Development and Initial Validation of a Brief Multidimensional Falls Efficacy Scale

Abstract

OBJECTIVE To develop and evaluate the initial psychometric properties of the Multidimensional Falls Efficacy Scale (MdFES). METHODS Stage 1 involved content development and validation through literature review and expert consensus. Stage 2 included psychometric testing with 179 older adults. Analyses included exploratory factor analysis (EFA), internal consistency, construct validity, and ROC analysis for clinical cut-offs. RESULTS EFA supported a two-factor structure, explaining 65.4% of the variance. The MdFES showed good internal consistency (α = 0.84). Construct validity was supported by moderate correlations with the Activities-specific Balance Confidence scale (ρ = 0.51), the Balance Recovery Confidence scale (ρ = 0.67), and a negative correlation with the Short Falls Efficacy Scale-International (ρ = -0.46). ROC analyses demonstrated moderate discriminative ability for identifying fallers (AUC = 0.65), high concerns about falling (AUC = 0.73), and poor balance (AUC = 0.71). A cut-off score of ≤13 balanced sensitivity and specificity. CONCLUSION The MdFES is a brief, valid instrument capturing the multidimensional nature of falls efficacy. It may support clinical screening and guide targeted intervention. Further research is needed to elucidate the value of the MdFES.