The Clinimetric Properties of Instruments Measuring Home Hazards for Older People at Risk of Falling: A Systematic Review

Abstract

Home hazards are associated with falls among older people living in the community. However, evaluating home hazards is a complex process as environmental factors vary according to geography, culture, and architectural design. As a result, many health practitioners commonly use nonstandardized assessment methods that may lead to inaccurate findings. Thus, the aim of this systematic review was to identify standardized instruments for evaluating home hazards related to falls and evaluate the clinimetric properties of these instruments for use by health practitioners. A systematic search was conducted in the Medline, CINAHL, AgeLine, Web of Science databases, and the University of Sydney Library CrossSearch Engine. Study screening, assessment, and quality ratings were conducted independently. Thirty-six studies were identified describing 19 instruments and three assessment techniques. The clinimetric properties varied between instruments. The Home Falls and Accidents Screening Tool, Home Safety Self-Assessment Tool, In-Home Occupational Performance Evaluation, and Westmead Home Safety Assessment were the instruments with high potential for evaluating home hazards associated with falls. Health practitioners can choose the most appropriate instruments for their practice, as a range of standardized instruments with established clinimetric properties are available.

The interrater and test‐retest reliability of the Home Falls and Accidents Screening Tool (HOME FAST) in Malaysia: Using raters with a range of professional backgrounds

“…It is possible that a rater from a nonhealth background may not be able to accurately score the HOME FAST. The HOME FAST has demonstrated psychometric properties and it has a smaller number of items; therefore, it may be easy to use in terms of training and requires less time to complete, which may be preferable for clinicians . In addition, a pilot study conducted with the research assistants of the Malaysian Elders Longitudinal Research (MELoR) project indicated the HOME FAST was feasible to be used as clinical and research tool in the Malaysian context …”

“…In addition, Terwee et al indicated that one of the important aspects in establishing psychometric properties of an assessment tool is the ability of the tool to be generalised for practice and in cross‐cultural practice. However, many home hazard assessment tools lack generalisability to other cultural contexts and lack the capacity for the tools to be used by people from a variety of backgrounds …”

“…However, many home hazard assessment tools lack generalisability to other cultural contexts and lack the capacity for the tools to be used by people from a variety of backgrounds. 9 2 | LITERATURE REVIEW A systematic review investigating the clinimetric properties of home hazards instruments found that the Home Falls and Accidents Screening Tool (HOME FAST) had strong evidence to support its use. 9 The HOME FAST was developed in Australia and first published in 2000 by Mackenzie et al 10 The HOME FAST is a 25-item tool and was developed out of 142 items pooled from a literature review and selected using a cross-sectional survey and expert panel focus group discussion to demonstrate content validity.…”

“…9 2 | LITERATURE REVIEW A systematic review investigating the clinimetric properties of home hazards instruments found that the Home Falls and Accidents Screening Tool (HOME FAST) had strong evidence to support its use. 9 The HOME FAST was developed in Australia and first published in 2000 by Mackenzie et al 10 The HOME FAST is a 25-item tool and was developed out of 142 items pooled from a literature review and selected using a cross-sectional survey and expert panel focus group discussion to demonstrate content validity. 10 The content validity of the HOME FAST has been investigated in the United Kingdom among occupational therapists, physiotherapists, and nurses, 11 and among occupational therapists in Iran.…”

Scoring the home falls and accidents screening tool for health professionals (HOME FAST‐HP): Evidence from one epidemiological study

“…To be effective as a screening tool, the HOME FAST‐HP needs to be able to identify older people with a currently unrecognized or unaddressed home hazard who may be at increased risk of a fall (Büttner & Muller, ). The HOME FAST‐HP has undergone extensive psychometric investigation since it was published (Rigby, Craciunoiu, Steir & Letts, ; Romli, Mackenzie, Lovarini, Tan & Clemson, ), including demonstrating predictive validity in relation to falls in a prospective study (Mackenzie, Byles & D'Este, ).…”