Reliability, construct validity, and clinical feasibility of the activities-specific fall caution scale for residential living seniors.

Abstract

To examine the reliability, validity, and feasibility of the Activities-specific Fall Caution (AFC) Scale. Cross-sectional studies with test-retest and interrater reliability. Residential care facilities in Ontario, Canada: 10 in study 1 and 6 in study 2. Convenience samples of 101 and 31 residents. Not applicable. In study 1, the AFC Scale was readministered to 44 residents, 64 were assessed using the Berg Balance Scale, Timed Up & Go, and Self-Paced Walk Test, and the Nursing Home Life-Space Diameter was completed for 80 residents. In study 2, staff administered the AFC Scale to 31 residents on 2 occasions. In study 1, test-retest reliability (intraclass correlation coefficient [ICC]) was .87 (95% confidence interval, .78-.93). AFC scores were associated with physical performance and mobility patterns (P<.001) and able to discriminate on the basis of gait aid use (P<.001), balance disorders (P<.05), and transfer assistance and walk speed (P<.01). Comparatively, general fear of falling showed weaker associations and a sex bias. In study 2, staff administration was fairly consistent (ICC=.71) and similar associations emerged for AFC scores. The AFC Scale shows good reproducibility, convergent and discriminative validity, and is feasible for clinical as well as research use.