Analysis of risk prediction capability and validity of Morse Fall Scale Brazilian version

Urbanetto, Janete de Souza; Pasa, Thiana Sebben; Bittencout, Hélio Radke; Franz, Flavia; Rosa, Vitor Pena Prazido; Magnago, Tânia Solange Bosi de Souza

doi:10.1590/1983-1447.2016.04.62200

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Sumário

Original Papers • Rev. Gaúcha Enferm. (Online) 37 (4) • 2016 • https://doi.org/10.1590/1983-1447.2016.04.62200 copy

Analysis of risk prediction capability and validity of Morse Fall Scale Brazilian version

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

To analyse the power to predict risk and verify the validity of the Morse Fall Scale – Brazilian version (MFS-B).

Method

This is a methodological, longitudinal study with 1487 adult patients of two university hospitals of Rio Grande do Sul, Brazil conducted from November 2013 to March 2014. The MFS-B was used to assess the risk of falls. Statistical analysis comprised multivariate methods (discriminant function analysis and ROC curve). The research was approved by the ethics committees of the institutions.

Results

The best estimate to predict falls was at the cutoff point 44.78 of the average MFS-B score, with a sensitivity of 95.2% and a specificity of 64%. The occurrence of falls and the high-risk classification were significant (p<0.00001).

Conclusions

The results show that the MFS-B can appropriately predict the risk of falls at the cutoff point for the high-risk classification, according to the original classification. The MFS-B had adequate validation test results and maintained the six items of the original scale.

Validation studies; Patient safety; Accidental falls; Nursing

Morse Fall Scale (MFS-B)*	Occurrence of falls				p	Cronbach’s Alpha if item excluded

	Yes (n = 104)		No (n = 1,383)

	n	%	n	%
MFS-B Classification
Low Risk	1	1.0	381	27.5	<0.00001
Moderate Risk	4	3.8	504	36.4		-
High Risk	99	95.2	498	36.0
Average Score items**
Fall history	20.7 ± 7.2 (25.0)		5.9 ± 10.6 (0.0)		<0.0001	0.100
Secondary diagnosis	10.0 ± 7.1 (15.0)		9.5 ± 7.2 (15.0)		0.543	0.277
Ambulatory aid	6.1 ± 10.5 (0.0)		1.8 ± 5.5 (0.0)		<0.001	0.206
IV or heparin or saline IV access	16.5 ± 6.2 (20.0)		15.9 ± 7.0 (20.0)		0.395	0.273
Gait	8.6 ± 6.7 (10.0)		4.1 ± 6.0 (0.0)		<0.001	0.199
Mental status	4.8 ± 6.2 (1.2)		1.4 ± 3.9 (0.0)		<0.001	0.100
Total Average Score**	66.7 ± 19.4 (64.8)		38.5 ± 20.6 (35.0)		<0.0001

Items of the MFS-B	Pearson’s correlation coefficient (r)

	Fall history	Secondary diagnosis	Ambulatory aid	IV therapy	Gait	Mental status
Fall history	1
Secondary diagnosis	0.106*	1
Ambulatory aid	0.144**	0.026	1
IV therapy	0.120**	-0.035	-0.019	1
Gait	0.150**	0.105*	0.527**	0.047	1
Mental status	0.134**	0.118**	0.181**	0.018	0.277**	1

Items of the MFS	Principal Components

	Factor 1	Factor 2	Factor 3	Factor 4	Factor 5	Factor 6
Fall history	0.060	0.061	0.992	0.061	0.032	0.060
Secondary diagnosis	0.038	0.008	0.031	-0.019	0.998	0.020
Ambulatory aid	0.076	0.959	0.066	-0.016	0.008	0.264
IV or heparin or saline IV access	0.006	-0.014	0.06	0.998	-0.019	0.022
Gait	0.137	0.273	0.066	0.026	0.023	0.949
Mental status	0.987	0.072	0.061	0.007	0.039	0.123

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

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[1] Corresponding author: Janete de Souza Urbanetto E-mail: jurbanetto@pucrs.br