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The reliability and validity of the Survey of Activities and Fear of Falling in the Elderly for assessing fear and activity avoidance among stroke survivors.

ABSTRACT: INTRODUCTION:Activity restriction due to fear of falling is a common problem after a stroke. It can lead to deteriorated physical condition, restricted social participation and deprived quality of life. The Survey of Activities and Fear of Falling in the Elderly (SAFE) was developed to assess these difficulties, and its utility has been demonstrated among the older adults and older people with Parkinson's disease. This study aimed to expand those demonstrations to community-dwelling chronic stroke survivors using a Chinese translation of the instrument. METHODS:One hundred and eight elderly individuals with a history of stroke completed the Chinese version of the SAFE (SAFE-C). The internal consistency of their responses was assessed using Cronbach's alpha. Twenty of the same subjects were reassessed after a 1-week interval to assess the instrument's test-retest reliability. Structure validity was examined by exploratory factor analysis. Pearson correlation was used to establish the instrument's convergent validity with respect to the results from the Chinese version of the Activities-specific Balance Confidence Scale (ABC-C) and the Chinese version of the Lawton Instrumental Activities of Daily Living scale (IADL-C). RESULTS:The items of the SAFE-C demonstrated excellent internal consistency with a Cronbach's alphas of 0.90. The SAFE-C also had excellent test-retest reliability with an overall intra-class correlaton coefficient of 0.91. A 1-factor structure termed "fear avoidance circumstances" was identified and it was shown to be consistent with the original measure developed among community-living older people. The correlations between the SAFE-C and the ABC-C (r = -0.68) and the IADL-C (r = -0.57) confirmed the convergent validity. CONCLUSIONS:Fear avoidance behavior is a homogeneous construct applicable to people with stroke-specific impairments alike. The SAFE-C is a reliable and valid instrument for measuring the level of fear avoidance behavior among community-dwelling stroke survivors. Stroke survivors with good functional mobility revealed a low level of fear and avoidance as measured by the SAFE-C.

SUBMITTER: Liu TW

PROVIDER: S-EPMC6443158 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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The reliability and validity of the Survey of Activities and Fear of Falling in the Elderly for assessing fear and activity avoidance among stroke survivors.

Liu Tai-Wa TW Ng Shamay S M SSM

PloS one 20190401 4

<h4>Introduction</h4>Activity restriction due to fear of falling is a common problem after a stroke. It can lead to deteriorated physical condition, restricted social participation and deprived quality of life. The Survey of Activities and Fear of Falling in the Elderly (SAFE) was developed to assess these difficulties, and its utility has been demonstrated among the older adults and older people with Parkinson's disease. This study aimed to expand those demonstrations to community-dwelling chro ...[more]

PMID: 30934022

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Project description:Introduction:Children with high dental anxiety display uncooperative behavior during dental procedures. Different self-assessment questionnaires are in use to estimate the prevalence of dental fear and anxiety (DFA) in children but they need to be tested for reliability and validity in different populations. Objectives:The aim of this study was to test the reliability and validity of two scales for the assessment of child dental fear and anxiety in a sample of Croatian children. Material and Methods:The sample comprised 202 pairs consisting of children and their mothers (97 boys and 105 girls) aged 5 - 12 years. Two scales were used to assess children's DFA: the Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) and the Modified Child Dental Anxiety Scale - face version (MCDAS-f). The Corah's Dental Anxiety Scale (CDAS) was used in the sample of children's mothers. The average scores of cooperative children and children with behavior management problem (BMP) were compared. Results:Cooperative children displayed significantly lower CFSS-DS scores than children with BMP (M = 28. 46 vs. M = 39. 36; P < 0.001). The average MCDAS-f score was significantly higher in children with BMP than in cooperative children (M = 28. 07 vs. 20. 01; P < 0.001). The CFSS-DS showed high internal consistency (Cronbach's ? = 0. 90), while internal consistency of MCDAS-f was good (? = 0. 73). The maternal CDAS showed good internal consistency (? = 0, 89). The correlations with other self-report measurements of DFS show good validity of all scales. The correlations between CFSS-DS and MCDAS-f were highly significant (r = 0.482; P < 0. 01) as well as the correlations of CFSS-DS and MCDAS-f with CDAS scores (r = 0.223; P < 0. 01 and r = 0.198; P < 0. 01, respectively. Conclusion:The obtained results suggest that both the CFSS-DS scale and the MCDAS-f scale are reliable and valid scales for measuring dental fear and anxiety in children in a sample of Croatian children. The MCDAS-f scale has shown slightly lower internal consistency but it is suitable for use in young children. In addition, the MCDAS-f scale is simple to administer.

