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Measurement properties of the Falls Efficacy Scale-International (FES-I) in persons with late effects of polio : A cross-sectional study

Brogårdh, Christina LU ; Lexell, Jan LU and Westergren, Albert LU (2023) In PM and R 15(6). p.751-760
Abstract

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... (More)

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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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
PM and R
volume
15
issue
6
pages
751 - 760
publisher
Wiley-Blackwell
external identifiers
  • scopus:85136646619
  • pmid:35666019
ISSN
1934-1482
DOI
10.1002/pmrj.12861
language
English
LU publication?
yes
id
e685549e-8c04-46d2-85ab-313c6635ecfc
date added to LUP
2022-10-18 15:41:25
date last changed
2024-07-11 17:10:29
@article{e685549e-8c04-46d2-85ab-313c6635ecfc,
  abstract     = {{<p>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 &gt;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.</p>}},
  author       = {{Brogårdh, Christina and Lexell, Jan and Westergren, Albert}},
  issn         = {{1934-1482}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{751--760}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{PM and R}},
  title        = {{Measurement properties of the Falls Efficacy Scale-International (FES-I) in persons with late effects of polio : A cross-sectional study}},
  url          = {{http://dx.doi.org/10.1002/pmrj.12861}},
  doi          = {{10.1002/pmrj.12861}},
  volume       = {{15}},
  year         = {{2023}},
}