Measurement properties of the Falls Efficacy Scale-International (FES-I) in persons with late effects of polio: A cross-sectional study.
Journal
PM & R : the journal of injury, function, and rehabilitation
ISSN: 1934-1563
Titre abrégé: PM R
Pays: United States
ID NLM: 101491319
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
revised:
29
04
2022
received:
28
12
2021
accepted:
13
05
2022
medline:
15
6
2023
pubmed:
7
6
2022
entrez:
6
6
2022
Statut:
ppublish
Résumé
Fear of falling (FoF) is very common in persons with late effects of polio (LEoP). An internationally recognized rating scale to assess FoF is the Falls Efficacy Scale-International (FES-I). Yet, there is limited knowledge about its measurement properties in persons with LEoP. To investigate the measurement properties of the FES-I (16-item version) and the short FES-I (7-item version) in persons with LEoP. Explorative factor analysis and Rasch model analysis of cross-sectional data. University hospital. A total of 321 persons with LEoP (mean age ± standard deviation [SD] 70 ± 10 years, 173 women). The FES-I and the short FES-I, comprising four response options about concerns of falling ranging from 1 (not at all concerned) to 4 (very concerned). Data were collected by a postal survey. First, a factor analysis was performed to investigate the unidimensionality of the scale. Thereafter, a Rasch model analysis was used to further analyze the measurement properties of the FES-I and the short FES-I, such as local dependency, targeting, hierarchical order of items, Differential Item Functioning (DIF), response category functioning and reliability (Person Separation Index, PSI). Raw score transformation to interval measurements was also performed. The factor analysis revealed that the FES-I was unidimensional, even though the Rasch analysis showed some misfit to the Rasch model and local dependency. Targeting for the FES-I and the short FES-I was somewhat suboptimal as the participants on average reported less FoF than expected. A negligible gender DIF was found for two items in the FES-I and for one item in the short FES-I. Reliability was high (PSI >0.86), and the response category thresholds worked as intended for both the FES-I and the short FES-I. The FES-I and the short FES-I have sufficient measurement properties in persons with LEoP. Both versions can be used to assess fear of falling (or FoF) in this population.
Sections du résumé
BACKGROUND
Fear of falling (FoF) is very common in persons with late effects of polio (LEoP). An internationally recognized rating scale to assess FoF is the Falls Efficacy Scale-International (FES-I). Yet, there is limited knowledge about its measurement properties in persons with LEoP.
OBJECTIVE
To investigate the measurement properties of the FES-I (16-item version) and the short FES-I (7-item version) in persons with LEoP.
DESIGN
Explorative factor analysis and Rasch model analysis of cross-sectional data.
SETTING
University hospital.
PARTICIPANTS
A total of 321 persons with LEoP (mean age ± standard deviation [SD] 70 ± 10 years, 173 women).
MAIN OUTCOME MEASUREMENT
The FES-I and the short FES-I, comprising four response options about concerns of falling ranging from 1 (not at all concerned) to 4 (very concerned).
METHODS
Data were collected by a postal survey. First, a factor analysis was performed to investigate the unidimensionality of the scale. Thereafter, a Rasch model analysis was used to further analyze the measurement properties of the FES-I and the short FES-I, such as local dependency, targeting, hierarchical order of items, Differential Item Functioning (DIF), response category functioning and reliability (Person Separation Index, PSI). Raw score transformation to interval measurements was also performed.
RESULTS
The factor analysis revealed that the FES-I was unidimensional, even though the Rasch analysis showed some misfit to the Rasch model and local dependency. Targeting for the FES-I and the short FES-I was somewhat suboptimal as the participants on average reported less FoF than expected. A negligible gender DIF was found for two items in the FES-I and for one item in the short FES-I. Reliability was high (PSI >0.86), and the response category thresholds worked as intended for both the FES-I and the short FES-I.
CONCLUSION
The FES-I and the short FES-I have sufficient measurement properties in persons with LEoP. Both versions can be used to assess fear of falling (or FoF) in this population.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
751-760Informations de copyright
© 2022 The Authors. PM&R published by Wiley Periodicals LLC on behalf of American Academy of Physical Medicine and Rehabilitation.
Références
Bickerstaffe A, Beelen A, Nollet F. Circumstances and consequences of falls in polio survivors. J Rehabil Med. 2010;42:908-915.
Brogardh C, Lexell J. Falls, fear of falling, self-reported impairments, and walking limitations in persons with late effects of polio. PM R. 2014;6:900-907.
Nam KY, Lee S, Yang EJ, et al. Falls in Korean polio survivors: incidence, consequences, and risk factors. J Korean Med Sci. 2016;31:301-309.
