Citation

Soh SLH. Front. Psychol. 2022; 13: e1011285.

Copyright

(Copyright © 2022, Frontiers Research Foundation)

DOI

10.3389/fpsyg.2022.1011285

PMID

36438360

PMCID

PMC9682162

Abstract

Falls efficacy has been keenly studied in older people since the introduction of the Falls Efficacy Scale. The seminal paper "Falls efficacy as a measure of fear of falling" has received over 2,500 citations since 1990 (Tinetti et al., 1990). The presence of newer versions of falls efficacy-related scales, either modified from the ancestral version or constructed afresh, suggests that many researchers and clinicians are interested in investigating the meaningful impact of falls efficacy (Soh et al., 2021a). Ultimately, endeavors aiming to empower older people to prevent and manage falls need a clear understanding of falls efficacy. Some articles featured in the Frontiers have demonstrated these efforts, such as presenting the mediating role of falls efficacy between fatigue and falls risk (He et al., 2022) and the role of a falls risk-reduction program on falls efficacy (Cho et al., 2014). Given the advances in research on falls efficacy, have we adequately understood this self-efficacy concept and have the most appropriate measure applied for the construct of interest?

Literature has reported several challenges in understanding falls efficacy since the 2000s. Two systematic reviews reported significant difficulties in deciphering whether the measures of falls efficacy were measuring falls efficacy, balance confidence or fear of falling (Jorstad et al., 2005; Moore and Ellis, 2008). Various researchers have attempted to clarify the falls efficacy concept. Hadjistavropoulos et al. (2011) presented key research findings to advocate that falls efficacy and balance confidence are equivalent and interchangeable. However, Hughes et al. (2015) drew on the theoretical origins of falls efficacy, balance confidence and outcome expectancy to recommend that researchers clarify the different constructs. Recently, Soh et al. (2021b) posited that falls efficacy and balance confidence are dissimilar and that falls efficacy encompasses four domains surrounding falls (i.e., pre-fall, near-fall, fall-landing, and completed-fall). Elucidating falls efficacy as a broader set of perceived capabilities would advocate a complete approach to helping older people overcome falls and falling.

This commentary aims to update the understanding of falls efficacy by revisiting Bandura's self-efficacy theory and then offering a contemporary interpretation. The commentary highlights some selected measures to suggest that appropriate measures should be applied in research surrounding falls efficacy...

Language: en

Keywords

falls prevention; self-efficacy; balance confidence; balance recovery confidence; falls efficacy; falls management; fear of falling; older people