Measuring Fear of Falling in Thai Community-dwelling Older Adults with a New Measure

Main Article Content

Sutthida Phongphanngam
Helen W Lach
Sangduen Phomkaewngam
Sutthilak Chantawang

Abstract

          Fear of falling (FOF) is a major problem for community-dwelling older adults, which can lead to activity restrictions and contribute to disability. The FOF Questionnaire (FFQ) was developed for the assessment of FOF based on Lazarus and Izzards’s conceptual definitions of fear and appraisals of harm. Later, the shorter FFQ was developed and has been translated into the Thai language. The purposes of this study were to explore the psychometric properties of the Thai Short-FFQ and examine FOF in Thai older adults living in a community. A total of 330 Thai community-dwelling older adults completed the survey (64.8% female, aged 69.92±7.11 years). A high number of Thai older adults reported FOF (93.6%) with a high mean FOF rating of 7.16 (SD=2.65) on a 1-10 scale. The reliability of the Thai Short-FFQ was examined as well as the construct, concurrent, convergent, and divergent validity.  Principle component factor analysis confirmed that the short scale had one component, “harm outcomes,” explained 68.72% of the variance. The mean score was 20.83 (SD=2.9; range11-24), with a Cronbach’s alpha of .91. This Thai Short-FFQ had a significant moderate correlation with the FOF rating 1-10 (r=.3, p<.001) and the Falls Efficacy Scale-International (r=.46,p<.001), whereas it had a low correlation with the Thai Geriatric Anxiety Scale (r=.25, p<.001). The relationship between the Thai Short-FFQ and the Center for Epidemiology Studies Depression (CESD) scale was not statistically significant (r=-.05). Multiple regression analyses indicated that visual impairment, concern about falls, and anxiety were significantly associated with the Thai Short-FFQ (R2=.23, Adjusted R2=.23, F (3, 326) = 33.05, p< .001). The findings suggest that the Thai Short-FFQ has excellent psychometric properties and is valid to use in further research aimed at assessing the FOF in terms of appraisals of harm falls this might cause to Thai community-dwelling older adults.

Downloads

Download data is not yet available.

Article Details

Section
บทความวิจัย (Research articles)

References

1) Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). American Journal of Preventive Medicine, 10(2), 77-84.

2) Brustio, P. R., Magistro, D., Zecca, M., Liubicich, M. E., & Rabaglietti, E. (2018). Fear of falling and activities of daily living function: mediation effect of dual-task ability. Aging ment health, 22(6), 856-861. doi: 10.1080/13607863.2017.1318257

3) Chang, H. T., Chen, H. C., & Chou, P. (2016). Factors associated with fear of falling among community-dwelling older adults in the Shih-Pai study in Taiwan. PloS One, 11(3), e0150612. doi: 10.1371/journal.pone.0150612

4) Choi, K., Jeon, G. S., & Cho, S. I. (2017). Prospective study on the impact of fear of falling on functional decline among community dwelling elderly women. International Journal of Environmental Research and Public Health, 14(5). doi: 10.3390/ijerph14050469

5) Clemson, L., Kendig, H., Mackenzie, L., & Browning, C. (2015). Predictors of injurious falls and fear of falling differ: an 11-year longitudinal study of incident events in older people. Journal of Aging and Health, 27(2), 239-256. doi: 10.1177/0898264314546716

6) Dayhoff, N. E., Baird, C., Bennett, S., & Backer, J. (1994). Fear of falling: measuring fear and appraisals of potential harm. Rehabilitation Nursing Research, 3(3), 97-104.

7) Gaxatte, C., Nguyen, T., Chourabi, F., Salleron, J., Pardessus, V., Delabrière, I., . . . Puisieux, F. (2011). Fear of falling as seen in the Multidisciplinary falls consultation. Annals of Physical and Rehabilitation Medicine, 54(4), 248-258.

8) Greenberg, S. A. (2012). Analysis of measurement tools of fear of falling for high-risk, community-dwelling older adults. Clinical Nursing Research, 21(1), 113-130.

9) Hill, K. D., Schwarz, J. A., Kalogeropoulos, A. J., & Gibson, S. J. (1996). Fear of falling revisited. Archives of Physical Medicine and Rehabilitation, 77(10), 1025-1029.

10) Hoang, O. T., Jullamate, P., Piphatvanitcha, N., & Rosenberg, E. (2017). Factors related to fear of falling among community-dwelling older adults. Journal of Clinical Nursing, 26(1-2), 68-76. doi: 10.1111/jocn.13337

11) Iaboni, A., Banez, C., Lam, R., Jones, S. A., Maki, B. E., Liu, B. A., & Flint, A. J. (2015). Depression and outcome of fear of falling in a falls prevention program. American Journal of Geriatric Psychiatry. doi: 10.1016/j.jagp.2015.02.006

12) Jefferis, B. J., Iliffe, S., Kendrick, D., Kerse, N., Trost, S., Lennon, L. T., . . . Whincup, P. H. (2014). How are falls and fear of falling associated with objectively measured physical activity in a cohort of community-dwelling older men? BMC Geriatrics, 14, 114. doi: 10.1186/1471-2318-14-114

13) Jeon, M., Gu, M. O., & Yim, J. (2017). Comparison of walking, muscle strength, balance, and fear of falling between repeated fall group, one-time fall group, and nonfall group of the elderly receiving home care service. Asian Nursing Research, 11(4), 290-296. doi: 10.1016/j.anr.2017.11.003

14) Kempen, G. I., Yardley, L., van Haastregt, J. C., Zijlstra, G., Beyer, N., Hauer, K., & Todd, C. (2008). The Short FES-I: a shortened version of the falls efficacy scale-international to assess fear of falling. Age and Ageing, 37(1), 45-50.
doi: https://dx.doi.org/10.1093/ageing/afm157

15) Khuankwai, P. (2007). Factors related to fall among community-dwelling eldery people (Unpubished Master's Thesis). Khon Kaen University, Khon Kaen, Thailand.

