Validation of the Morse Fall Scale – Brazilian version for institutionalized older adults (MFS-B/ ILPI)

Rosa, Vitor Pena Prazido; Pasa, Thiana Sebben; Magnago, Tania Solange Bosi de Souza; Urbanetto, Janete de Souza

doi:10.1590/1981-22562024027.230218.en

Vitor Pena Prazido Rosa

conception, analysis and interpretation of data

writing of the paper

approval of the version to be published

responsible for all aspects of the work, ensuring that issues related to the accuracy or integrity of any part of the work.

Pontifícia Universidade Católica do Rio Grande do Sul, Programa de Pós-Graduação em Gerontologia Biomédica da Escola de Medicina. Porto Alegre, RS, Brasil.

https://orcid.org/0000-0001-5420-9772

Thiana Sebben Pasa

analysis and interpretation of data

writing of the paper

approval of the version to be published

responsible for all aspects of the work, ensuring that issues related to the accuracy or integrity of any part of the work.

Pontifícia Universidade Católica do Rio Grande do Sul, Programa de Pós-Graduação em Gerontologia Biomédica da Escola de Medicina. Porto Alegre, RS, Brasil.

https://orcid.org/0000-0003-3931-4149

Tania Solange Bosi de Souza Magnago

analysis and interpretation of data

writing of the paper

approval of the version to be published

responsible for all aspects of the work, ensuring that issues related to the accuracy or integrity of any part of the work.

Universidade Federal de Santa Maria, Programa de Pós-Graduação em Enfermagem do Departamento de Enfermagem. Santa Maria, RS, Brasil.

https://orcid.org/0000-0002-5308-1604

Janete de Souza Urbanetto

conception, analysis and interpretation of data

writing of the paper

approval of the version to be published

responsible for all aspects of the work, ensuring that issues related to the accuracy or integrity of any part of the work.

Pontifícia Universidade Católica do Rio Grande do Sul, Programa de Pós-Graduação em Gerontologia Biomédica da Escola de Medicina, Curso de Enfermagem da Escola de Ciências da Saúde e da Vida. Porto Alegre, RS, Brasil.

https://orcid.org/0000-0002-4697-1641

Correspondence Janete de Souza Urbanetto jurbanetto@pucrs.br

The authors declare that there is no conflict in the conception of this work.

Edited by: Isac Davidson S. F. Pimenta

MFS-B Itens	Descriptive statistics			Reliability Statistics
MFS-B Itens	Mean	Sd	Median	Corrected Total Item Correlation	Guttman Reliability (S-H)*	Split Half if Item Excluded
History of Falls	12.5	12.5	12.5	0.316	0.682	0.440
Secondary Diagnosis	14.3	3.2	15.0	0.117		0.577
Assistance with Ambulation	5.8	8.2	0.0	0.450		0.318
Intravenous Therapy	0.1	1.5	0.0	0.006		0.772
Gait	10.8	8.1	10.0	0.403		0.444
Mental state	9.6	7.2	15.0	0.441		0.433

MFS-B Itens	Communality (Extraction)	Factor Loadings
MFS-B Itens	Communality (Extraction)	Factor 1	Factor 2
History of Falls	0.641	0.557	0.128
Secondary Diagnosis	0.457	0 .972	-0.234
Assistance with Ambulation	0.810	0.426	0.061
Intravenous Therapy/Saline or Heparinized Intravenous Device	0.176	-0.015	0.216
Gait	0.839	0.612	0.204
Mental state	0.604	0.418	0.190

Morse Fall Scale – Brazilian version for institutionalized older adults (MFS-B/ILPI)
MFS-B/ILPI item	Score	Operational Definition
1 - History of Falls
No	0	If the older adult has no history of falls in the past three months.
Yes	25	If the older adult has fallen during their stay in the ILPIs or has a recent history (up to three months) of falls due to physiological causes such as seizures or compromised gait before institutionalization.
2 - Secondary Diagnosis
No	0	If the older adult's medical record presents only one medical diagnosis.
Yes	15	If the older adult's medical record presents more than one medical diagnosis.
3 - Ambulation Assistance
None / Bedridden / Assisted Ambulation by Healthcare Professional	0	If the older adult ambulates without assistive equipment (crutch, cane, or walker), OR If they ambulate with the assistance of a healthcare professional, OR If they use a wheelchair or are bedridden and do not get out of bed on their own.
Crutches/Cane/Walker	15	If the older adult uses crutches, cane, or walker.
Furniture/Wall	30	If the older adult moves by leaning on furniture/walls.
4 – Gait
Normal / No Ambulation, Bedridden, Wheelchair	0	Normal gait is characterized by walking with an upright head, arms swinging freely by the sides, and wide steps, without hesitation. It also receives the same score if the older adult is bedridden and/or uses a wheelchair (no ambulation).
Weak	10	Steps are short and may be hesitant. When the gait is weak, although the older adult leans forward while walking, they can raise their head without losing balance. Additionally, if they use furniture for support, it is done lightly only to feel secure, not to maintain an upright position.
Impaired/Wobbly	20	The older adult takes short, wobbly steps and may have difficulty getting up from a chair, needing to lean on the chair's arms to stand and/or propel the body (making several attempts to stand by pushing the body). With this type of gait, the older adult's head is lowered, and they look at the ground. Due to the lack of balance, they grasp furniture, a person, or use some walking aid equipment (crutches, canes, walkers) to hold onto and cannot walk without this assistance. When helping these older adults walk, the healthcare professional notices that they actually lean on them, and when the older adult leans on a handrail or furniture, they do so forcefully, until the joints of their fingers turn white.
5 – Mental status
Oriented/ Capable of self-assessment	0	When asking the older adult, "Are you able to go to the bathroom on your own, or do you need help?" verify if the response is consistent with the information in the medical record and/or with your assessment. If so, the older adult is classified as capable.
Overestimates capacity/ Forgets limitations	15	When asking the older adult, "Are you able to go to the bathroom on your own, or do you need help?" verify if the response is not consistent with the medical record and/or your assessment or if the older adult's assessment is unrealistic. If this happens, this older adult is overestimating their abilities and forgetting their limitations.
Total score: Sum the points from each item of the MFS-B/ILPI and record the value. Risk classification: 0–24: Low Risk; 25–44: Moderate Risk; ≥45: High Risk.

[1] Correspondence Janete de Souza Urbanetto jurbanetto@pucrs.br

Brasil

Brasil

Validation of the Morse Fall Scale – Brazilian version for institutionalized older adults (MFS-B/ ILPI)

Abstract

Objective

Method

Results

Conclusions

Brasil

Brasil

Validation of the Morse Fall Scale – Brazilian version for institutionalized older adults (MFS-B/ ILPI)

Abstract

﻿Objective

Method

Results

Conclusions

Objective