Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Health and Rehabilitation Sciences

Supervisor

Joy MacDermid

2nd Supervisor

David Walton

Co-Supervisor

3rd Supervisor

Ruby Grewal

Affiliation

McFarlane Hand & Upper Limb Centre, St. Joseph's Health Care

Co-Supervisor

Abstract

Falls screening can prevent falls and their consequences. The two studies of this thesis aimed to identify the accuracy of falls screening tools and explore patient preferences and empirical validity of the self-rated Falls Risk Questionnaire (FRQ). The first study, Systematic Literature Review, found the Toulouse-St. Louis University Mini Falls Assessment and the Activities-specific Balance Confidence scale Hindi version emerged as accurate tools for predicting falls in the target population. The second study determined most of respondents, 36%, had no preference between Activities Specific Balance Confidence 6 items (ABC-6) or FRQ. The Bland & Altman approach revealed a degree of agreement between the FRQ and ABC-6. Furthermore, respondents with a history of falls had substantially lower FRQ and ABC-6 scores than non-fallers. Findings of this thesis can be used to support the use of the FRQ that the CDC and several health institutes recommend for falls screening in older adults.

Summary for Lay Audience

In the first study, we identified and summarized published studies of falls screening questionnaires in community-dwelling older adults. In the second study, we explored patient preferences and whether or not the self-rated Falls Risk Questionnaire (FRQ) and the Activities-specific Balance Confidence 6 items (ABC-6) provide similar results about falls risks.

What is the problem?

Falls are most common in older people. As a result, they need to consider whether or not they are at risk of falling. Completing questionnaires designed to predict their risk of falling is one way to accomplish this. The questionnaires must be understandable to older adults and provide accurate data.

How did the team study the problem?

We conducted a review study on falls screening questionnaires in the first study and participants were asked to take the FRQ and ABC-6 online surveys in the second study.

What did the team find?

In the first study, we found that the fall rates among older adults varied between 10% and 39%. We found that the Toulouse-Saint-Louis University Mini Falls Assessment and the Activities-specific balance confidence scale Hindi version accurately predicted falls in community-dwelling older adults. About 44.8% of respondents reported they had fallen in the previous year. The FRQ and ABC-6 scores of people who had a history of falling were lower than those who had never fallen. There was good agreement between both questionnaires. Most of respondents, 36% had no preference between the ABC-6 or FRQ for falls screening. A variety of reasons were given regarding preference.

How can this research be used?

The first study results updated our knowledge about falls screening questionnaires and their accuracy for predicting falls. The second study results can be evidence to promote the use of the FRQ as a falls screening tool in community-dwelling older adults.

Cautions

Because of the COVID-19 crisis, the survey was conducted online. Also, we considered people older than 55 years as older adults. Furthermore, the fall rates and classification of participants as fallers or non-fallers were determined using falls history and retrospective design, which might not be an accurate estimate of the fall rate.

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