16) Lipardo, D. S., Leung, A. Y. M., Gabuyo, C. M. A., Escuadra, C. J. T., Leung, P. A., Aseron, A. M. C., . . . Tsang, W. W. N. (2019). Cross-cultural adaptation and psychometric properties of the Falls Efficacy Scale - International in Filipino community-dwelling older adults. Disability and Rehabilitation, 1-7. doi: 10.1080/09638288.2018.1519045

17) Makino, K., Makizako, H., Doi, T., Tsutsumimoto, K., Hotta, R., Nakakubo, S., . . . Shimada, H. (2018). Impact of fear of falling and fall history on disability incidence among older adults: Prospective cohort study. International Journal of Geriatric Psychiatry, 33(4), 658-662. doi: 10.1002/gps.4837

18) Mueller, A. E., Segal, D. L., Gavett, B., Marty, M. A., Yochim, B., June, A., & Coolidge, F. L. (2015). Geriatric Anxiety Scale: item response theory analysis, differential item functioning, and creation of a ten-item short form (GAS-10). International Psychogeriatrics, 27(7), 1099-1111. doi: 10.1017/s1041610214000210

19) Noimontree, W., & Lach, H. W. (2017). Development of a short version of the fear of falling questionnaire (Short-FFQ). Paper presented at the 23th Annual Graduate Student Association Research Symposium, Saint Louis University.

20) Oh-Park, M., Xue, X., Holtzer, R., & Verghese, J. (2011). Transient versus persistent fear of falling in community-dwelling older adults: Incidence and risk factors. Journal of the American Geriatrics Society, 59(7), 1225-1231.

21) Pallant, J. (2013). SPSS Survival Manual (5th ed. ). New York: McGraw-Hill.Payette, M. C., Belanger, C., Benyebdri, F., Filiatrault, J., Bherer, L., Bertrand, J. A., . . . Grenier, S. (2017). The association between generalized anxiety disorder, subthreshold anxiety symptoms and fear of falling among older adults: preliminary results from a pilot study. Clinical Gerontologist, 40(3), 197-206. doi: 10.1080/07317115.2017.1296523

22) Pett, M. A., Lackey, N. R., & Sullivan, J. L. (2003). Making sense of factor anlysis: The use of analysis for instrument development in health care reserach. United States of America: Sage Publications, Inc.

23) Phongphanngam, S. (2015). Fear of falling and disability among Thai communitt-dwelling older adults (Unpublished Dissertation). Saint Louis University School of Nursing.

24) Phongphanngam, S., & Lach, H. W. (2019). Cross-cultural instrument translation and adaptation: Challengesand Strategies. Pacific Rim International Journal of Nursing Research, 23(2), 170-179.

25) Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401.

26) Sangpring, P., Vongsirinavarat, M., Hiengkaew, V., & Kaewkungwal, J. (2012). Development of a geriatric fear of falling questionnaire for assessing the fear of falling of thai elders. Journal of Physical Therapy Science, 24(4), 359-364.

27) Scheffer, A. C., Schuurmans, M. J., Van dijk, N., Van der hooft, T., & De rooij, S. E. (2008). Fear of falling: Measurement strategy, prevalence, risk factors and consequences among older persons. Age and Ageing, 37(1), 19-24.

28) Schoene, D., Heller, C., Aung, Y. N., Sieber, C. C., Kemmler, W., & Freiberger, E. (2019). A systematic review on the influence of fear of falling on quality of life in older people: is there a role for falls? Clinical Interventions in Aging, 14, 701-719. doi: 10.2147/cia.s197857

29) Segal, D. L., June, A., Payne, M., Coolidge, F. L., & Yochim, B. (2010). Development and initial validation of a self-report assessment tool for anxiety among older adults: the Geriatric Anxiety Scale. Journal of Anxiety Disorders, 24(7), 709-714. doi: 10.1016/j.janxdis.2010.05.002

30) Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics. Boston: Perason.Thiamwong, L. (2011). Psychometric testing of the falls efficacy scale-international (FES-I) in Thai older adults. Songklanakarin medical journal, 29, 277-287.

31) Thiamwong, L., & Suwanno, J. (2017). Fear of falling and related factors in a community-based studyof people 60 years and older in Thailand. International Journal of Gerontology, 11, 80-84.

32) Tinetti, M. E., Richman, D., & Powell, L. (1990). Falls efficacy as a measure of fear of falling. Journals of Gerontology, 45(6), P239-P243.

33) Vorapongsathron, T., Pandii, W., & Traimchaisri, T. (1990). A validity study of the Center for epidemiology studies depression scale. Journal of Clinical Psychology, 21, 26-45.

34) Watkins, M. W. (2006). Determining parallel analysis criteria. Journal of Modern Applied Statistical Methods and Achievements in Experimental Pathology, 5(2), 344-346.

35) Wongpanitkul, K. (2012). Factors related to fear of falling among community-dwelling older adults in Kanchanaburi provine. Faculty of Nursing, Burapha University, Chonburi, Thailand.

36) Yardley, L., Beyer, N., Hauer, K., Kempen, G., Piot-Ziegler, C., & Todd, C. (2005). Development and initial validation of the falls efficacy scale-international (FES-I). Age and Ageing, 34(6), 614-619.