Cross-cultural Adaptation And Reliability And Validity Test Of Iconographical Falls Efficacy Scale

BackgroundFalls can lead to injuries,related disabilities and premature deaths among the elderly,increasing the financial burden on families and societies.With the acceleration of global aging process,the fall of elderly people have become a worldwide public health problem faced by countries.There are many risk factors for falls.As the population ages,researchers are beginning to pay attention to the impact of psychological factors on falls,while fear of falling(FOF)is one of the risk factors for falls in the elderly.About 50%of fallers had symptoms of fear of falling after falling,forming a vicious circle of"fear of falling-limitedmobility-weakenedphysicalfunction-anxiety/-declineinqualityof life-weaker-more likely to fall".Therefore,the assessment of fear of falling is of great significance to prevent falls.ObjectiveThe assessment of fear of falling is important to prevent falls.This study intends to make cross-cultural adaptation to the Iconographic Falls Efficacy Scale(Icon-FES)and test its reliability and validity among community-dwelling older people in China.MethodsAfter being authorized by Delbaere Kim,according to cross-cultural guidelines,Icon-FES was translated,synthesized,back-translated and reviewed by expert groups,and the Chinese version Icon-FES was initially formed.50 community-dwelling elderly people from Wuhan City,Hubei province,were selected by convenience sampling method to carry out pre-testing,and the items that did not conform to local culture,ambiguous and difficult to understand were modified.From December 2017 to March 2018,elderly people in two communities were selected to conduct a questionnaire survey using the general demographic questionnaire,the Chinese version of Icon-FES and the Chinese version of FES-I(Falls Efficacy Scales-International).The acceptability,reliability and validity of the scale were evaluated.Results(1)This study included a total of 450 elderly people,old age,weight loss,illiteracy,living in elevator room,using walker aids,falling history,chronic diseases and taking more than four kinds of drugs are risk factors for older people who are fear of falling.(2)Acceptability:A total of 475 questionnaires were distributed in this study,and450 were effectively recovered with an effective recovery rate of 94.7%.The average finished time was 1~5 min,the quality of filling was high.(3)Reliability:The Chinese version of Icon-FES has a Cronbach's?coefficient was0.972;The correlation coefficient between each item and total score was 0.252~0.851.After 2weeks,the test-retest reliability was 0.951.(4)Validity:The Spearman-Brown split-half reliability coefficient was 0.947 bydividing the items into two groups.The Spearman rank correlation coefficient between FES-I and Icon-FES was 0.663(P<0.001).The KMO value was 0.942,and the Bartlett spherical test show?~2=17 980.370(P<0.01),which is suitable for exploratory factor analysis.By using principal component analysis,two common factors were obtained after maximum variance rotation.The eigenvalues were greater than 1,and the cumulative variance contribution rate was 67.327%.(5)The short version of Icon-FES shows similar psychometric properties toIcon-FES,both of which can be used to identify,intervene,and evaluate the effect of intervention on fear of falling.ConclusionIcon-FES includes a wide range of daily living activities,and provides vivid context with pictures.It has good acceptability,reliability and validity in measuring the fear of falling among the elderly in community.It can be used as one of the practical evaluation tools.