Project description:BackgroundFear of falling (FoF) and physical activity (PA) are important psychological and behavioral factors associated with falls. No instrument quantifies the link between these two factors to evaluate the risk of falls. We aimed to design a scale linking FoF with PA (Composite Activities-specific Risk of Falls Scale, CARFS) for people with various disability levels.MethodsFirst, we designed a questionnaire comprising 40 balance-related activities from the International Classification of Functioning, Disability, and Health (ICF) for a pilot survey. Second, participants were interviewed about their activities-specific FoF degree and PA frequency. The participants comprised 30 community-dwelling older adults, hospitalized patients with strokes, and those with spinal cord injuries, each with different disability levels. Third, the content validity of the items was evaluated twice by 12 experienced rehabilitation professionals: one based on experience and the other on the survey responses. Items with a higher than moderate relevance in both evaluations were included in the CARFS. The panel of professionals discussed and voted on the contribution of FoF and PA on the CARF score. Finally, the scale sensitivity in distinguishing disability levels was analyzed to evaluate the population suitability to the CARFS.ResultsThe CARFS included 14 activities. A five-point Likert scale was used to quantify degree of FoF (A) and frequency of PA (B). The CARF score (C), which was determined using the eq. C = A+(4-B) + A × B/2, reflected sensitivity to disability levels in most items.ConclusionsThe CARFS has strong content validity for measuring risk of falls in relation to the FoF and PA of people with various disability levels. It has a potential to provide a guide for designing individualized exercise- and behavior-focused fall prevention programs and enable the precise trtrun 0acking of program effectiveness as a multidimensional outcome measure.

Project description:Purpose: The walk ratio (WR)-the step-length/cadence relation-is a promising measure for gait control. GPS-running watches deliver clinically relevant outcomes including the WR. The aim of this study was to determine test-retest agreement, reliability and concurrent validity of an outdoor WR assessment using a GPS-running watch. Methods: Healthy adults and moderate-high functioning stroke survivors (≥6 months), performed the 1 km-outdoor walk twice using a GPS-running watch (Garmin Forerunner 35, GFR35) and a Step Activity Monitor (SAM 3). Global cognition was assessed using the Montreal Cognitive Assessment. Test-retest agreement and reliability were assessed using Bland-Altman plots, standard error of measurement (SEM), intraclass correlation coefficients (ICCs) and smallest detectable changes (SDCs). Concurrent validity was determined by the mean difference (MD), standard error (SE), mean absolute percentage errors (MAPEs) and Spearman's Rho between GFR35 and SAM3. WR values of the two groups were compared by a Welch's test. A hierarchical multiple regression was performed with the WR as dependent variable and possible predictors as independent variables. Results: Fifty-one healthy adults [median: 60.0 (47.0, 67.0) years) and 20 stroke survivors [mean: 63.1 (12.4) years, median: 76 (30, 146) months post-stroke] were included. Test-retest agreement and reliability were excellent (SEM% ≤ 2.2, ICCs > 0.9, SDC% ≤ 6.1) and concurrent validity was high (MAPE < 5, ρ > 0.7) for those walking ≥ 1 m/s. Walking < 1 m/s impaired accurate step counting and reduced agreement, reliability, and validity. The WR differed between healthy adults and stroke survivors (t = -2.126, p = 0.045). The hierarchical regression model including stroke and global cognition (Montreal Cognitive Assessment, 0-30) explained 25% of the WR variance (ΔR2 = 0.246, p < 0.001). Stroke had no effect (β = -0.05, p = 0.682), but global cognition was a predictor for an altered WR (β = 0.44, p = 0.001). Discussion: The outdoor WR assessment using the GFR35 showed excellent test-retest agreement, reliability and concurrent validity in healthy adults and chronic stroke survivors walking at least 1 m/s. As the WR seems relevant in chronic stroke, future studies should further investigate this parameter.

Dataset Information

The reliability and validity of the Survey of Activities and Fear of Falling in the Elderly for assessing fear and activity avoidance among stroke survivors.

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The reliability and validity of the Survey of Activities and Fear of Falling in the Elderly for assessing fear and activity avoidance among stroke survivors.

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