Table 1 Data summary table
From: Falls risk perception measures in hospital: a COSMIN systematic review
References and country Year of tool development and author (if applicable) | Primary fall perception measure and construct(s) measured | Target population and cognitive status of population | Setting | No. of scale items | Description of scale | Interpretation of scoring | Test completion time | Recall period |
|---|---|---|---|---|---|---|---|---|
Birgili et al. [33] and Turkey Original author of SAFE scale: Shyu et al. [20] | Adapted Turkish version of the Self-Awareness of Falls in Elderly (SAFE) scale Construct: Falls Risk Awareness | n = 346 inpatients aged 65 years and older Cognitively intact | Hospital | 21-items (four subfactors measuring awareness of activity safety and environment, awareness of physical functions, awareness of medication, awareness of cognitive behaviour) | A 5-pt Likert scale was used to rate awareness levels from 1 = strongly agree to 5 = strongly disagree | Higher scores indicate a high level of falls risk awareness (Score range from 21 to 105) | 30 min (all data tools) | Undefined |
1Bower et al. [34] and USA N/A – developed by author based on the original FFQ by Dayhoff et al. [16] | Fear of Falling Questionnaire-revised (FFQ-R) Construct: Fear of falling | n = 405 adults following a hip fracture, mean age 78.0 years ± 8.7 Cognitively intact or mild cognitive impairment | Hospital/rehabilitation facility | 15-item (6-item version proposed in post-hoc analysis) | Likert type scale from 1 to 4, in which patients’ rate whether they strongly disagree, disagree, agree or strongly agree | Higher scores indicate higher levels of FoF (Score range from 15 to 60 for 15-item) | Not reported | Undefined |
Büla et al. [35] and Switzerland Original authors: Tinetti et al. [15] later revised to Tinetti et al. [36] | Adapted version of the Falls Efficacy Scale (FES) Construct: Confidence that a person has in performing ADLs without falling | n = 70 adults mean age 81.1 years ± 8.6 Inclusion criteria for MMSE: ≥ 20 | Post-acute rehabilitation facility | 12-items | Scores for individual ADLs are on a scale ranging from 0 = no confidence to 10 = full confidence | High scores indicate higher confidence in performing ADLs (Score range from 0 to 120) | Median of 4 min, 10 s | Undefined |
Caronni et al. [37] and Italy Original author of FES-I: Yardley et al. [38] | Validated Italian version of FES-I Construct: Concern for falling | n = 251 adults with balance impairment, mean age 74 years Cognitively intact | Inpatient rehabilitation | 16-items | Scores for individual activities ranged from 1 (not at all concerned) to 4 (very concerned) | Higher scores indicate high concerns about falling (Score range from 16 to 64) | Not reported | Undefined |
Choi et al. [21] and South Korea N/A—developed by author | Falls Risk Perception Questionnaire (FRPQ) Construct: Perceived risk of falling | n = 236 mean age 62.2 years ± 10.99 Cognitively intact | Acute care hospitals | 27-items (three subfactors measuring personal-mobility, personal-chronic condition and environmental factor) | Scores for statements range from 0 = absolutely not true to 3 = absolutely true | High scores indicate a perception of a high risk for falling (Score range from 0 to 81) | 7–15 min to complete both questionnaires (KFES-I and FRPQ) | Undefined |
Dautel et al. [39] and Germany Original author of FFQ-R: Bower et al. [34] | German version of the Fear of Falling Questionnaire-revised (FFQ-R) Construct: Fear of falling | n = 152 patients with hip or pelvic fracture, mean age 84.3 years ± 6.2 Inclusion criteria for MMSE: ≥ 24 | Inpatient rehabilitation | 6-item version | Likert type scale from 1 to 4, in which patients’ rate whether they strongly disagree, disagree, agree or strongly agree | Higher scores indicate higher levels of FOF (Score range from 6 to 24) | Not reported | Undefined |
Ferrer Soler et al. [40] and Switzerland N/A—adapted by author based on the Short FES-I scale | Perform-FES Construct: Fear of falling based on performance | n = 52 adults with mean age 85.3 years ± 6.0 Mean MMSE scores = 23.0 ± 4.6 Inclusion criteria for MMSE: not stated | Geriatric hospital | 7-items | Scores for individual activities ranged from 1 (not at all concerned) to 4 (very concerned) | Higher scores indicate high concern about falling (Score range from 7 to 28) | 15–25 min | Undefined |
