Development and validation of a Chinese version of the Falls Efficacy Scale International

The FES-I is an instrument developed to assess concern about falls. The aim of this study was to develop a Chinese version of the 16-item Falls Efficacy Scale International (FES-I(Ch)) and evaluate its structure, measurement properties and convergent and predictive validity. The FES-I(Ch) was developed following the recommended 10-step protocol. The FES-I(Ch) was then administered to 399 community-dwelling Chinese older people (61-93 years) in conjunction with a range of other socio-demographic, physical, medical and functional measures. Falls were prospectively monitored over 12 months. Sub-samples were reassessed for determination of the FES-I(Ch)'s test-retest and inter-rater reliability. The overall structure and measurement properties of the FES-I(Ch), as evaluated with factor analysis and item-total correlations, was good. Internal consistency was excellent (Cronbach's α=0.94), as was test-retest and inter-rater reliability (ICC_3,1=0.89 and ICC_2,1=0.95 respectively). FES-I(Ch) scores were significantly higher in participants with poor physical performance, depression, medical conditions associated with falls and disability indicating acceptable congruent validity. FES-I(Ch) scores did not differ between those who did and did not fall in the 12-month follow-up period. We found that the FES-I(Ch) is a valid and reliable measure of concern about falls in Chinese older people. The relatively high level on concern (high FES-I(Ch) scores) as well as relatively few prospective falls may explain the lack of association between FES-I(Ch) scores and falls in this population. Future studies should explore the FES-I(Ch)'s responsiveness to change over time and during intervention studies.