Development of a scale to assess avoidance behavior due to a fear of falling: The Fear of Falling Avoidance Behavior Questionnaire (FFABQ)

摘要

Background: A history of falls or imbalance may lead to a fear of falling which may lead to self-imposed avoidance of activity; this avoidance may stimulate a vicious cycle of deconditioning and subsequent falls.Objective: The purpose of this study was to develop a questionnaire that would quantify avoidance behavior due to a fear of falling.Design: This study consisted of two parts, questionnaire development and psychometric testing. Questionnaire development included an expert panel and 39 assisted living residents. Psychometric testing included 63 community dwelling subjects with various health conditions.Methods: Questionnaire development included the evaluation of face and content validity, and factor analysis of the initial questionnaire. The final result of questionnaire development was the Fear of Falling Avoidance Behavior Questionnaire (FFABQ). In order to determine its psychometrics properties, reliability and construct validity were assessed through administration of the FFABQ to subjects twice one week apart and comparison of the FFABQ to other questionnaires related to fear of falling, functional measures of balance and mobility, and daily activity levels using an activity monitor.Results: The FFABQ had good overall test-retest reliability (ICC= .812) and was found to differentiate between those who were considered fallers (i.e., at least one fall in the past year) and non-fallers (pu3c .015). The FFABQ predicted time spent sitting or lying, and endurance.Limitations: A relatively small number of subjects with a fear of falling were willing to participate.Conclusion: Results from this study offer evidence for the reliability and validity of the FFABQ and support the notion that the FFABQ is measuring avoidance behavior rather than balance confidence, self-efficacy or fear.