Rahimi Shoeleh, Khankeh Hamid Reza, Ebadi Abbas, Mohammadian Batol, Arsalani Narges, Fallahi-Khoshknab Masoud, Akbarfahimi Nazila, Loni Elham
Department of Nursing University of Social Welfare and Rehabilitation Sciences Tehran Iran.
Shiraz University of Medical Sciences Instructor, School of Nursing and Midwifery Shiraz Fars Iran.
Health Sci Rep. 2024 Nov 5;7(11):e70040. doi: 10.1002/hsr2.70040. eCollection 2024 Nov.
Falling is a serious threat for patient safety in hospitals. This study aimed to identify the risk factors of fall amongst rehabilitation patients and to use them for developing and validating the Persian version of Fall Risk Assessment Scale (FRAS).
The current methodological study was conducted in two phases. In the first phase, based on the review of the literature and investigation of the medical records of 251 patients selected via purposive sampling, the risk factors of fall were extracted and the FRAS was developed accordingly. In the second phase, the face and content validities of the designed scale were determined by cognitive interview and Content Validity Index (CVI) and to evaluate the construct validity, known-groups comparison was performed. Its inter-rater reliability was analyzed using the Kappa Coefficient (). The study adhered to COSMIN guidelines.
Fall was significantly associated with disease diagnosis, used medications, history of fall, cognitive impairments, and three items of the Functional Independence Measure (toilet transfer, bed transfer, and shoer transfer). The CVI of the scale was 0.94. The risk for falls group had a significantly higher perceived fall risk than the no risk for falls group, thus establishing known-group validity. Its weighted kappa coefficient was >0.85, its sensitivity was 73%, and its specificity was 82%.
The valid and reliable FRAS may accurately assess the level of Fall Risk patients in Rehabilitation wards, helping to predict fall during hospitalization. So, enabling the planning and implementation of effective caring interventions.
跌倒对医院患者安全构成严重威胁。本研究旨在确定康复患者跌倒的风险因素,并将其用于开发和验证波斯语版跌倒风险评估量表(FRAS)。
本方法学研究分两个阶段进行。第一阶段,基于文献回顾和对通过目的抽样选取的251例患者病历的调查,提取跌倒风险因素并据此开发FRAS。第二阶段,通过认知访谈和内容效度指数(CVI)确定所设计量表的表面效度和内容效度,并通过已知组比较评估结构效度。使用Kappa系数()分析其评分者间信度。本研究遵循COSMIN指南。
跌倒与疾病诊断、所用药物、跌倒史、认知障碍以及功能独立性测量的三个项目(厕所转移、床转移和鞋转移)显著相关。该量表的CVI为0.94。跌倒风险组的感知跌倒风险显著高于无跌倒风险组,从而确立了已知组效度。其加权kappa系数>0.85,敏感性为73%,特异性为82%。
有效且可靠的FRAS可准确评估康复病房患者的跌倒风险水平,有助于预测住院期间的跌倒情况。因此,能够规划和实施有效的护理干预措施。