Development and Initial Validation of the Iconographical Falls Efficacy Scale
Delbaere, K and Smith, ST and Lord, SR, Development and Initial Validation of the Iconographical Falls Efficacy Scale, Journals of Gerontology. Series A: Biological Sciences and Medical Sciences, 66, (6) pp. 674-680. ISSN 1079-5006 (2011) [Refereed Article]
Background. Fear of falling scales typically have a strong floor effect in active people and use short phrases to state overall context of fear-related activities. We developed the Iconographical Falls Efficacy Scale (Icon-FES), which includes more demanding activities and uses pictures to provide more complete environmental contexts.
Methods. Two-hundred and fifty community-dwelling older people (70–90 years) were assessed on the Icon-FES in conjunction with the Falls Efficacy Scale International (FES-I).
Results. Overall structure and measurement properties of the 30-item Icon-FES (evaluated with item-response theory) were good. It measured a single factor with 2 dimensions assessing fear about less and more demanding daily activities. It had high internal consistency (Cronbach's alpha = 0.96) and excellent test–retest reliability. The Icon-FES distribution was considerably closer to normal compared with FES-I, indicating absence of floor and ceiling effects. Construct validity of the Icon-FES was supported by its relation with FES-I and its ability to discriminate between groups relating to demographic characteristics and fall risk factors. A shortened 10-item Icon-FES showed similar psychometric properties to the 30-item Icon-FES.
Conclusions. The Icon-FES is an innovative way of assessing fear of falling using pictures to describe a range of activities and situations. This initial validation study showed that the Icon-FES has excellent psychometric properties and showed close continuity with the FES-I. Main advantages of the Icon-FES over the FES-I are its normal distribution and its ability to assess fear of falling in high functioning older people.
Accidental falls; Fear of falling ; Aging; Sensitivity to change; Rasch analysis