Reliability, Validity and Clinical Utility of a Self-Reported Home Falls and Accidents Screening Tool for Older People

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Authors (including presenting author) :
LAI FHY(1), FAN SHU(2), Mackenzie L(3), Fong KNK(1), Kranz GS(1), YU KKY(4)
Affiliation :
(1) Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, (2) Occupational Therapy Department, Tai Po Hospital, (3) Faculty of Health Sciences, The University of Sydney, (4) The Salvation Army Tai Po Integrated Service for Senior Citizens
Introduction :
About 40% of falls which occurred in geriatric population are in the presence of home environment hazards. However, assessment and intervention of falls in literature have mainly focused on physical abilities and less attention is given to the environment. Moreover, there is a lack of culturally specific functional-oriented assessments or interventions related to falls in older people. The demand of resources would be huge if healthcare professionals have to attend home visit for every subjects. A proper screening can help us to identify the priorities.
Objectives :
The Chinese Home Fall and Accident Screening Tool (Chinese Home FAST) was developed to screen potential home falls and accidents in geriatric population.
Methodology :
Purposeful sampling strategy was employed in collecting data from subjects with age from 65 or above.
Result & Outcome :
50 older adults were recruited for interrater reliability (ICC = .89, with 95% CI: 0.84-.93). Moreover, a good test-retest reliability with an ICC of .88 (with individual item ICC ranging from .86 to .95 (95% CI: .90 - .94)), and good to excellent internal consistency with Cronbach’s alpha = 0.94. The inter-rater reliability between health professionals and older people in using Chinese HomeFAST was tested by comparing participants’ findings with five experienced occupational therapists. There was good test-retest reliability with an ICC of .84 and good to excellent internal consistency with Cronbach’s alpha = 0.92. 150 participants were recruited through convenient sampling for factor analysis and validity testing. By using Categorical Principal Components Analysis (CatCA), the CHomeFAST-SR resulted in a three factors structure, “Home Environment and Furniture” and “Capability in Activities of Daily Living” and “Use of Devices.” A score of more than seven hazards was associated with prediction of unplanned admissions to hospital due to a fall at home at six-months with sensitivity of 83.3% and specificity of 80.0%. Outcomes: CHomeFAST-SR shown to be a reliable tool to measure home hazards.

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