title: Reliability and validity of the Falls Efficacy Scale-International after hip fracture in patients aged ≥ 65 years.
abstract: OBJECTIVE
  To assess the measurement properties of the Falls Efficacy Scale-International (FES-I) in patients after a hip fracture aged ≥ 65 years.
  
  
  METHODS
  In a sample of 100 patients, we examined the structural validity, internal consistency and construct validity. For the structural validity a confirmatory factor analysis was carried out. For construct validity predetermined hypotheses were tested. In a second sample of 21 older patients the inter-rater reliability was evaluated.
  
  
  RESULTS
  The factor analysis yielded strong evidence that the FES-I is uni-dimensional in patients with a hip fracture; the Cronbach's alpha was 0.94. When testing the reliability, the intra-class correlation coefficient was 0.72, while the Standard Error of Measurement was 6.4 and the Smallest Detectable Change was 17.7 (on a scale from 16 to 64). The Spearman correlation of the FES-I with the one-item fear of falling instrument was high (r = 0.68). The correlation was moderate with instruments measuring functional performance constructs and low with instruments measuring psychological constructs.
  
  
  CONCLUSIONS
  Reliability and structural validity of the FES-I in patients after a hip fracture are good. The construct validity appears more closely related to functional performance constructs than to psychological constructs, suggesting that the concept measured by the FES-I may not capture all aspects of fear of falling.
  
  
  CONCLUSIONS
  The Falls Efficacy Scale-International (FES-I), which is commonly used to measure fear of falling in community-dwelling older persons, can also be used to assess fear of falling in patients after a hip fracture. The reliability and the structural validity of the FES-I for these hip patients are good, whereas the construct validity of the FES-I is not optimal. The FES-I may not capture all aspects of fear of falling and may be more closely related to functional performance than to psychological concepts such as anxiety.
authors.affiliation: a Department of Public Health and Primary Care , Leiden University Medical Centre , Leiden , The Netherlands .|b Zorggroep Solis , Deventer , The Netherlands , and.
authors.forename: Jan H M
authors.initials: JH
authors.lastname: Visschedijk
authors.affiliation: c Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research , VU University Medical Center , Amsterdam , The Netherlands.
authors.forename: Caroline B
authors.initials: CB
authors.lastname: Terwee
authors.affiliation: a Department of Public Health and Primary Care , Leiden University Medical Centre , Leiden , The Netherlands .
authors.forename: Monique A A
authors.initials: MA
authors.lastname: Caljouw
authors.affiliation: a Department of Public Health and Primary Care , Leiden University Medical Centre , Leiden , The Netherlands .
authors.forename: Monica
authors.initials: M
authors.lastname: Spruit-van Eijk
authors.affiliation: a Department of Public Health and Primary Care , Leiden University Medical Centre , Leiden , The Netherlands .
authors.forename: Romke
authors.initials: R
authors.lastname: van Balen
authors.affiliation: a Department of Public Health and Primary Care , Leiden University Medical Centre , Leiden , The Netherlands .
authors.forename: Wilco P
authors.initials: WP
authors.lastname: Achterberg
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D005163:Factor Analysis, Statistical; D005239:Fear / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006620:Hip Fractures; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000592:standards; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life; D015203:Reproducibility of Results; D012307:Risk Factors; D020377:Self Efficacy; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Falls Efficacy Scale-International; fear of falling; hip fractures; measurement properties