Measuring the Psychological Outcomes of Falling: A Systematic Review

Authors

  • Ellen C. Jørstad MSc,

    1. From the *Warwick Emergency Care and Rehabilitation, Center for Primary Health Care Studies, University of Warwick, Coventry, United KingdomResearch Department, Bethanien-Krankenhaus an der Universität Heidelberg, Heidelberg, GermanyDepartment of Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, GermanyGeriatric Center of the University of Ulm, Ulm, GermanyKadoorie Critical Care Research Center, John Radcliffe Hospital, Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom.
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  • Klaus Hauer PhD,

    1. From the *Warwick Emergency Care and Rehabilitation, Center for Primary Health Care Studies, University of Warwick, Coventry, United KingdomResearch Department, Bethanien-Krankenhaus an der Universität Heidelberg, Heidelberg, GermanyDepartment of Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, GermanyGeriatric Center of the University of Ulm, Ulm, GermanyKadoorie Critical Care Research Center, John Radcliffe Hospital, Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom.
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  • Clemens Becker MD,

    1. From the *Warwick Emergency Care and Rehabilitation, Center for Primary Health Care Studies, University of Warwick, Coventry, United KingdomResearch Department, Bethanien-Krankenhaus an der Universität Heidelberg, Heidelberg, GermanyDepartment of Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, GermanyGeriatric Center of the University of Ulm, Ulm, GermanyKadoorie Critical Care Research Center, John Radcliffe Hospital, Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom.
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  • Sarah E. Lamb DPhil,

    1. From the *Warwick Emergency Care and Rehabilitation, Center for Primary Health Care Studies, University of Warwick, Coventry, United KingdomResearch Department, Bethanien-Krankenhaus an der Universität Heidelberg, Heidelberg, GermanyDepartment of Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, GermanyGeriatric Center of the University of Ulm, Ulm, GermanyKadoorie Critical Care Research Center, John Radcliffe Hospital, Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom.
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  • on behalf of the ProFaNE Group

    1. From the *Warwick Emergency Care and Rehabilitation, Center for Primary Health Care Studies, University of Warwick, Coventry, United KingdomResearch Department, Bethanien-Krankenhaus an der Universität Heidelberg, Heidelberg, GermanyDepartment of Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, GermanyGeriatric Center of the University of Ulm, Ulm, GermanyKadoorie Critical Care Research Center, John Radcliffe Hospital, Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom.
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  • The work for this report was funded by the European Commission (QLRT-2001–02705). The authors are participants in the “Prevention of Falls Network Europe (ProFaNE)” Thematic Network, which is a project within Key Action #6 (The Aging Population and Their Disabilities), part of the European Union's Quality of Life and Management of Living Resources Programme, funded by the European Commission (QLRT-2001–02705). The content of the manuscript does not represent the opinion of the European Community, and the Community is not responsible for any use that might be made of the information presented in the text.

Address correspondence to Ellen C. Jørstad, MSc, Warwick Emergency Care and Rehabilitation, Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom. E-mail: e.c.jorstad@warwick.ac.uk

Abstract

The objectives were to identify fall-related psychological outcome measures and to undertake a systematic quality assessment of their key measurement properties. A Cochrane review of fall-prevention interventions in older adults was used to identify fall-related psychological measurements. PubMed, CINAHL, and PsycINFO were systematically searched to identify instruments not used in trials and papers reporting the methodological quality of relevant measures. Reference lists of articles were searched for additional literature, and researchers were contacted. Two reviewers undertook quality extraction relating to content, population, reliability, validity, responsiveness, practicality, and feasibility. Twenty-five relevant papers were identified. Twenty-three measures met the inclusion criteria: six single-item questions, Falls Efficacy Scale (FES), revised FES, modified FES, FES-UK, Activities-specific Balance and Confidence Scale (ABC), ABC-UK, Confidence in maintaining Balance Scale, Mobility Efficacy Scale, adapted FES, amended FES, Survey of Activities and Fear of Falling in the Elderly (SAFFE), University of Illinois at Chicago Fear of Falling Measure, Concern about Falling Scale, Falls Handicap Inventory, modified SAFFE, Consequences of Falling Scale, and Concern about the Consequences of Falling Scale. There is limited evidence about the measurement properties of single-item measures. Several multiitem measures obtained acceptable reliability and validity, but there is less evidence regarding responsiveness, practicality, and feasibility. Researchers should select measures based on the constructs they intend to study. Further research is needed to establish and compare the instruments' measurement properties.

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