Franchignoni et al. [41] and Italy Original author of ABC: Powell and Myers [17] Author of ABC-6: Peretz et al. [42] Author of ABC-6: Oude Nijhuis et al. [43] Author of ABC-5: Lohnes and Earhart [44] | Activities-Specific Balance Confidence Scale (ABC) Construct: Confidence in performing an activity without losing balance ABC-6P ABC-6ON ABC-5L | n = 217 patients with PD, mean age 71 years Inclusion criteria for MMSE: ≥ 24 | Rehabilitation institute | 16-items 6-items 6-items 5-items | Each item rated on a scale from 0% (no confidence) to 100% (full confidence in performing the activity without losing balance) Items 5, 6, 13, 14, 15, 16 Items 5, 6, 12, 13, 15, 16 Items 5, 6, 13, 15, 16 | The total score is the mean sum of individual items, where a high score indicates high confidence | Not reported | Undefined Undefined Undefined Undefined |
Galante-Maia et al. [45] and Brazil Original author of SCI-FCS: Boswell-Ruys et al. [18] | Brazilian-Portugese version of the Spinal Cord Injury-Falls Concern Scale (SCI-FCS) Construct: Self-report concern about falling | n = 130 adults with SCI, mean age 36 years for pre-test group, 37 years for test–retest group Cognitively intact | Rehabilitation hospitals | 16-items | Scores for individual activities ranged from 1 (not at all concerned) to 4 (very concerned) | Higher scores indicate a high concern about falling (Score range from 16 to 64) | Not reported | Undefined |
Hauer et al. [46] and Germany Original author of FES: Tinetti et al. [15] later revised to Tinetti et al. [36] Original author of FES-I: Yardley et al. [38] | FES Construct: Confidence that a person has in performing ADLs without falling FES-I Construct: Concern for falling | n = 156 adults mean age 81.7 years ± 6.1 MMSE scores: 24.2 ± 3.7 Inclusion criteria for MMSE: ≥ 17 | Geriatric rehabilitation | 10-items 16-items | Authors reported that FES data was collected from the first 10 items of the FES-I score, in which scores ranged from 1 (not at all concerned) to 4 (very concerned) – the original scale for FES is scored from 0 = no confidence to 10 = full confidence Scores for individual activities ranged from 1 (not at all concerned) to 4 (very concerned) | High scores indicate high concern about falling (Score range from 10 to 100) according to original scale [15] High scores indicate high concern about falling (Authors state score range from 16 to 56, however original scale is 16–64) | For cognitively impaired: self-report 5.65 min and interview 5.89 min For cognitively intact: self-report 5.65 min and interview 5.89 min | Undefined Undefined |
Mihaljcic et al. [19] and Australia N/A—developed by author | Self-Awareness of Falls Risk Measure (SAFRM) Construct: Falls Risk Awareness | n = 91 adults mean age 77.97 years ± 8.04 Inclusion criteria for MMSE: ≥ 18 | Inpatient rehabilitation | 31-items (three subsections measuring intellectual, emergent and anticipatory self-awareness) | First subsection (intellectual awareness) is measured on a 5pt Likert scale where 1 = greatly increased risk of falling to 5 = no difficulties. Second subsection (emergent awareness) is measured on a 5-pt Likert scale where 1 = much worse to 5 = much better. Third subsection (anticipatory awareness) is measured on a 7-pt Likert scale where 1 = unable to complete, to 7 = complete independence | Awareness scores for each section are calculated by subtracting the clinician ratings from the patient ratings. Larger scores indicate disparities in falls risk awareness. Positive scores demonstrate underestimating falls risk by the patient, negative scores indicate overestimation of falls risk and a score of 0 indicates agreement | 10 min for clinician version and 20 min for the patient version | None (current level) |
1Perrot et al. [47] and France Original author of M-FES: Hill et al. [48] | French version of the Modified-Falls Efficacy Scale (M-FES Fr) Construct: Fear of falling (as described by authors) | n = 56 geriatric patients with mean age of 79.5 years ± 7.6 Cognitive status not reported | Geriatric hospitals | 14-items (9-items for indoor activities, 5-items for outdoor activities) | Scores for activities are on a scale ranging from 0 = not at all confident to 10 = completely confident | Higher scores indicate higher confidence in completing activities without falling (Score range from 0 to 140) | Not reported | Undefined |
