MEASUREMENT
Find the Right Measure
Good measurement begins with a clear understanding of the construct you intend to assess. Falls efficacy, balance confidence, balance recovery confidence, fear and concern about falling are related, but they should not automatically be treated as interchangeable.
Start with the construct and purpose of assessment, then select a measurement instrument that best represents that question.
START HERE
What Do You Want to Measure?
Similar wording across questionnaires does not necessarily mean that they assess the same construct. Identify the psychological capability, perception or response of interest before selecting an instrument.
MULTIDIMENSIONAL
Falls efficacy
Perceived capability to prevent and manage fall-related situations across different stages of a fall.
Consider when asking:
How capable does the individual feel across both
fall-prevention and fall-management situations?
PRE-FALL
Balance confidence
Confidence in maintaining balance while undertaking activities.
Consider when asking:
How confident is the individual in maintaining stability
during everyday activities?
NEAR-FALL
Balance recovery confidence
Confidence in recovering balance following a loss of stability, such as a slip, trip or other perturbation.
Consider when asking:
How confident is the individual in arresting a potential
fall after balance has been disturbed?
RELATED CONSTRUCT
Fear or concern about falling
Emotional or cognitive responses relating to the possibility or consequences of falling.
Consider when asking:
How afraid, worried or concerned is the individual about
falling?
FALLS-EFFICACY DOMAINS
Match the Measure to the Fall-related Situation
Falls efficacy can be considered across distinct fall-related situations. A measure should therefore reflect the stage and capability that are relevant to the clinical or research question.
PRE-FALL
Balance confidence
Confidence in maintaining balance during activities.
NEAR-FALL
Balance recovery confidence
Confidence to arrest a fall following a loss of balance, slip or trip.
FALL-LANDING
Safe-landing confidence
Confidence in protecting oneself during a fall.
COMPLETED FALL
Post-fall recovery confidence
Confidence to get up or obtain help after a fall.
FEATURED MEASURES
Falls Efficacy Measures Developed Within the Programme
Two measures within this research programme address complementary aspects of falls efficacy: reactive balance recovery confidence and multidimensional confidence across fall-prevention and fall-management situations.
NEAR-FALL DOMAIN
BRC: Balance Recovery Confidence Scale
The BRC focuses specifically on confidence in recovering balance after a significant loss of stability.
MULTIDIMENSIONAL
MdFES: Multidimensional Falls Efficacy Scale
The MdFES considers confidence across multiple fall-related situations spanning both fall prevention and fall management.
MEASUREMENT DECISION
How Should I Select a Measure?
Instrument selection should be driven by conceptual alignment as well as the practical requirements of the intended application.
Define the construct
Specify precisely what you intend to understand: confidence, capability, fear, concern, perceived control or another fall-related construct.
Match the context
Consider the population, setting, language, fall-related situation and purpose for which the measure will be used.
Review measurement properties
Examine whether available evidence supports the reliability, validity and interpretability required for the intended use.
Consider feasibility
Review administration burden, scoring, language availability, licensing and how the results will inform research or practice.
CONSTRUCT CLARITY
Falls Efficacy Is Not the Same as Fear of Falling
A questionnaire should be interpreted according to the construct represented by its items and response options, rather than solely by its title or historical use.
CAPABILITY
Falls efficacy
Focuses on perceived capability or confidence in responding to particular fall-related situations.
FEAR / CONCERN
Psychological response to falling
Focuses on fear, worry or concern relating to the possibility or consequences of falling.
Related constructs may correlate with one another, but association does not make them conceptually interchangeable. Interpretation should remain aligned with what the instrument actually asks the respondent to report.
MEASURE LIBRARY
Browse the Full Measure List
The full catalogue brings together measures relevant to multidimensional falls efficacy, balance confidence, balance recovery confidence, safe landing, post-fall recovery, fear and concern about falling, fall-risk perception and perceived control.
Looking for a specific questionnaire?
Browse the detailed Measure List to compare instruments, developers, item numbers, scoring approaches and their underlying conceptualisation.
Start with the Construct
Define what you want to understand, then select the measure that best represents that clinical or research question.