Cross-cultural validation of the Falls Efficacy Scale International (FES-I) in Greek community-dwelling older adults.

Abstract

The cross-cultural adaptation and validation of Falls Efficacy Scale-International (FES-I) in community-dwelling seniors in Greece.  For cross-cultural adaptation, the back-translation procedure was utilised by four bi-lingual translators. For validation, 89 community-dwellings (50 males, 39 females) aged 61-90 years old (mean: 72.87 ± 6.04) completed four questionnaires adapted into Greek; two instrument specific ones, FES-I and Confidence in Maintaining Balance (CONFbal), and two generic Questionnaires, Short-form Health Survey (SF-36v2) and General Health Questionnaire (GHQ30). Additionally, three functional/balance tests were compared against the FES-I. All questionnaires and measurements were repeated after 7-10 days to explore repeatability.  Content validity was achieved as all participants found the questionnaire appropriate and comprehensible. Validity of the FES-I yielded moderate to strong correlations with CONFbal (r = 0.694, p<0.01), three SF-36 subscales (r ranging between 0.560 and 6.55, p<0.01), GHQ30 (r = 0.584, p<0.01) and one functional test (r = 0.638, p<0.01 for Timed Up and Go test). FES-I's test-retest reliability (ICC:0.951, SEM: 1.79, SDD:20.44%, r = 0.950) and internal consistency (Cronbach's α = 0.925) were excellent, and responsiveness across fallers and non-fallers yielded a large effect size (0.89), indicating good discriminant validity.  The Greek FES-I was valid, reliable, comprehensible and acceptable for the sample tested and may thus, be used in cross-cultural rehabilitation research and practice.