Pramodhyakul and Pramodhyakul [49] and Thailand Original author of SCI-FCS: Boswell-Ruys et al. [18] | Thai version of the Spinal Cord Injury-Falls Concern Scale (SCI-FCS) Construct: Self-report concern about falling | n = 54 adults with SCI with mean age of 31.8 years ± 9.5 Cognitive status not reported | Tertiary rehabilitation setting | 16-items | Scores for individual activities ranged from 1 (not at all concerned) to 4 (very concerned) | Higher scores indicate a high concern about falling (Score range from 16 to 64) | Not reported | Undefined |
Roaldsen et al. [50] Original author of SCI-FCS: Boswell-Ruys et al. [18] | Norwegian version of the Spinal Cord Injury-Falls Concern Scale (SCI-FCS) Construct: Self-report concern about falling for people with a SCI | n = 56 adults with complete or incomplete SCI with mean age of 49 years Cognitive status not reported | Inpatient rehabilitation setting | 16-items | Scores for individual activities ranged from 1 (not at all concerned) to 4 (very concerned) | Higher scores indicate a high concern about falling (Score range from 16 to 64) | 5–20 min | Undefined |
Shyu et al. [20] and Taiwan N/A—developed by author | SAFE Construct: Falls Risk Awareness | n = 600 adults mean age 70.22 years ± 14.83 Cognitively intact | Inpatients from three medical university hospitals | 21-items (four subfactors measuring awareness of activity safety and environment, awareness of physical functions, awareness of medication, awareness of cognitive behaviour) | A 5-pt Likert scale was used to rate awareness levels from 1 = strongly agree to 5 = strongly disagree | Higher scores indicate a high level of falls risk awareness (Score range from 21 to 105) | 30-min face to face interview | Undefined |
Twibell et al. [51] and USA N/A—developed by author | Confidence to Perform Without Falling Scale Fear of Falling While Hospitalized Scale Consequences of Falling While Hospitalized Scale Intention to Engage in Fall Prevention Scale Perceived Likelihood of Falling While Hospitalized Perceived likelihood of injury if they did fall while hospitalized Perceived fear of falling | n = 158 adults mean age 69.9 years ± 13.37 Cognitively intact | Acute care units | 7-items 7-items 12-items 9-items Single item Single item Single item | 5-pt Likert scale from 1 = strongly disagree to 5 = strongly agree 4-pt Likert scale from 1 = not at all concerned to 4 = very concerned 4-pt Likert scale from 1 = strongly disagree to 4 = strongly agree 5-pt Likert scale from 1 = strongly disagree to 5 = strongly agree 5-pt Likert scale from 1 = not at all likely to 5 = very likely 5-pt Likert scale from 1 = not at all likely to 5 = very likely 5-pt Likert scale from 1 = not at all likely to 5 = very likely | Higher scores indicate higher confidence (Score range from 7 to 35) Higher scores indicate higher concern (Score range from 7 to 28) Higher scores indicate higher awareness of consequences (Score range from 7 to 28) Higher scores show increased intention to engage (Score range from 9 to 45) As per scale title As per scale title As per scale title | Not reported | Undefined Undefined Undefined Undefined Undefined Undefined Undefined |
1Visschedijk et al. [52] and the Netherlands Original author of FES-I: Yardley et al. [38] | FES-I Construct: Concern for falling | Group 1, n = 100 adults following a hip fracture, mean age 83.1 years ± 8.3 19% had short-term memory impairment 6% had long-term memory impairment | Skilled nursing facility | 16-items | Scores for individual activities ranged from 1 (not at all concerned) to 4 (very concerned) | High scores indicate high concern about falling (Score range from 16 to 64) | 3–4 min | Undefined |
1Wiens et al. [53] and Canada N/A—developed by author | Falls Risk Awareness Questionnaire (FRAQ) Construct: Awareness and perception of risk factors for falling | n = 50 hospitalised respondents, mean age 80 years ± 7.4 Cognitive status not reported, however one person was noted to have Alzheimer’s disease | Acute care and rehabilitation (two separate hospitals) | 19-multiple choice questions | Multiple choice questions to assess awareness or perception of select characteristics | Answers were weighted, providing a maximum total score of 24 points, in which a higher score indicates higher awareness of risk factors | 15 min | Undefined |