Reliability, validity, and clinical utility of a self-reported screening tool in the prediction of fall incidence in older adults

Abstract

Background: The Chinese HomeFAST self-reported screening tool was developed to measure the number of hazards and the risk of home falls and other accidents for community-living older adults.Methods: This reliability, validity, and clinical utility study consisted of three phases. The tool’s linguistic validity was established in the first phase of study, with a panel of domiciliary healthcare experts. In the second phase, the instrument yielded inter-rater reliability between community-living older adults and a group of experienced occupational therapists. Furthermore, in the third phase of study, factor analysis of the Chinese Home-FAST self-reported screening tool was conducted.Results: There was good linguistic validity, test-retest reliability and good to excellent internal consistency of the Chinese Home-FAST self-reported screening tool among older adults living in the community. Moreover, a structure with three factors – namely “Home Environment and Furniture,” “Capability in Activities of Daily Living,” and “Use of Devices” – was yielded from categorical principal components analysis. Clinically, the incidence of falls among this group of recruited older adults in a six-month period was 18%. The identification of seven or more hazards was associated with prediction of unplanned fall-related hospital admission with sensitivity of 83.33% and specificity of 95.83%. Conclusion: The Chinese HomeFAST self-reported screening tool is thus demonstrated to be a valid and reliable tool for measuring home hazards and can predict home falls in Chinese-speaking older adults.

Implications for rehabilitation

• To develop an easily understandable screening tool for older adults.

• Older adults can perform home safety screening on their own, and can identify potential risk of falls and other accidents at home.

• This can serve as a communication tool between older adults and healthcare professionals.

• Identified hazards can be reported to healthcare professionals for further intervention.

• This validated instrument can help healthcare professionals to identify higher-risk older adults in the community and thus to better prioritize their provision of professional services.

Keywords:

• Reliability
• validity
• home safety
• self-reported assessment
• home safety
• fall prevention
• procedures

Disclosure statement

The authors report no declarations of interest.