-10 具有足够的相关性，MFES-14 具有足够的可理解性。简化的活动特异性平衡信心量表（ABC-15）具有足够的相关性，其平衡信心测量结果得到了中等质量证据的支持。其他仪器的内容有效性则基于低至非常低质量的证据。高质量的证据支持八种仪器（FES-10、MFES-14、ABC-6、ABC-15、ABC-16、Iconographical FES（Icon-FES）、FES-International（FES-I）和感知预防和管理跌倒风险的能力（PAPMFR））具有足够的一维性。
衡量跌倒效能的工具的内容有效性研究不足。结构有效性对于许多常用的仪器来说是足够的。衡量平衡信心是跌倒效能的一个子集。需要进一步研究更广泛的跌倒效能结构。
