Development of a concern about falling scale for older adults living in long-term care settings.

Background Over half of older adults in long-term care (LTC) experience concern about falling (CaF), yet existing CaF measurement tools do not adequately capture concerns related to daily activities specific to LTC, limiting their usefulness for assessment and management. This study aimed to: (i) de...

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Published in:Age & Ageing Vol. 55; no. 7; pp. 1 - 12
Main Authors: Lim, Mei Ling, Miles, Lillian, Ellmers, Toby Jack, Schooten, Kimberley S van, Dawson, Rik, Wesson, Jacqueline, Hewitt, Jennie, Ambrens, Meghan, Poulos, Christopher J, Parker, Deborah
Format: Article
Published: Oxford University Press / USA Jul2026
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Online Access:View this record in EBSCOhost
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          Lim, Mei Ling
          Miles, Lillian
          Ellmers, Toby Jack
          Schooten, Kimberley S van
          Dawson, Rik
          Wesson, Jacqueline
          Hewitt, Jennie
          Ambrens, Meghan
          Poulos, Christopher J
          Parker, Deborah
        affil:
          Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, AustraliaThe George Institute for Global Health, University of New South Wales, Sydney, NSW, AustraliaSchool of Population Health, University of New South Wales, Sydney, NSW, Australia
          Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia
          Department of Brain Sciences, Imperial College London, London, UK
          Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, AustraliaSchool of Population Health, University of New South Wales, Sydney, NSW, Australia
          Institute for Musculoskeletal Health, University of Sydney, Sydney, NSW, Australia
          Faculty of Medicine and Health, Sydney School of Health Sciences, Occupational Therapy, The University of Sydney, Camperdown, NSW, Australia
          Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
          Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, AustraliaSchool of Health Sciences, University of New South Wales, Randwick, NSW, Australia
          School of Population Health, University of New South Wales, Sydney, NSW, AustraliaHammondCare, Centre for Positive Ageing, Sydney, Australia
          School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
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        Australia
        Fear
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          Marketing Research and Public Opinion Polling
          All Other Support Activities for Transportation
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          Scale analysis (Psychology)
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          Experimental design
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          Research methodology
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        aged
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        cellular angiofibroma
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        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        coronary artery fistula
        cyclophosphamide/doxorubicin/fluorouracil protocol
        fear of falling
        https://dx.doi.org/10.1093/ageing/afag171
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        internship and residency
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        medical residencies
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        publisher:Oxford University Press
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        sameAs:https://pubmed.ncbi.nlm.nih.gov/42462203/
        accidental falls
        aged
        assessment tool
        caffeine
        cellular angiofibroma
        central african republic
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        coronary artery fistula
        cyclophosphamide/doxorubicin/fluorouracil protocol
        fear of falling
        https://dx.doi.org/10.1093/ageing/afag171
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        internship and residency
        long-term care
        medical residencies
        nursing home
        older people
        publisher:Oxford University Press
        qualitative research
        residential aged care
        sameAs:https://pubmed.ncbi.nlm.nih.gov/42462203/
      ab: Background Over half of older adults in long-term care (LTC) experience concern about falling (CaF), yet existing CaF measurement tools do not adequately capture concerns related to daily activities specific to LTC, limiting their usefulness for assessment and management. This study aimed to: (i) develop a co-designed LTC-specific scale by working directly with older residents, adapting relevant Iconographical Falls Efficacy Scale (IconFES) items and adding newly identified activities reflecting their daily lives and CaF (IconFES-LTC), and (ii) identify gaps in current CaF management practices in LTC. Methods Semi-structured interviews were conducted with 15 LTC residents (aged 60+ years) to identify daily activities associated with CaF and with 10 LTC staff members to explore resident experiences, barriers and facilitators to implementing a CaF scale, and gaps in current CaF management. Interviews were analysed using reflexive thematic analysis to identify patterns across resident and staff perspectives. The draft IconFES-LTC was pilot-tested with nine residents and further refined. Results The final IconFES-LTC comprises 20 items, including seven adapted from the original IconFES. Items reflect common activities of daily living, undertaken within and outside the facility. Interviews further identified key practice gaps, including the absence of a suitable CaF measure, low participation in exercise programmes, limited falls prevention knowledge and a lack of evidence-based programmes addressing CaF in LTC. Conclusion Co-designed with LTC residents and staff, the IconFES-LTC offers a context-specific approach to assessing CaF in LTC settings and may inform targeted fall-prevention strategies, with further psychometric validation required in larger, more diverse populations.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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