Development and validation of a fall risk assessment scale for hospitalized cancer patients undergoing chemotherapy

Hospitalized cancer patients undergoing chemotherapy are at high risk of falls. This study aimed to develop a Fall Risk Assessment Scale for Hospitalized Cancer Patients Undergoing Chemotherapy to provide an effective tool to prevent falls and improve patient safety.

An initial item pool was constructed using an evidence-based approach. The initial scale was refined through expert consultations and then used to assess fall risk in 329 patients. We tested the scale's reliability and validity. The optimal cut-off value was determined using Receiver Operating Characteristic (ROC) curve analysis, and risk levels were defined using a quartile-based method.

The final scale consisted of 3 dimensions (Personal factors, Chemotherapy-related symptoms and signs, and Diagnostic and treatment factors) and 12 items. Scale Content Validity Index (S-CVI) and Item Content Validity Index (I-CVI) were both 1.000. Exploratory factor analysis (EFA) extracted three factors with eigenvalues greater than 1, with a cumulative variance rate of 52.667%, and all item loadings exceeded 0.40. ROC analysis identified a cut-off of 20 points for the scale, with Area Under the Curve (AUC) = 0.742, sensitivity 94.7%, and specificity 53.3%. Based on the 20-point threshold, scores of 20-25 indicated low risk, 26-33 medium risk, and ≥ 34 high risk.

The Fall Risk Assessment Scale for Hospitalized Cancer Patients Undergoing Chemotherapy demonstrated good reliability and validity and can be used as a clinical tool to identify and predict falls.