Fall risk assessment scale for hemodialysis patients (ERQUE_HD): development and validation

Hemodialysis patients present multiple comorbidities and complications during therapy, factors that increase the risk of falls. Adequate risk assessment is essential for implementing effective preventive measures.

To develop and validate a scale for assessing fall risk in hemodialysis patients.

A methodological study with quantitative and qualitative approaches, conducted in five stages: integrative review, focus groups, instrument development, content validation, and scale validation.

The integrative review included 17 articles and supported the initial item development. Nine focus groups with patients and healthcare professionals enabled the identification of additional risk factors, resulting in the construction of the ERQUE_HD (Fall Risk Assessment Scale for Hemodialysis Patients), composed of 17 items distributed across four domains: health history, dialysis-related factors, functional capacity, and nutrition. Content validation reached a content validity index (CVI) of 0.95, considered highly satisfactory. The scale was then applied to 66 patients and analyzed using logistic regression with generalized estimating equations (GEE), including variables such as post-dialysis fatigue, interdialytic weight gain, and intradialytic hypotension. Patients classified as high-risk were 8.7 times more likely to experience falls compared to the moderate-risk group. The ERQUE-HD demonstrated good accuracy (AUC = 0.817). Post-dialysis fatigue and interdialytic weight gain >4% were identified as significant fall predictors.

The ERQUE-HD proved to be effective in assessing and predicting fall risk among hemodialysis patients.