Revision of the fall risk self-assessment scale for community-dwelling older adults and assessment of reliability and validity

Abstract

Background: Fall is a common accidental injury of the older people, which seriously threatens their physical and mental health. The occurrence of fall often due to the interaction of multiple risk factors. The Fall Risk Self-Assessment Scale (FRSAS) is a multi-dimensional fall risk assessment tool. Pre-experiments have shown that the first version of FRSAS can be used for assessing the fall risks of the older people in communities, with strong operability and good reliability and validity. This study aims at further optimizing the items of the Scale through large sample survey, and assessing the reliability and validity of the revised FRSAS. Methods: This study is a cross-sectional study, using the convenient sampling method. A total of 500 older adults aged 65 and above were recruited from four health service centers in Beijing from October 2021 to March 2022. Among whom, 489 subjects completed FRSAS as required, and the effective response rate of the Questionnaire was 97.8%; 44 subjects completed the repeated survey with the repeated measurement rate of 8.8%. The items of FRSAS were analyzed and screened to form the final version of the Scale with the comprehensive screening method, and the reliability and validity of the final version of the Scale were tested. Results: The items of the Scale were compared and analyzed with the comprehensive screening method, of which, six items, namely D1, P12, C3, C9, C10 and H11, with two or more screening methods prompt to be deleted. After discussion by the experts, they agreed to delete the above 6 items and adjust the structure of the final FRSAS to 35 items and 4 dimensions. The Cronbach's α coefficient of the final FRSAS was 0.783 and the test-retest reliability was 0.98. Taking whether the subjects had a history of fall in the past year as the grouping variable, the total score of the Scale was tested by T test, and the difference between both groups was statistically significant (P =0.000). Conclusion: The revision of the final version of FRSAS meets the actual needs of the older people in communities, with simple items and better reliability and validity. FRSAS can be used as an important reference tool for assessing the risks of fall in the older people in communities. Trial registration: Registration number: ChiCTR2000038856; Date of registration:7 Oct 2020.