Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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Psychometric Properties of the Fall Risk Perception Questionnaire-Short Version for Inpatients in Acute Care Hospitals

  • Choi, Jeeeun (Department of Nursing, Asan Medical Center) ;
  • Lee, Sujin (Department of Nursing, Asan Medical Center) ;
  • Park, Eunjin (Department of Nursing, Asan Medical Center) ;
  • Ku, Sangha (Department of Nursing, Asan Medical Center) ;
  • Kim, Sunhwa (Department of Nursing, Asan Medical Center) ;
  • Yu, Wonhye (Department of Nursing, Asan Medical Center) ;
  • Jeong, Eunmi (Department of Nursing, Asan Medical Center) ;
  • Park, Sukhee (Department of Nursing, Asan Medical Center) ;
  • Park, Yusun (College of Nursing, Korea University) ;
  • Kim, Hye Young (College of Nursing, Research Institute of Nursing Science, Jeonbuk National University) ;
  • Kim, Sung Reul (College of Nursing, Korea University Nursing Research Institute, Korea University)
  • Received : 2023.10.05
  • Accepted : 2024.03.25
  • Published : 2024.05.31
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Abstract

Purpose: Patients' perception of fall risk is a promising new indicator for fall prevention. Therefore, a fall risk perception questionnaire that can be used rapidly and repeatedly in acute care settings is required. This study aimed to develop a short version of the fall risk perception questionnaire (Short-FRPQ) for inpatients. Methods: For the psychometric measurements, 246 inpatients were recruited from an acute care hospital. The construct (using confirmatory factor analysis and discriminant validity of each item), convergent, and known-group validities were tested to determine the validity of the Short-FRPQ. McDonald's omega coefficient was used to examine the internal consistency of reliability. Results: In the confirmatory factor analysis, the fit indices of the Short-FRPQ, comprising 14 items and three factors, appeared to be satisfactory. The Short-FRPQ had a significantly positive correlation with the original scale, the Korean Falls Efficacy Scale-International, and the Morse Fall Scale. The risk of falls group, assessed using the Morse Fall Scale, had a higher score on the Short-FRPQ. McDonald's omega coefficient was .90. Conclusion: The Short-FRPQ presents good reliability and validity. As patient participation is essential in fall interventions, evaluating the fall risk perception of inpatients quickly and repeatedly using scales of acceptable validity and reliability is necessary.

Keywords

Acknowledgement

This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) grant funded by the Korea government (Ministry of Science and ICT) [NRF-2021R1F1A1048955]. The funding source was not involved in the study design, data collection, analysis, interpretation of results, preparation of the manuscript, or decision to publish.

