Reliability and Validity of Caregivers' Fear of Falling Index When Caring for Home-Based Rehabilitation Patients With Fall-Related Fractures

Assessment tools of the fear of falling: A scoping review

AIM

To comprehensively evaluate and synthesize fear of falling assessment tools and their psychometric properties.

METHODS

The literature in PubMed, Web of Science Core Collection, Cochrane Library, Embase, Google Scholar, CNKI, Wanfang, VIP, and CBM was systematically searched, and the search period was from the establishment of the database to September 1, 2023, and updated on September 1, 2024.

RESULTS

A total of 104 documents covering 19 assessment tools were included. Of the 19 instruments, the Falls Efficacy Scale-International was the most widely used and had been tested for reliability and validity in different countries and populations. A total of 18 studies focused on tool development and validation, and the remaining 86 were related to tool validation.

CONCLUSION

Scientific and reliable assessment instruments for FOF are an important part of future targeted intervention research. The future research direction of tools should be based on local demographic characteristics and qualitative interview results, combined with objective quantitative indicators measured by professional instruments.

Association between Caregivers' Fear of Post-fracture Patients Falling and a Decline in Patients' Activities

Objectives

To evaluate caregivers' fear of post-fracture patients falling, we previously developed the Caregivers' Fear of Falling Index (CFFI). In this study, we investigated the relationship between patient performance in activities of daily living (ADLs) and CFFI.

Methods

We surveyed 55 patients receiving home-visit rehabilitation after fall-related fracture and their primary caregivers. Participants (patient and caregiver pair) were divided into two groups based on patient performance in basic ADLs (BADLs) and instrumental ADLs (IADLs). ROC analysis was conducted to assess the usefulness of CFFI and Falls Efficacy Scale-International (FES-I) in determining declines in performance in BADLs and IADLs. Multivariate logistic regression analysis was performed to examine the association between CFFI and declining performance in BADLs and IADLs.

Results

ROC analysis showed that CFFI exhibited a higher accuracy than FES-I (AUC: 0.73 in BADLs, 0.77 in IADLs) as an indicator of reduced ADL performance. Multivariate logistic analysis adjusted for age, sex, and physical function showed that CFFI was associated with a decline in patients' performance in IADLs (odds ratio, 0.92; 95% confidence interval, 0.85-0.99).

Conclusions

Caregivers' fear of post-fracture patients falling was associated with a decline in patients' performance in IADLs. These findings may serve as a guide for supporting caregivers of post-fracture patients.