Falls Efficacy Scale-International: Exploring psychometric properties with adult day care users

The majority of validation studies with the Falls Efficacy Scale-International (FES-I) are conducted with independent community-dwelling older people, which limits extrapolation to more vulnerable people, namely those receiving adult day care services. This study aimed to analyse the psychometric properties of the FES-I in terms of internal consistency, test-retest reliability, concurrent and convergent validity with users of adult day care centres. A cross-sectional study was conducted. Data collection included a socio-demographic questionnaire, the FESI, the Activities-specific Balance Confidence Scale (ABC), the Hospital Anxiety and Depression Scale (HADS), the Timed Up and Go test (TUG) and the Five Times Sit to Stand Test (FTSST). Descriptive and inferential analyses were performed. A total of 100 users of adult day care centres (81.94 +/- 6.43 years old; 77% female) have participated. The FES-I had excellent internal consistency (alpha = 0.970) and test-retest reliability (ICC2,1 = 0.979). A significant negative correlation was found between the FES-I and the ABC (r(s) = -0.828; p < 0.001), suggesting good concurrent validity. FES-I scores were significantly higher among those who were female, had less educational levels and reported having fear of falling. Significant correlations were found between FES-I and age (r(s) = 0.217; p < 0.05), HADS-Anxiety (r(s) = 0.486; p < 0.001), HADS-Depression (r(s) = 0.658; p < 0.001), TUG (r(s) = 0.653; p < 0.001) and FTSST (r(s) = 0.635; p < 0.001), indicating acceptable convergent validity. The FES-I is a reliable and valid instrument to assess concern about falling among users of adult day care centres. The findings are highly comparable with those previously found for non-users. FES-I can be used to prevent risk of falls in this type of care settings.