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Evaluation of the Morse Fall Scale: applicability in Chinese hospital populations
Susan K Y Chow1, Claudia K Y Lai, Thomas K S Wong
1School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong. hssusan@polyu.edu.hk
Background:
Patient falls have been identified as a significant health problem in the general hospital patient population. The Morse Fall Scale (MFS) is an individualized criterion-referenced assessment tool designed for measuring the likelihood of patient falls in hospitals. Despite the scale has demonstrated high validity and reliability in the previous researches, this study is to provide additional validity tests to determine the applicability in the Chinese hospital population.
Objectives:
To examine the predictive power of the MFS to predict patient falls. To conduct reliability tests on internal consistency, item analysis, inter-rater and test-retest reliability.
Design:
The study was a cross-sectional study.
Settings:
The medical and geriatric units of three rehabilitation hospitals in Hong Kong participated in the study.
Participants:
A convenience sample of 954 Chinese patients was recruited sequentially upon admission in the hospital ward units. They ranged in age from 17 to 100 years, with a mean of 70.2 years.
Methods:
The patients were assessed for fall risk using the MFS on admission. Data was collected on the number of patients who fell rather than the number of falls.
Results:
The scale had a sensitivity of 31% and a specificity of 83% when the cut-off point was determined at 45. The field test demonstrated excellent inter-rater reliability with an ICC value of 0.97 (95%CI 0.94-0.98). Repeatability was high with an ICC of 0.98 (95% CI 0.98-0.99). The evaluation revealed a low Cronbach's alpha coefficient and a low to moderate item-to-scale correlation.
Conclusions:
The evidence collected in this study has shown both the positive and negative aspects of using the MFS in assessing the fall risk of Chinese patients during rehabilitation. The discriminative validity and internal consistency reliability provide researchers and clinicians with a major step in further developing or modifying the scale.
Insights
The Morse Fall Scale (MFS) shows potential for predicting patient falls in Chinese hospitals, with strong inter-rater reliability but mixed results on internal consistency. Further modifications may enhance its applicability.
Area of Science:
- Gerontology
- Nursing
- Healthcare Management
Background:
- Patient falls are a significant concern in hospital settings.
- The Morse Fall Scale (MFS) is a widely used tool for assessing fall risk.
- Previous research supports the MFS's validity and reliability, but its applicability in diverse populations requires further investigation.
Purpose of the Study:
- To evaluate the predictive accuracy of the MFS for patient falls in a Chinese hospital population.
- To assess the reliability of the MFS, including internal consistency, item analysis, inter-rater, and test-retest reliability.
Main Methods:
- A cross-sectional study was conducted in medical and geriatric units of three rehabilitation hospitals in Hong Kong.
- 954 Chinese patients were recruited sequentially upon admission.
- The Morse Fall Scale (MFS) was administered to assess fall risk, with data collected on patient falls.
Main Results:
- The MFS demonstrated a sensitivity of 31% and specificity of 83% at a cutoff of 45.
- Excellent inter-rater reliability (ICC=0.97) and high test-retest reliability (ICC=0.98) were observed.
- The scale exhibited a low Cronbach's alpha and low to moderate item-to-scale correlations.
Conclusions:
- The MFS shows promise for assessing fall risk in Chinese rehabilitation patients, with strong reliability metrics.
- However, limitations in discriminative validity and internal consistency suggest potential areas for scale modification.
- These findings offer insights for refining the MFS for improved clinical use in this population.