A new measure of fear of falling: psychometric properties of the fear of falling questionnaire revised (FFQ-R)

Abstract

Background Although fear of falling is prevalent among older adults recovering from hip fracture, current instruments are inadequate due to focus on specific situations and measurement of self-efficacy rather than fear. Methods The authors revised and tested a form of the Fear of Falling Questionnaire with three groups of older adults: 405 recovering from hip fracture, 89 healthy community-dwelling, and 42 with severe fear of falling. Test-retest reliability was evaluated in a subsample of 16 hip fracture patients. Internal consistency was compared across all groups Construct validity was established through factor analysis, convergent validity with a measure of fall-related self-efficacy, and discriminant validity with measures of depression and affect. Results A revised two-factor, 6-item scale appears to have adequate psychometric properties. Scores were lower among the healthy comparison group relative to the hip fracture and fear of falling groups. Cronbach’s alphas ranged from .72–.83, with test-retest reliability of .82. Correlations with a measure of fall-related self-efficacy were moderate for the hip fracture group (.42) and high with the healthy comparison (.68) and fear of falling (.70) groups. Correlations with depression, negative, and positive affect were low to moderate. Conclusions The Fear of Falling Questionnaire - Revised shows promise as a self-report measure of fear of falling, and is one of the first to be tested in older adults recovering from hip fracture. Advantages are that it is global rather than situation-specific and measures fear rather than self-efficacy. Future research on this scale is recommended in other older adult samples for whom fear of falling is relevant.

Predictors of Posttraumatic Stress Symptoms and Association with Fear of Falling After Hip Fracture

“…The FFQ also displays good criterion validity by differentiating those who endorse FoF from those who do not. A recent analysis of this measure using this dataset confirmed its utility . The FFQ is completed using a 4‐point scale ranging from strongly disagree to strongly agree for each question.…”

“…Despite other research showing that approximately 4% of elderly adults hospitalized for a fall‐related injury develop PTSD, the current study found that only 3% (n = 11) had probable fPTSD according to the PCL‐S screening measure and that, of these, none met criteria for full diagnosable PTSD using the CAPS. Given the lack of fPTSD and that, in many trauma‐exposed populations, pPTSD is more prevalent than fPTSD and is also associated with significant psychiatric impairment, it was decided to focus on individuals with pPTSD.…”

“…To ensure that reverse‐scored items were counted toward the appropriate categories, the FFQ measure was dichotomized after it was initially scored. For the purpose of reporting rates of FoF, the single item (item 4, “I am afraid of falling again”) that is most characteristic of the entire scale was used. Because FoF is not a construct with an associated diagnosis, the FFQ does not provide a suggested cut‐off score from which to assess presence or absence of FoF.…”

Effects Of Bingocize® On Quality Of Life, Fall Risk, And Health Knowledge In Community-Dwelling Older Adults

“…Another thing to consider about fear of falling is that it is multi-dimensional and strongly correlated to "the perceived threat of falling, perceived risk of falling, concern about the consequences of falls, and fall-related self-efficacy" (Liu, 2015, p. 1). While the FES is considered to be a reliable and valid assessment to use to measure fear of falling, it only captures the perceived self-efficacy dimension of fear of falling in an individual (Bower et at., 2015).…”

Late-life anxiety is coming of age

“…The reverse is also true in that there are age-specific and fear related situations that are insufficiently captured using existing instruments. A prime example is fear of falling, an instrument for which is tested for the first time in a large sample of elderly persons recovering from hip fracture in the current issue (Bower et al, 2015). This issue also contains a review of psychological factors associated with falls-related psychological concerns in community-dwelling older people (by Hughes and colleagues), which further explicates this important topic with respect to late-life anxiety.…”