Imoto D, Sawada K, Horii M, et al. Factors associated with falls in Japanese polio survivors. Disabil Rehabil. 2020;42:1814-1818.
Wekre LL, Stanghelle JK, Lobben B, Oyhaugen S. The Norwegian polio study 1994: a nation-wide survey of problems in long-standing poliomyelitis. Spinal Cord. 1998;36:280-284.
McNalley TE, Yorkston KM, Jensen MP, et al. Review of secondary health conditions in postpolio syndrome: prevalence and effects of aging. Am J Phys Med Rehabil. 2015;94:139-145.
Brogardh C, Flansbjer UB, Lexell J. Determinants of falls and fear of falling in amulatory persons with late effects of polio. PM R. 2017;9:455-463.
Legters K, Verbus NB, Kitchen S, Tomecsko J, Urban N. Fear of falling, balance confidence and health-related quality of life in individuals with postpolio syndrome. Physiother Theory Pract. 2006;22:127-135.
Brogardh C, Lexell J. How various self-reported impairments influence walking ability in persons with late effects of polio. NeuroRehabilitation. 2015;37:291-298.
Mohammad AF, Khan KA, Galvin L, Hardiman O, O′Connell PG. High incidence of osteoporosis and fractures in an aging post-polio population. Eur Neurol. 2009;62:369-374.
Sherf RM, Cantrell D, Or K, et al. The risk of bone fractures in post-poliomyelitis patients transitioning to middle adulthood. Endocr Pract. 2020;26:1277-1285.
Brogårdh C, Lexell J, Hammarlund CS. Experiences of falls and strategies to manage the consequences of falls in persons with late effects of polio: a qualitative study. J Rehabil Med. 2017;49:652-658.
Silver JK, Aiello DD. Polio survivors: falls and subsequent injuries. Am J Phys Med Rehabil. 2002;81:567-570.
Galvão TS, Magalhães Júnior ES, Orsini Neves MA, de Sá FA. Lower-limb muscle strength, static and dynamic postural stabilities, risk of falling and fear of falling in polio survivors and healthy subjects. Physiother Theory Pract. 2020;36:899-906.
Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990;45:P239-P243.
Winberg C, Brogardh C, Flansbjer UB, Carlsson G, Rimmer J, Lexell J. Physical activity and the association with self-reported impairments, walking limitations, fear of falling, and incidence of falls in persons with late effects of polio. J Aging Phys Act. 2015;23:425-432.
Matsuda PN, Eagen T, Hreha KP, Finlayson ML, Molton IR. Relationship between fear of falling and physical activity in people aging with a disability. Pm&R. 2020;12:454-461.
Brogårdh C, Lexell J, Sjödahl HC. Fall-related activity avoidance among persons with late effects of polio and its influence on daily life: a mixed-methods study. Int J Environ Res Public Health. 2021;18:7202. doi:10.3390/ijerph18137202
Delbaere K, Close JCT, Mikolaizak AS, Sachdev PS, Brodaty H, Lord SR. The falls efficacy scale international (FES-I). A comprehensive longitudinal validation study. Age Ageing. 2010;39:210-216.
Helbostad JL, Taraldsen K, Granbo R, Yardley L, Tood CJ, Sletvold O. Validation of the falls efficacy scale-international in fall-prone older persons. Age Ageing. 2010;39:256-259.
Halvarsson A, Ståhle A. Psychometric properties of the Swedish version of the falls efficacy scale-international for older adults with osteoporosis, self-reported balance deficits and fear of falling. Disabil Rehabil. 2018;40:2658-2661.
Hauer KA, Kempen GIJM, Schwenk M, et al. Validity and sensitivity to change of the falls efficacy scales international to assess fear of falling in older adults with and without cognitive impairment. Gerontology. 2011;57:462-472.
van Vliet R, Hoang P, Lord S, Gandevia S, Delbaere K. Falls efficacy scale-international: a cross-sectional validation in people with multiple sclerosis. Arch Phys Med Rehabil. 2013;94:883-889.
Jonasson SB, Ullén S, Iwarsson S, Lexell J, Nilsson MH. Concerns about falling in Parkinson's disease: association with disabilities and personal and environmental factors. J Parkinsons Dis. 2015;5:341-349.
Abou L, Alluri A, Fliflet A, Du Y, Rice LA. Effectiveness of physical therapy interventions in reducing fear of falling among individuals with neurologic diseases: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2021;102:132-154.
Kempen GIJM, Yardley L, van Haastregt JCM, et al. The short FES-I: a shortened version of the falls efficacy scale-international to assess fear of falling. Age Ageing. 2008;37:45-50.
