title: Pathways from fear of falling to quality of life: the mediating effect of the self-concept of health and physical independence.
abstract: OBJECTIVE
  Fear of falling leads to many adverse consequences and may compromise the quality of life of older adults. Psychological factors are potential mediators between the fear of falling and quality of life, but have yet to be explored in detail. This study presents results from examining the mediating effect of the self-concept of health and physical independence. Data from Western and Eastern countries were compared.
  
  
  METHODS
  Concerns about falling, the level of participation in physical activities, the self-concept of health and physical independence, and health-related quality of life were measured using samples from Taiwan (n = 193) and Germany (n = 182). Multiple regression models were used to test the mediating effects.
  
  
  RESULTS
  The relationship between fear of falling and quality of life was partially mediated through participation in physical activities and the self-concept of health and physical independence in both the Taiwanese and German samples. In particular, the self-concept of health and physical independence of the Taiwanese sample resulted in the strongest mediating effect.
  
  
  CONCLUSIONS
  Potential mediating mechanisms through both participation in physical activities and the self-concept of health and physical independence provide useful information for understanding related theories and for explicating interventions. Cultural factors should also be accounted for when conducting research and programs related to the fear of falling.
authors.affiliation: Graduate Institute of Physical Education, National Taiwan Sport University, Taoyuan, Taiwan. tgieva@gmail.com
authors.forename: Yawen
authors.initials: Y
authors.lastname: Hsu
authors.forename: Dorothee
authors.initials: D
authors.lastname: Alfermann
authors.forename: Frank J H
authors.initials: FJ
authors.lastname: Lu
authors.forename: Linda L
authors.initials: LL
authors.lastname: Lin
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D003469:Culture; D015444:Exercise; D005239:Fear / Q000523:psychology*; D005858:Germany; D006801:Humans; D026684:Personal Autonomy; D011788:Quality of Life; D012044:Regression Analysis; D012649:Self Concept; D058992:Social Participation / Q000523:psychology*; D011795:Surveys and Questionnaires; D013624:Taiwan