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Reliability, construct validity, and clinical feasibility of the activities-specific fall caution scale for
Robin A Blanchard1, Anita M Myers, Nancy J Pearce
1Department of Health Studies and Gerontology, University of Waterloo, Waterloo, ON, Canada.
Objective:
To examine the reliability, validity, and feasibility of the Activities-specific Fall Caution (AFC) Scale.
Design:
Cross-sectional studies with test-retest and interrater reliability.
Setting:
Residential care facilities in Ontario, Canada: 10 in study 1 and 6 in study 2.
Participants:
Convenience samples of 101 and 31 residents.
Interventions:
Not applicable.
Main Outcome Measures:
In study 1, the AFC Scale was readministered to 44 residents, 64 were assessed using the Berg Balance Scale, Timed Up & Go, and Self-Paced Walk Test, and the Nursing Home Life-Space Diameter was completed for 80 residents. In study 2, staff administered the AFC Scale to 31 residents on 2 occasions.
Results:
In study 1, test-retest reliability (intraclass correlation coefficient [ICC]) was .87 (95% confidence interval, .78-.93). AFC scores were associated with physical performance and mobility patterns (P<.001) and able to discriminate on the basis of gait aid use (P<.001), balance disorders (P<.05), and transfer assistance and walk speed (P<.01). Comparatively, general fear of falling showed weaker associations and a sex bias. In study 2, staff administration was fairly consistent (ICC=.71) and similar associations emerged for AFC scores.
Conclusions:
The AFC Scale shows good reproducibility, convergent and discriminative validity, and is feasible for clinical as well as research use.
