Cross-cultural validation of the Falls Efficacy Scale International (FES-I) in Greek community-dwelling older adults

Abstract

Purpose. The cross-cultural adaptation and validation of Falls Efficacy Scale-International (FES-I) in community-dwelling seniors in Greece.

Method. For cross-cultural adaptation, the back-translation procedure was utilised by four bi-lingual translators. For validation, 89 community-dwellings (50 males, 39 females) aged 61–90 years old (mean: 72.87  ±  6.04) completed four questionnaires adapted into Greek; two instrument specific ones, FES-I and Confidence in Maintaining Balance (CONFbal), and two generic Questionnaires, Short-form Health Survey (SF-36v2) and General Health Questionnaire (GHQ30). Additionally, three functional/balance tests were compared against the FES-I. All questionnaires and measurements were repeated after 7–10 days to explore repeatability.

Results. Content validity was achieved as all participants found the questionnaire appropriate and comprehensible. Validity of the FES-I yielded moderate to strong correlations with CONFbal (r  ==  0.694, p<0.01), three SF-36 subscales (r ranging between 0.560 and 6.55, p<0.01), GHQ30 (r  ==  0.584, p<0.01) and one functional test (r  ==  0.638, p<0.01 for Timed Up and Go test). FES-I's test–retest reliability (ICC:0.951, SEM: 1.79, SDD:20.44%%, r  ==  0.950) and internal consistency (Cronbach's α  ==  0.925) were excellent, and responsiveness across fallers and non-fallers yielded a large effect size (0.89), indicating good discriminant validity.

Conclusions. The Greek FES-I was valid, reliable, comprehensible and acceptable for the sample tested and may thus, be used in cross-cultural rehabilitation research and practice.

Keywords:

• Falling
• FES-I
• Greece
• community-dwelling
• elderly

Acknowledgements

The authors are grateful to the FES-I's developers within ProFaNE, who provided assistance on the cross-cultural adaptation process; in particular, they would like to thank Lucy Yardley and Gertrudis Kempen for their help and support. They would also like to thank the three KAPIs (KAPIs of Kanapiatsa, A’ & B’) of Municipality of N. Iraklion, Athens, for their assistance in recruiting the participants.

Declaration of interest

This research has been partly funded by grants from the EC and the Ministry of National Education and Religious Affairs of Greece (via ‘Archimedes II’ research project). The Greek version of the SF-36v2 was provided by QualitiMetric Incorporated (license agreement number: F1-063004-19356).

Note

1. KAPI in Greek is an acronym for Centres for Open Protection of the Elderly. They were established in 1979 for communitydwelling older people in Greece. Their aims are (i) to prevent biological, psychological and social problems in order to maintain their autonomy and independence as well as encourage them to continue to be active members of society, (ii) to inform them on the availability of specialized services for them, and also to inform the involved health professionals on Cross-cultural adaptation of the FES-I into Greek 7 their particular problems and needs, so that they can work together to overcome them and (iii) to promote research in older people.