Development of a fall‐risk checklist using the Delphi technique

Abstract

This study developed a checklist of both intrinsic and extrinsic risk factors for falls among older people based on consensus among a panel of experts and obtained expert content validity. The developed checklist is intended to help nurses better understand risk factors and take effective measures to prevent falls. Ageing involves changes in musculoskeletal and neuromuscular systems that make older people more prone to balance problems and falling. While it is believed that both environmental factors and personal habits play important roles in predisposing older people to falls, few broad-based approach checklists to identify both intrinsic and extrinsic risk factors have been published. Even fewer checklists addressing psychosocial problems currently exist. The authors developed a preliminary checklist through literature review. This study was designed using the Delphi technique, which is widely accepted as an effective method to secure consensus from experts of different backgrounds and perspectives. The Delphi technique was used to consolidate and compare the opinions of qualified experts from six different fields over three review rounds. Experts' content validity index was used to confirm validity. Authors developed a preliminary checklist covering nine domains, which, after using the Delphi technique, was expanded to the 10 domains of demographics, illness, medicine, balance measurement, footwear, nutrition, cognitive function, social support, environment and fear of falling. Changes based on panel member suggestions made in the first review round included clarification of definitions for 'dim light', 'slippery', 'doormat' and 'clutter' and revisions to definitions of cigarette and alcohol consumption and types of exercise. Changes made following the second round review included clarification of the meaning and function of social support and the replacement of SPMSQ with MMSE. In the final round, the term 'physical mental disturbance' was changed to 'fear of falling'. The scores of CVI were very high. The Delphi technique was used successfully to refine the author-developed checklist based on experts' input. To ensure expert input reliability, concepts were defined by the authors and supported with photographs and videos, as needed. The checklist helps assess risk factors and identify older people at higher risk of falls and may help reduce fall risk.