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Psychometric properties of the German version of the Fear of Falling Questionnaire-revised (FFQ-R) in a sample of older adults after hip or pelvic fracture

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Abstract

Background

Identifying patients with maladaptive fear of falling (FOF) is important in the rehabilitation phase after serious fall. The 6-item Fear of Falling Questionnaire-revised (FFQ-R) was seen as promising measurement instrument as it evaluates FOF in a broader way than the one-item-question and independent of physical activities.

Aim

The purpose of the analysis was to evaluate the psychometric properties of the translated German FFQ-R.

Methods

Back-translation method was applied. Confirmatory factor analysis (CFA) with diagonally weighted least square estimation was used to verify the two-factor structure. Data were collected during inpatient rehabilitation from hip and pelvic fracture patients [age 84.3 ± 6.2, Mini-Mental State Examination (MMSE) scores > 23] participating in an RCT (N = 112) and a cross-sectional survey (N = 40).

Results

Internal consistency was 0.78 (Cronbach´s alpha). No floor or ceiling effects were found. Discriminatory power on item level was moderate to good (r = 0.43–0.65). CFA revealed a good model fit and confirmed the two-factor structure. The German FFQ-R was moderately correlated (r = 0.51) with the Short Falls Efficacy Scale-International (Short FES-I) used as a proxy measure for FOF.

Missing rates up to 9% for specific items were because some individuals, independent of cognitive level or age, had problems to rate items with conditional statements on possible negative consequences of a fall.

Conclusions

Results demonstrated moderate to good psychometric properties similar to the original English version in a comparable sample of fracture patients.

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Acknowledgements

We thank Emily Bower and Julie Wetherell for permission to translate the English 6-item FFQ-R.

Funding

The data were derived in the context of a dual-center interventional study which belongs to a series of projects for the prevention and rehabilitation of osteoporotic fractures in disadvantaged populations in Germany being funded by the German Federal Ministry of Education and Research [PROFinD2, Subproject 3, reference number 01EC1404).

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Authors and Affiliations

  1. Department of Clinical Gerontology and Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany

    Anja Dautel, Michaela Gross, Clemens Becker & Klaus Pfeiffer

  2. Agaplesion Bethanien Hospital, Heidelberg, Germany

    Bastian Abel, Rebekka Pomiersky, Tobias Eckert & Klaus Hauer

  3. Hochschule Mannheim, University of Applied Science, Mannheim, Germany

    Rebekka Pomiersky & Martina Schäufele

  4. Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany

    Gisela Büchele

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  1. Anja Dautel
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Contributions

AD: acquisition of data, conception and design, analysis and interpretation of data, and drafting the manuscript. MG, BA, RP, and TE: acquisition of data, revising the article critically for important intellectual content. KH, MS, GB, and CB: revising the article critically for important intellectual content. KP: conception and design, analysis and interpretation of data, and drafting the manuscript. All authors read and approved the final manuscript. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Anja Dautel.

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The authors declare that they have no conflict of interest.

Ethical approval

The interventional study as well as the supplementary cross-sectional survey were performed in line with the principles of the Declaration of Helsinki and both have been approved by the Ethical Review Committees of the Faculties of Medicine in Tuebingen (Project number 150/2015BO1) and Heidelberg (Project number S-256/2015).

Informed consent

Written informed consent was obtained from all individual participants included in the interventional study as well as the supplementary cross-sectional survey.

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Dautel, A., Gross, M., Abel, B. et al. Psychometric properties of the German version of the Fear of Falling Questionnaire-revised (FFQ-R) in a sample of older adults after hip or pelvic fracture. Aging Clin Exp Res 33, 329–337 (2021). https://doi.org/10.1007/s40520-020-01657-2

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