title: Validation of an adapted falls efficacy scale in older rehabilitation patients.
abstract: OBJECTIVE
  To determine the psychometric properties of an adapted version of the Falls Efficacy Scale (FES) in older rehabilitation patients.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Postacute rehabilitation facility in Switzerland.
  
  
  METHODS
  Seventy elderly persons aged 65 years and older receiving postacute, inpatient rehabilitation.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  FES questions asked about subject's confidence (range, 0 [none]-10 [full]) in performing 12 activities of daily living (ADLs) without falling. Construct validity was assessed using correlation with measures of physical (basic ADLs [BADLs]), cognitive (Mini-Mental State Examination [MMSE]), affective (15-item Geriatric Depression Scale [GDS]), and mobility (Performance Oriented Mobility Assessment [POMA]) performance. Predictive validity was assessed using the length of rehabilitation stay as the outcome. To determine test-retest reliability, FES administration was repeated in a random subsample (n=20) within 72 hours.
  
  
  RESULTS
  FES scores ranged from 10 to 120 (mean, 88.7+/-26.5). Internal consistency was optimal (Cronbach alpha=.90), and item-to-total correlations were all significant, ranging from .56 (toilet use) to .82 (reaching into closets). Test-retest reliability was high (intraclass correlation coefficient, .97; 95% confidence interval, .95-.99; P<.001). Subjects reporting a fall in the previous year had lower FES scores than nonfallers (85.0+/-25.2 vs 94.4+/-27.9, P=.054). The FES correlated with POMA (Spearman rho=.40, P<.001), MMSE (rho=.37, P=.001), BADL (rho=.43, P<.001), and GDS (rho=-.53, P<.001) scores. These relationships remained significant in multivariable analysis for BADLs and GDS, confirming FES construct validity. There was a significant inverse relationship between FES score and the length of rehabilitation stay, independent of sociodemographic, functional, cognitive, and fall status.
  
  
  CONCLUSIONS
  This adapted FES is reliable and valid in older patients undergoing postacute rehabilitation. The independent association between poor falls efficacy and increased length of stay has not been previously described and needs further investigations.
authors.affiliation: Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. christophe.bula@chuv.ch
authors.forename: Christophe J
authors.initials: CJ
authors.lastname: Büla
authors.forename: Estelle
authors.initials: E
authors.lastname: Martin
authors.forename: Stéphane
authors.initials: S
authors.lastname: Rochat
authors.forename: Chantal
authors.initials: C
authors.lastname: Piot-Ziegler
mesh_terms: D000058:Accidental Falls; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D015999:Multivariate Analysis; D011594:Psychometrics; D011597:Psychomotor Performance; D012047:Rehabilitation Centers; D015203:Reproducibility of Results; D019467:Subacute Care