Jonasson SB, Nilsson MH, Lexell J. Psychometric properties of the original and short versions of the falls efficacy scale-international (FES-I) in people with Parkinson's disease. Health Qual Life Outcomes. 2017;15:116. doi:10.1186/s12955-017-0689-6
Mazumder R, Lambert WE, Nguyen T, Bourdette DN, Cameron MH. Fear of falling is associated with recurrent falls in people with multiple sclerosis: a longitudinal cohort study. Int J MS Care. 2015;17:164-170.
Wright BD, Linacre JM. Observations are always ordinal: measurement, however, must be interval. Arch Phys Med Rehabil. 1989;70:857-860.
Richard LG. Exploratory factor analysis: its role in item analysis. J Pers Assess. 1997;68:532-560.
Smith EJ. Metric development and score reporting in Rasch measurement. J Appl Meas. 2000;1:303-326.
Kempen GI, Todd CJ, Van Haastregt JC, et al. Cross-cultural validation of the falls efficacy scale international (FES-I) in older people: results from Germany, The Netherlands and the UKwere satisfactory. Disabil Rehabil. 2007;29:155-162.
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 Ageing. 2005;34:614-619.
Lorenzo-Seva U, Ferrando P. FACTOR: a computer program to fit the exploratory factor analysis model. Behav Res Methods. 2006;38:88-91.
Gadermann A, Guhn M, Zumbo B. Estimating ordinal reliability for Likert-type and ordinal item response data: a conceptual, empirical, and practical guide. Pract Assess Res Eval. 2012;17:1-13.
Baglin J. Improving your exploratory factor analysis for ordinal data: a demonstration using FACTOR. Pract Assess Res Eval. 2014;19:5.
Beavers AS, Lounsbury JW, Richards JK, Huck SW, Skolits GJ. Practical considerations for using exploratory factor analysis in educational research. Pract Assess Res Eval. 2013;18:1-13.
Gie Yong A, Pearce S. A Beginner's guide to factor analysis: focusing on exploratory factor analysis. Tutor Quant Methods Psychol. 2013;9:79-94.
Rasch G. Probablistic Models for some Intelligence and Attainment Tests. University of Chicago Press; 1960.
Andrich D, Pedler P. A law of ordinal random error: the Rasch mea-surement model and random error distributions of ordinal assessments. Measurement. 2019;131:771-781.
Masters GN. A rasch model for partial credit scoring. Psychometrika. 1982;47:149-174.
Smith EV. Detecting and evaluating the impact of multidimensionality using item fit statistics and principal component analysis of residuals. J Appl Meas. 2002;3:205-231.
Tennant A, Pallant J. Unidimensionality matters. Rasch Measur Trans. 2006;20:1048-1051.
Marias I, Andrich D. Formalizing dimension and response violations of local independence in the unidimensional Rasch model. J Appl Meas. 2008;9:200-215.
Hobart J, Cano S. Improving the evaluation of therapeutic interventions in multiple sclerosis: the role of new psychometricmethods. Health Technol Assess. 2009;13:177.
Hagquist C, Bruce M, Gustavsson JP. Using the Rasch model in nursing research: an introduction and illustrative example. Int J Nurs Stud. 2009;46:380-393.
Hudgens S, Dineen K, Webster K, Lai J, Cella D. Assessing statistically and clinically meaningful construct deficiency/saturation:recommended criteria for content coverage and item writing. Rasch Measur Trans. 2004;17:954-955.
Hagquist C, Andrich D. Recent advances in analysis of differentialitem functioning in health research using the Rasch model. Health Qual Life Outcomes. 2017;15:181.
Andrich D, Marais I. A Course in Rasch Measurement Theory: Measuring in the Educational, Social and Health Sciences. Springer Nature Singapore Pte Ltd.; 2019.
Smith EV. Evidence for the reliability of measures and validity of measure interpretation: a Rasch measurement perspective. J Appl Meas. 2001;2:281-311.
Smith EV. Metric development and score reporting in Rasch mea-surement. J Appl Meas. 2000;1:303-326.
Wright B, Masters G. Rating Scale Analysis. MESA Press; 1982.
Costello A, Osborne J. Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Pract Assess Res Eval. 2005;10:1-9.
Watson R, Thompson DR. Use of factor analysis in journal of advanced nursing: literature review. J Adv Nurs. 2006;55:330-341.
Ferguson GA. The factorial interpretation of test difficulty. Psychometrika. 1941;6:323-329.
Bond TG, Fox CM. Applying the Rasch Model. Fundamental Measurement in the Human Sciences. Taylor and Francis; 2010.
Mundfrom DJ, Shaw DG, Ke TL. Minimum sample size recommendations for conducting factor analyses. Int J Test. 2005;5:159-168.
Linacre JM. Sample size and item calibration stability. Rasch Meas Trans. 1994;7:328.