Key result
FES-I and short FES-I show high reliability for assessing fear of falling in late-effect polio.
Why the study?
Fear of falling is common in persons with late effects of polio, but there is limited knowledge about the measurement properties of the Falls Efficacy Scale-International in this population.
What are the measurement properties of the FES-I and short FES-I in persons with late effects of polio?
Cross-Sectional (n=321)
What are the measurement properties of the FES-I and short FES-I in persons with late effects of polio?
The FES-I and short FES-I are reliable and valid tools for assessing fear of falling in patients with late effects of polio.
Supports FES-I use for fear of falling in late polio effects; extends validation but leaves broader adoption open.
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.
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Brogårdh et al. (2022) conducted a cross-sectional in Late effects of polio (LEoP) (n=321). Falls Efficacy Scale-International (FES-I) and short FES-I was evaluated on Measurement properties including unidimensionality, local dependency, targeting, Differential Item Functioning, and reliability. The FES-I and short FES-I demonstrated sufficient measurement properties and high reliability (PSI >0.86) for assessing fear of falling in persons with late effects of polio.
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