References

  1. LeLaurin JH, Shorr RI. Preventing falls in hospitalized patients: State of the science. Clinics in Geriatric Medicine. 2019;35(2):273-283. https://doi.org/10.1016/j.cger.2019.01.007
  2. Heikkila A, Lehtonen L, Junttila K. Fall rates by specialties and risk factors for falls in acute hospital: A retrospective study. Journal of Clinical Nursing. 2023;32(15-16):4868-4877. https://doi.org/10.1111/jocn.16594
  3. Zhao YL, Kim H. Older adult inpatient falls in acute care hospitals: Intrinsic, extrinsic, and environmental factors. Journal of Gerontological Nursing. 2015;41(7):29-43; quiz 44-45.
  4. Spano-Szekely L, Winkler A, Waters C, Dealmeida S, Brandt K, Williamson M, et al. Individualized fall prevention program in an acute care setting: An evidence-based practice improvement. Journal of Nursing Care Quality. 2019;34(2): 127-132. https://doi.org/10.1097/NCQ.0000000000000344
  5. Schoberer D, Breimaier HE, Zuschnegg J, Findling T, Schaffer S, Archan T. Fall prevention in hospitals and nursing homes: Clinical practice guideline. Worldviews on Evidence-Based Nursing. 2022;19(2):86-93. https://doi.org/10.1111/wvn.12571
  6. Choi EJ, Lee YS, Yang EJ, Kim JH, Kim YH, Park HA. Characteristics and risk factors for falls in tertiary hospital inpatients. Journal of Korean Academy of Nursing. 2017; 47(3):420-430. https://doi.org/10.4040/jkan.2017.47.3.420
  7. Rice LA, Ousley C, Sosnoff JJ. A systematic review of risk factors associated with accidental falls, outcome measures and interventions to manage fall risk in non-ambulatory adults. Disability and Rehabilitation. 2015;37(19):1697-1705. https://doi.org/10.3109/09638288.2014.976718
  8. Solares NP, Calero P, Connelly CD. Patient perception of fall risk and fall risk screening scores. Journal of Nursing Care Quality. 2023;38(2):100-106. https://doi.org/10.1097/NCQ.0000000000000645
  9. Dabkowski E, Cooper S, Duncan JR, Missen K. Adult inpatients' perceptions of their fall risk: A scoping review. Healthcare. 2022;10(6):995. https://doi.org/10.3390/healthcare10060995
  10. Dabkowski E, Cooper SJ, Duncan JR, Missen K. Exploring hospital inpatients' awareness of their falls risk: A qualitative exploratory study. International Journal of Environmental Research and Public Health. 2022;20(1):454. https://doi.org/10.3390/ijerph20010454
  11. Opsahl AG, Ebright P, Cangany M, Lowder M, Scott D, Shaner T. Outcomes of adding patient and family engagement education to fall prevention bundled interventions. Journal of Nursing Care Quality. 2017;32(3):252-258. https://doi.org/10.1097/NCQ.0000000000000232
  12. Reuben DB, Gazarian P, Alexander N, Araujo K, Baker D, Bean JF, et al. The strategies to reduce injuries and develop confidence in elders intervention: Falls risk factor assessment and management, patient engagement, and nurse co-management. Journal of the American Geriatrics Society. 2017;65(12):2733-2739. https://doi.org/10.1111/jgs.15121
  13. Tzeng HM, Yin CY. Patient engagement in hospital fall prevention. Nursing Economics. 2015;33(6):326-334.
  14. Gravesande J, Richardson J, Griffith L, Scott F. Test-retest reliability, internal consistency, construct validity and factor structure of a falls risk perception questionnaire in older adults with type 2 diabetes mellitus: A prospective cohort study. Archives of Physiotherapy. 2019;9:14. https://doi.org/10.1186/s40945-019-0065-4
  15. Vivrette RL, Rubenstein LZ, Martin JL, Josephson KR, Kramer BJ. Development of a fall-risk self-assessment for community-dwelling seniors. Journal of Aging and Physical Activity. 2011;19(1):16-29. https://doi.org/10.1123/japa.19.1.16
  16. Choi J, Choi SM, Lee JS, Seo SS, Kim JY, Kim HY, et al. Development and validation of the fall risk perception questionnaire for patients in acute care hospitals. Journal of Clinical Nursing. 2021;30(3-4):406-414. https://doi.org/10.1111/jocn.15550
  17. Kyriazos TA. Applied psychometrics: Sample size and sample power considerations in factor analysis (EFA, CFA) and SEM in general. Psychology. 2018;9(8):2207-2230. https://doi.org/10.4236/psych.2018.98126
