Study On Reliability And Validity Of The Questionnaire About Fall Knowledge,attitude And Practice In Hospitalized Patients In Rehabilitation Medicine Department

BackgroundStudies show that at least 20 million elderly people in China experience 25 million falls every year,with direct medical costs of more than 5 billion Yuan.According to the survey on chronic diseases and their risk factors in China,the incidence rate of falls in residents aged ?60 years was 8%within 6 months,and falls accounted for 34.83%of all injury deaths among the elderly,which was the first cause of injury death among the elderly.Falls are also a common cause of death and injury.Due to illness and the limitation of hospitalization environment,inpatients are more likely to fall,causing injury to patients.Fall injury causes prolonged hospital stay and increases patient suffering.Studies have shown that inpatients' knowledge and practice on preventing falls directly affects patients' falls.It is very meaningful to improve the knowledge,attitude and practice to reduce the falls among inpatients.Objectives1 To establish a questionnaire of fall awareness and practice for inpatients inrehabilitation medicine department,so as to understand the current situation of inpatients' fall awareness and practice.2 To test the reliability and validity of the questionnaire on fall knowledge,attitude and practice.MethodsBased on the Ten Safety Objectives of Inpatients,Fall Prevention Guidelines,combined with relevant literature andthe adverse events of falling in a third-grade A-level hospital,a questionnaire with 29 items of inpatients' fall knowledge,attitude and practice was established,and 37 final items were formed after two rounds of expert consultation.After a preliminary survey of 46 patients,some entries were modified.Then 249 inpatients were investigated,and the results were tested for reliability and validity.The items of the questionnaire were analyzed by using extreme grouping method,correlation analysis and exploratory factor analysis.Reliability test includes split reliability and Cronbach's a coefficient analysis;validity analysis includes expert validity,surface validity and structural validity.The statistical software used were IBM SPSS Statistics 24.0.Results1The basic structure of the initial entry pool included three aspects of patients'knowledge,attitude and behavior,and the questionnaire items are set for the risk factor assessment,fall prevention intervention and post-fall treatment.The items consisted of general information,living conditions,self-care ability,medical factors and specific fall prevention measures,etc.There were 29 initial items.Selection of items:We conducted 2 rounds of expert letter consultation and pilot survey.After the first round of expert letter consultation,the number of items in the questionnaire increased from 29 to 37.After the second round of expert letter consultation,after the preliminary investigation forms a formal questionnaire.The correlation coefficient between each item and the total score was calculated in the formal questionnaire.The items with the correlation less than 0.3 were modified combining with the clinical practice and expert opinions.TheCronbach's a coefficient of this questionnaire was 0.907,the Cronbach's a coefficient of knowledge,attitude and behavior were 0.745,0.848 and 0.850.After 2 weeks,the retest reliability was 0.742,0.844 and 0.850.4The content validity of expert assessment was 0.93.KMO of exploratory factor analysis was 0.855.The correlation between the three dimensions was 0.597,0.622 and 0.684.There were statistically significant correlations(P<0.05).Conclusion1 The questionnaire established in this study included 37 items of fall knowledge,attitude and practice among inpatients rehabilitation medicine department,including 14 items of knowledge,8 items of attitude and 15 items of behavior.2 This study shows that the questionnaire has good reliability and validity,which can be used as a relevant tool to investigate the fall awareness and compliance of inpatients and is suitable for inpatients.