Falls efficacy: Extending the understanding of self-efficacy in older adults towards managing falls

Abstract

Falls efficacy is a widely studied construct. The understanding of falls efficacy has evolved over time. Falls efficacy was initially perceived to be suitably used as a measure of fear of falling. However, further research suggested that falls efficacy and fear of falling are distinct constructs, and therefore, would be inappropriate to be used as a proxy. Instead, some researchers posited that falls efficacy is synonymous with balance confidence. Falls efficacy has been conventionally understood as the perceived ability of individuals to perform activities without losing balance or falling. A recently conducted systematic review by the authors on existing falls efficacy related measures had revealed a fresh perspective of recognising falls efficacy as a perceived ability to manage a threat of a fall. Falls efficacy, with a broadened interpreted construct, relates to the individual’s perceived self-efficacy of performing necessary actions needed in different scenarios, including pre-fall, near-fall, fall-landing and completed fall. The conventional interpretation of falls efficacy needs a rethinking of perspective. An extended understanding of falls efficacy would provide an integral approach towards improving the agency of individual to deal with falls and would enhance person-centred care.

Feasibility and Effectiveness of a Novel Intervention Integrating Physical Therapy Exercise and Dance Movement Therapy on Fall Risk in Community-Dwelling Older Women: A Randomized Pilot Study

“…Additionally, the current study assessed various measures of falls-related psychological concerns. The constructs of FSe, balance confidence and FOF have been reconceptualized, but there is sometimes overlap between the construct measures [ 94 , 95 ]. It is possible that using multiple questionnaires addressing similar contexts and indistinct constructs led to poor self-reporting quality and can be burdensome.…”

Taekwondo Poomsae practise in slow motion and the balance of healthy older adults: A Pre‐Experimental Study

“…One consideration is that older adults with lower balance confidence scores also have poorer kinematics such as lower turning speed and increased number of steps taken to turn, which is a fall risk, during a ‘turn to sit’ functional task (Almajid et al., 2020). Another consideration is falls efficacy, which is defined as the self‐perceived competency of performing mitigating actions to cope with a threat of falling (Soh et al., 2021). Although balance confidence and falls efficacy should be viewed differently based on their constructs (Soh et al., 2021), it is logical to assume that older adults with lower balance confidence might mitigate falls risks by changing the way they move or avoid exercises and certain movements in daily activities.…”

“…Another consideration is falls efficacy, which is defined as the self‐perceived competency of performing mitigating actions to cope with a threat of falling (Soh et al., 2021). Although balance confidence and falls efficacy should be viewed differently based on their constructs (Soh et al., 2021), it is logical to assume that older adults with lower balance confidence might mitigate falls risks by changing the way they move or avoid exercises and certain movements in daily activities. Movement avoidance may lead to physical deconditioning, which is a long‐term fall risk in older adults (Pua et al., 2017; Tinetti & Williams, 1998).…”

Perceived balance and self‐reported falls: A retrospective cross‐sectional study using the National Health and Aging Trend Study

“…Falls efficacy, understood as one's selfefficacy or confidence at avoiding falls, was initially developed to measure FOF (Tinetti et al, 1990). Since then, the concept of falls efficacy has evolved to include balance confidence (Soh et al, 2021).…”