Cross-cultural adaptation and psychometric property testing of the Taiwan Chinese version of the iconographical falls efficacy scale

Background: The Iconographical Falls Efficacy Scale (Icon-FES) uses short phrases and images to depict activities. This study culturally adapted and validated the Taiwan Chinese version of the 30and 10 -item Icon-FESs (IconFESs [TW]) in community -dwelling older individuals. Methods: The Icon-FES (TW) was developed using forward-backward translation. A total of 120 communitydwelling older individuals were recruited. They completed the Taiwan Chinese version of the Falls Efficacy Scale -International (FES-I [TC]), the Icon-FES (TW), the Mini -Mental State Examination, and the World Health Organization Quality of Life Questionnaire Brief Version (WHOQOL-BREF) and were assessed using the Berg Balance Scale and the Short Physical Performance Battery (SPPB). The Icon-FES (TW) was recompleted 1 week later. Confirmatory factor analysis was used to evaluate the overall structure and measurement properties. Results: Cronbach's alpha values of 0.97 and 0.91 indicated that the 30and 10 -item Icon-FESs (TW) had high internal consistency. The 30and 10 -item Icon-FESs (TW) exhibited significantly high correlation with the FES-I (r = 0.88 and 0.84, respectively). Both versions of the Icon-FES (TW) exhibited mild correlation with the physical domain of the WHOQOL-BREF. The 30and 10 -item Icon-FESs (TW) discriminated by intensity of concern and SPPB score. Their test-retest reliability was high (intraclass correlation coefficient = 0.79 and 0.80 for the 30and 10 -item Icon-FESs (TW), respectively). Neither floor nor ceiling effects were observed. Conclusion: The Icon-FES (TW) is a reliable and valid questionnaire useful for assessing the levels of concern regarding falling among older adults in clinical practice and research.