Interobserver analysis of safety practices and behaviors adopted by elderly people to prevent falls

Baixinho, Cristina Rosa Soares Lavareda; Dixe, Maria dos Anjos Coelho Rodrigues; Madeira, Carla; Alves, Silvia; Henriques, Maria Adriana

doi:10.1590/1518-8345.3209.3268

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 28 • 2020 • https://doi.org/10.1590/1518-8345.3209.3268 copy

Interobserver analysis of safety practices and behaviors adopted by elderly people to prevent falls

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

determine the psychometric properties of the safety practices and behaviors dimension of the Scale of Practices and Behaviors of Institutionalized Elderly People to Prevent Falls in a sample of elderly people with cognitive decline.

Method:

methodological study, with a quantitative approach, to assess the psychometric properties of the mentioned scale in a sample with 102 elderly people with cognitive decline who lived in two long-term care institutions for the public in this age group. Internal consistency evaluation was carried out by calculating the Cronbach’s alpha coefficient; interobserver reliability was expressed by Cohen’s kappa coefficient; and temporal stability, by obtaining Spearman correlation. Compliance with all ethical procedures was observed.

Results:

the dimension of safety practices and behaviors showed α = 0.895 for its 11 items. Seven out of the 11 items reached good to excellent agreement among the experts for interobserver reliability. Kappa index values indicated that the instrument is valid and reliable. Safety practices and behaviors were influenced by institutionalization time, being at least 85 years old, and gait skills.

Conclusion:

the results pointed out that the instrument has good reproducibility and is valid and reliable, which allows its use in clinical practice in elderly people with cognitive decline as well as in research.

Descriptors:
Geriatric Nursing; Validation Studies; Psychometrics; Accidental Falls; Elderly; Home for the Aged

Sample characterization
Age (years) ≥ 65 and < 75 ≥ 75 and < 85 ≥ 85	Percentage 2.9% 27.5% 69.6%
Gender Female Male	73.5% 26.5%
Fall episodes over the previous year Yes No	40.2% 59.8%
Recurrent fall Yes No	73.4% 26.6%
Injury resulting from the fall Yes No	51.3% 48.7%
Level of dependence None (independent) Low Intermediate High	18.8% 26.6% 49.2% 5.4%
Gait Does not use an auxiliary gait device Uses an auxiliary gait device Stick Crutches Walker Wheelchair (independently) Wheelchair (needs help)	8.9% 90.1% 4.0% 10.9% 10.9% 1.0% 61.4%

Safety practices and behaviors dimension
Indicator	κ^* * κ = kappa agreement coefficient;	p^† † p = significance probability value;	agreement
1. Seeks to persevere in choosing the best fall prevention measures	.789	< 0.001	Excellent
2. Selects shoes that are suitable for their feet	.369	< 0.001	Weak
3. Opts to wear closed-toe shoes	.712	< 0.001	Good
4. Opts to wear shoes with non-slip soles	.922	< 0.001	Excellent
5. Organizes their bedroom's space to facilitate moving in it	.882	< 0.001	Excellent
6. Removes obstacles that hinder gait in the bedroom	.826	< 0.001	Excellent
7. Keeps the bed wheels stopped	.000^‡ ‡ .000 = no statistical parameter was calculated because the values were constant
8. When getting up off the bed, first seats, with their feet well supported on the ground, and only then stands up	.000^‡ ‡ .000 = no statistical parameter was calculated because the values were constant
9. Ensures that their feet are well supported on the ground before standing	.841	< 0.001	Excellent
10. Verifies if the bathroom floor is not slippery/wet before using the room	.853	< 0.001	Excellent
11. Ensures that the floor is not slippery before carrying out hygiene care	.370	< 0.001	Weak

Indicator	Mean	Median	SD^* * SD = standard deviation
Practices and behaviors total result	31.45	33.00	2.34
1. Seeks to persevere in choosing the best fall prevention measures	2.83	3.00	.375
2. Selects shoes that are suitable for their feet	2.90	3.00	.299
3. Opts to wear closed-toe shoes	2.95	3.00	.217
4. Opts to wear shoes with non-slip soles	2.59	3.00	.569
5. Organizes their bedroom's space to facilitate moving in it	2.59	3.00	.569
6. Removes obstacles that hinder gait in the bedroom	2.91	3.00	.285
7. Keeps the bed wheels stopped	3.00	3.00	.000
8. When getting up off the bed, first seats, with their feet well supported on the ground, and only then stands up	3.00	3.00	.000
9. Ensures that their feet are well supported on the ground before standing	2.89	3.00	.312
10. Verifies if the bathroom floor is not slippery/wet before using the room	2.83	3.00	.375
11. Ensures that the floor is not slippery before carrying out hygiene care	2.95	3.00	.217

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding author: Cristina Lavareda Baixinho E-mail: crbaixinho@esel.pt https://orcid.org/0000-0001-7417-1732