Balance Confidence and Falls Self-Efficacy in Older Breast Cancer Survivors

Abstract

Purpose: The aim of the study was to examine the reliability, validity, and measurement error of balance confidence and fall-related self-efficacy measures in older breast cancer survivors. Design: A cross-sectional study was performed. Methods: The Activities-Specific Balance Confidence Scale (ABC), the shorter, six-item version of the ABC (ABC-6), and the Modified Falls Efficacy Scale (MFES) were completed by 35 older breast cancer survivors. Absolute reliability was examined with Cronbach's alpha, test-retest reliability with intraclass correlation coefficient, and Pearson's correlation coefficient for construct validity. Findings: Absolute reliability was good for the ABC. Test-retest reliability was good for the ABC and the ABC-6 and moderate for the MFES. Construct validity was present for all measures. Conclusions: Breast cancer survivors' balance confidence measures should be assessed with either the ABC or the ABC-6, whereas falls self-efficacy should be examined with the MFES. Clinical Relevance: Nurses and other health professionals who treat breast cancer survivors should include assessing psychological factors associated with falls using the ABC, the ABC-6, or the MFES as low balance confidence or falls self-efficacy contribute to increased falls risk.

Overestimation of Balance Ability Among Older Adults at Risk for Falls

“…In our present sample of older community dwelling adults, the majority tended to overestimate rather than underestimate their balance confidence in comparison to their classification (“at fall risk” or “not at fall risk”). A number of studies have focused on the relationship between self-perceived balance confidence and actual physical performance both in healthy adults and those with different medical diagnoses (Blackwood & Rybicki, 2021; Ko & Chye, 2020; Lamarche et al, 2013; Medley & Thompson, 2015; Schinkel-Ivy et al, 2016, 2017). In these studies, low balance confidence has been identified as a contributor to fall risk.…”

Balance Ability and Occupational Performance in Patients With Parkinson’s Disease and On-Medication-State Freezing of Gait

“…Persons with on-medication-state FOG show significantly lower values of self-reported confidence in balance in comparison with paired PD patients and healthy participants. Considering that lower balance confidence may contribute to limited mobility, reduced activity levels, and falls rehabilitation, nurses have an important role in screening these areas to identify risk factors that should be addressed through a multifactorial approach (Blackwood & Rybicki, 2021).…”

“…Determining which specific balance characteristics (e.g., anticipatory transitions, reactive postural control, sensory orientation, or dynamic gait) are impaired and their repercussions on occupational performance may provide a deeper understanding of potential mechanisms of on-medication-state FOG and may facilitate the identification of rehabilitation goals and the development of fall prevention plans (Cosentino et al, 2020; Duncan et al, 2015). Blackwood and Rybicki (2021) state that, as a part of the management of fall risk, some measures such as balance confidence and dual-task should be assessed by members of the healthcare team, including rehabilitation nurses. Because of very limited research in this area, the purpose of the study was to examine balance ability and occupational performance in patients with PD and on-medication-state FOG.…”