What Is the Modified Falls Efficacy Scale (M-FES)?
The Modified Falls Efficacy Scale (M-FES) is a 14-item questionnaire used to assess an individual's confidence in performing various daily activities without falling. Building on the original 10-item Falls Efficacy Scale (FES), the M-FES includes four additional items related to more challenging outdoor activities, offering a broader assessment of fall-related self-efficacy both inside and outside the home. Healthcare professionals utilize the M-FES to inform care plans and monitor patient progress.
The 14 Activities on the Scale
The M-FES asks individuals to rate their confidence for 14 specific activities. These activities include a mix of indoor tasks like answering the door, reaching into cabinets, walking around the house, preparing meals, and dressing, as well as outdoor and community tasks such as light gardening, walking on uneven surfaces, using public transportation, navigating crowded areas, crossing a road, carrying groceries, and hanging up laundry.
Understanding the 0-10 Rating System
For each activity, individuals rate their confidence on an 11-point scale from 0 to 10. A score of 0 signifies no confidence, 5 indicates moderate confidence, and 10 represents complete confidence. Any whole number between 0 and 10 can be chosen to reflect their perceived confidence, which is distinct from their actual ability.
Calculating the Final Score: A Simple Average
The final M-FES score is determined by calculating the average of the ratings for all 14 items. To do this, sum the scores from all 14 activities and divide the total by 14. The resulting average score will fall between 0 and 10. For example, a total score of 112 across 14 items results in an M-FES score of 8.0 (112 / 14).
How to Interpret the Modified Falls Efficacy Scale Score
Interpreting the M-FES score is essential for clinical decision-making. Higher scores reflect greater confidence and reduced fear of falling, while lower scores indicate less confidence and increased fear. An average score below 8.0 is often considered an indicator of reduced fall-related self-efficacy, suggesting a need for intervention or closer monitoring. Scores should always be considered within the context of a comprehensive clinical assessment, including medical history and other functional evaluations. Some studies also link scores below 5.0 on hospital admission to a higher risk of in-hospital falls and longer hospital stays.
Comparison of Falls Efficacy Scales
| Feature | Falls Efficacy Scale (FES) | Modified Falls Efficacy Scale (M-FES) |
|---|---|---|
| Number of Items | 10 | 14 |
| Activities Covered | Indoor, basic daily activities | Both indoor and outdoor activities, including more challenging tasks |
| Rating Scale | Varies, but often 1-10 or 1-100 format | 0-10 visual analog scale |
| Scoring | Sum of item scores, often out of 100 or 10 | Average of item scores (0-10) |
| Focus | Confidence in basic indoor activities | Confidence in a wider range of daily and community activities |
Practical Implications and Benefits of Scoring
The M-FES is a valuable tool in clinical practice due to its straightforward scoring and ease of use. It allows clinicians to track a patient's progress over time and assess the effectiveness of interventions. For patients, understanding their score can be empowering, encouraging active participation in fall prevention. By identifying specific activities that cause apprehension, therapists can tailor exercises to improve confidence in those areas. The M-FES also highlights the psychological aspect of fall risk, addressing the fear of falling alongside physical limitations. For further clinical guidance on MFES usage, resources like Medbridge offer detailed explanations.
Conclusion: A Holistic Approach to Fall Prevention
Understanding how is the modified falls efficacy scale scored facilitates a more comprehensive approach to fall prevention. By systematically assessing and interpreting an individual's confidence across various daily tasks, healthcare providers can address both the physical and psychological factors contributing to fall risk. This leads to more effective and personalized strategies to enhance safety, mobility, and overall quality of life.
