Development of a Comprehensive Fall Risk Assessment Tool for Older People in Elderly Care Institutions and Its Test
Background Since China officially entered into an aging society in 1999,the issue of population aging has escalated significantly,leading to institutional care becoming a popular option for older people. However,falls among residents are a recurring problem,and the current assessment tools have shown limited effectiveness. Objective To construct a comprehensive fall risk assessment tool for older people in elderly care institutions and verify its reliability and validity. Methods From March to December 2021,the initial item pool of the tool was developed through a literature review,semi-structured interviews and 2 rounds of expert consultation and pre-investigation. Older people and nursing assistants in elderly care facilities were randomly selected to make a survey. SPSS 26.0 and AMOS 26.0 software were used to analyze and evaluate the reliability and validity of the assessment tool. The correlation coefficient method,critical ration,internal consistency test and exploratory factor analysis were used for item analysis and screening. The intrinsic reliability,split-half reliability,scores reliability and inter-item consistency reliability were used to examine the reliability;face validity,content validity,criterion-related validity,contract validity and discriminant validity were used to examine the validity. Results The assessment tools included three sub-instruments:(i)Fall risk assessment scale for older people;(ii)Fall record form for older people;(iii)Daily fall risk checklist for older people. The total Cronbach's alpha coefficient for sub-instrument(i)was 0.73 and the scorer reliability coefficient was 0.85;the exploratory factor analysis extracted three common factors with a cumulative variance contribution of 57.95％;the fit indices of the confirmatory factor model:Chi-square degrees of freedom ratio(x2/df),Goodness of fit index (GFI),adjusted goodness of fit index(AGFI),standardized moderate index(NFI),comparative fit index(CFI),Tucker-Lewis coefficient(TLI),approximation error(RMSEA)were 2.43,0.95,0.91,0.89,0.93,0.91,and 0.07,and discriminant validity is statistically significant(P<0.001). The results of the predictive ability analysis showed an area under the test work characteristic curve(AUC)of 0.87 for Morse Fall Scale(MFS)≥ 55 and 0.84 for MFS ≤ 25. Sub-instrument (ii)and(iii)were evaluated by a combination of experts and nursing assistants to form the final version. Conclusion This study has developed a comprehensive fall risk assessment tool for elderly people in elderly care institutions,which contains three sub-instruments that complement each other to improve the whole pathway from assessment to prevention,with good reliability,validity and predictive ability,and can provide a reference for fall prevention and management in the future.
Accidental fallsAgedElderly care institutionRisk assessment
万方数据
维普