  18. Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age and Ageing. 2005; 34(6):614-619. https://doi.org/10.1093/ageing/afi196
  19. Park GB, Cho BL, Kwon IS, Park BJ, Kim T, Cho KY, et al. Reliability and validity of Korean version of Falls Efficacy Scale-International (KFES-I). Journal of the Korean Academy of Rehabilitation Medicine. 2010;34(5):554-559.
  20. Morse JM, Morse RM, Tylko SJ. Development of a scale to identify the fall-prone patient. Canadian Journal on Aging. 1989;8(4):366-377. https://doi.org/10.1017/S0714980800008576
  21. Sung YH, Cho MS, Kwon IG, Jung YY, Song MR, Kim K, et al. Evaluation of falls by inpatients in an acute care hospital in Korea using the Morse Fall Scale. International Journal of Nursing Practice. 2014;20(5):510-517. https://doi.org/10.1111/ijn.12192
  22. Jewell VD, Capistran K, Flecky K, Qi Y, Fellman S. Prediction of falls in acute care using the Morse Fall Risk Scale. Occupational Therapy in Health Care. 2020;34(4):307-319. https://doi.org/10.1080/07380577.2020.1815928
  23. Bagui S, Long T, Bagui S. Selecting the optimal Morse Falls Scale cut-off point for patient fall risk. Health. 2019;11(7): 924-931. https://doi.org/10.4236/health.2019.117074
  24. Park SH, Kim EK. Systematic review and meta-analysis for usefulness of fall risk assessment tools in adult inpatients. Korean Journal of Health Promotion. 2016;16(3):180-191. https://doi.org/10.15384/kjhp.2016.16.3.180
  25. Hair JF Jr, Black WC, Babin BJ, Anderson RE. Multivariate data analysis. 7th ed. Pearson; 2010. p. 1-816.
  26. Kim GS. Analysis structural equation modeling. Hannarae Publishing Co; 2010. p. 1-663.
  27. Kim YJ, Choi KO, Cho SH, Kim SJ. Validity of the Morse Fall Scale and the Johns Hopkins Fall Risk Assessment Tool for fall risk assessment in an acute care setting. Journal of Clinical Nursing. 2022;31(23-24):3584-3594. https://doi.org/10.1111/jocn.16185
  28. Matarese M, Ivziku D, Bartolozzi F, Piredda M, De Marinis MG. Systematic review of fall risk screening tools for older patients in acute hospitals. Journal of Advanced Nursing. 2015;71(6):1198-1209. https://doi.org/10.1111/jan.12542
  29. Montero-Odasso MM, Kamkar N, Pieruccini-Faria F, Osman A, Sarquis-Adamson Y, Close J, et al. Evaluation of clinical practice guidelines on fall prevention and management for older adults: A systematic review. JAMA Network Open. 2021;4(12):e2138911. https://doi.org/10.1001/jamanetworkopen.2021.38911 
  30. Chang WP, Jen HJ, Huang TW. A retrospective cross-sectional study on the risk factors of recurrent falls among inpatients. Journal of Nursing Care Quality. 2022;37(2):E31-E37. https://doi.org/10.1097/NCQ.0000000000000585
  31. Hayes AF, Coutts JJ. Use Omega rather than Cronbach's alpha for estimating reliability. But…. Communication Methods and Measures. 2020;14(1):1-24.  https://doi.org/10.1080/19312458.2020.1718629 
  32. Dunn TJ, Baguley T, Brunsden V. From alpha to omega: A practical solution to the pervasive problem of internal consistency estimation. British Journal of Psychology. 2014;105(3):399-412. https://doi.org/10.1111/bjop.12046
  33. McDonald RP. Test theory: A unified treatment. Psychology Press; 1999. p. 1-498.
  34. Hansen CF, Madsen MO, Warming S, Lind M, Fauno P, Rathcke MW, et al. Pedi-IKDC exhibits questionable measurement properties in a cohort of pediatric patients with ACL rupture. Scandinavian Journal of Medicine and Science in Sports. 2023;33(9):1831-1840. https://doi.org/10.1111/sms.14413
  35. Campo-Arias A, Caamano-Rocha L, Pedrozo-Pupo JC. Spanish version of the Attitude towards COVID-19 Vaccines Scale: Reliability and validity assessment. Journal of Nursing Measurement. 2023;31(2):219-229. https://doi.org/10.1891/JNM-2021-0044
  36. Byrne BM, Baron P, Campbell TL. Measuring adolescent depression: Factorial validity and invariance of the Beck Depression Inventory across gender. Journal of Research on Adolescence. 1993;3(2):127-143.
  37. Kobayashi K, Ando K, Inagaki Y, Suzuki Y, Nagao Y, Ishiguro N, et al. Characteristics of falls in orthopedic patients during hospitalization. Nagoya Journal of Medical Science. 2018;80(3):341-349. https://doi.org/10.18999/nagjms.80.3.341