Development of Home Falls Hazards Assessment Model for Fall Risk Screening among Community-Dwelling Thai Elderly

Abstract

This prospective analytic study aimed to develop Home Falls and Accidents Screening Tool and investigate factors related the risk of falls. The Home-FAST was developed by translating into Thai language and was adapted across cultures. The assessment tool was tested for content validity by 5 experts. The test-retest of the assessment tool, the intra-rater reliability and the internal consistency of the questions were examined with 50 elderly people. The predictive validity was tested at 1-year follow-up period during November 2018 and March 2020 with 480 individuals aged 60 years and older in Nakhon Ratchasima province. Statistical analyses were conducted using Cox proportional hazard model; the area under the curve (AUC), sensitivity, specificity, and other predictive validity indices were estimated.

Results: A total of 480 elderly people in the sample, with an average age of 72.8 years, during a 1-year study period, found an incidence of falling at least once, 30.8 percent. Elderly people who had recurrent falls, 68.2 percent. The content validity of The Thai Home-FAST assessment is good. The reliability for repeated measures and inter-rater reliability were good. The interclass correlation coefficient were 0.853 and 0.796, respectively. The internal consistency of the entire questionnaire was 0.856, with predictive validity for falls of 53.7%, sensitivity of 29.7%, and specificity of 77.7%. The results found that the difficulty of sitting and getting out of the toilet, and the steps were related to initial fall. As for the risk factors, insufficient light inside the house, flush toilet unavailable, inconvenience to sit and get up from the toilet and difficult to turn on the light from the bed were statistically significant related to recurrent falls. Conclusion: Thai Home-FAST was qualified for psychometric testing both reliability and validity.