Volume 14, Issue 3 (Autumn 2019)                   Salmand: Iranian Journal of Ageing 2019, 14(3): 272-283 | Back to browse issues page

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Karimi E, Hassani Mehraban A, Akbar Fahimi M, Maghfouri B, Jamali A R. A Self-report Home Environment Screening Tool for Determining Fall Risk in Iranian Older People. Salmand: Iranian Journal of Ageing. 2019; 14 (3) :272-283
URL: http://salmandj.uswr.ac.ir/article-1-1527-en.html
1- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Occupational Therapy, School of Rehabilitation Sciences, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran.
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1. Introduction
Falling is one of the leading causes of death, injury, and functional limitations among older people [1, 2]. The consequences of falls include physical injuries, fear of falling, and partial or complete inactivity that can dramatically affect the lives of older people y [3, 4]. Evaluating home risks is a key component of managing the risks of falling among older people living in the community and requires appropriate tools to assist therapists in falls risk screening. Home risks are identified through home safety checklists, many of which are valid and reliable. Among the available tools, we used the Home Falls and Accidents Screening Tool (HOME FAST) to detect the elderly people who are at the high risk of falling or experienced a fall at home [5, 6]. Self-report and self-assessment are in line with the client-centered approach to interventions [7, 8]. This study aimed to prepare a self-report version of the HOME FAST for the elderly Iranian population.
2. Materials and Methods
After obtaining ethical clearance from the Research Ethics Committee of Iran University of Medical Sciences, the HOME FAST self-report design process was begun. The study was a non-experimental study performed in different areas of Tehran. In this regard, first, the Persian version of this tool was examined with the help of 5 occupational therapists and psychometrics experts. Twenty-five items were broken down into several questionsand each question was subdivided into several intelligible questions. Then, to evaluate its content validity, a panel of 10 occupational therapists in geriatrics (6 women and 4 men with at least older people years of experience) from Iran University of Medical Sciences and Tabriz University of Medical Sciences examined the questions. Five older adults were randomly pre-tested to assess the face validity of the tool, and they were asked to examine the questionnaire in terms of comprehensibility and clarity for examining how seniors interpret each item and provide clear and orderly instruction. To evaluate the concurrent validity and degree of agreement between the therapist and the elderly, the scores of the Self Report (SR) version provided by the elderly were compared with the scores obtained from the Health Professional (HP) version, using the Spearman test. The obtained data were analyzed in SPSS V. 16.
3. Results
In this study, the participants consisted of 64 people aged over 60 years (35 men and 29 women). Thirty (46.9%) participants had a history of falling in the past year; 13 lived alone, 49 with family, and 2 with caregivers. During 4 sessions with experts (each taking 3 hours), 25 items were provided; 15 main questions and 75 sub-questions were answered by “Yes” or “No”. Assessing the content validity of the tool, the agreement among 10 experts should be above 62%, and it was calculated according to the content validity ratio formula [30]. The results showed that out of the 80 items in the questionnaire, their agreement in 73 items was above 0.6. Since the questionnaire is designed for older people and requires minimal subjective judgment and a simple understanding of concepts and sentences, it is advised to include all items in the questionnaire. The consensus among the experts was significant, and their opinions were homogeneous; so, it is worth mentioning that the designed questionnaire is valid in terms of content. The results of the Spearman test showed that the correlation between SR and HP versions was r =0.95 and P<0.001. According to the statistical data and the results presented in Table 3 , absolute repeatability) SEM =0.25 (indicates good test-retest reliability of the designed tool, since it is less than 10% of the total score. Moreover, the relative repeatability (ICC =0.99) indicates its good test-retest reliability, since the values are greater than 0.8.
4. Conclusion
The designed Home FAST-SR tool had good validity and reliability and could be used in epidemiological studies or to examine all nursing homes because of the lack of therapeutic force. By using this tool, if multiple hazards are identified, more detailed studies can be recommended.
Ethical Considerations
Compliance with ethical guidelines

This study obtained its ethical clearance from the Research Ethics Committee of Iran University of Medical Sciences (Code: IR.IUMS.REC.93.1055403).
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors' contributions
All authors had contribution in preparing this paper.
Conflicts of interest
The authors declare no conflict of interest.
The authors would like to thank all seniors, who participated in the study and members of the Faculty of Occupational Therapy at Iran University of Medical Sciences.
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Type of Study: Research | Subject: Occupational therapy
Received: 2018/04/25 | Accepted: 2018/07/18 | Published: 2019/11/10

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