The evaluation of the risk of falling in stroke patients: A comparison of three risk of falling evaluation tools

This descriptive study was conducted with the aim of determining which one among the İtaki, Morse, and Hendrich II Risk of Falling Evaluation Scales had the best power of prediction in the determination of the risk of falling for stroke inpatients. Study data was obtained between July and December 2018. The study was conducted with 125 stroke patients being treated in the neurology service of a public hospital. For data collection, a Patient Identification Form prepared by the researcher through a literature scan, the Glasgow Coma Scale, the İtaki Risk of Falling Scale, the Hendrich II Risk of Falling Scale, and the Morse Falling Scale were used. The functionality statuses of the patients were evaluated using the Functional Independence Scale. The events of falling occurring in the patients were recorded using a Falling Report Form. For risk of falling evaluation and events of falling, the patients were monitored daily throughout their hospital stays. In the evaluation of the risk of falling scales, sensitivity – selectivity analyses and the ROC curve were used. The mean age of the 125 stroke patients included in the study was calculated to be 71.47±11.16. The mean duration of hospital stay was 8.66±1.80 among the patients, and falling in the hospital was detected in 9.6% (n=12). While 11 of the 12 patients who experienced events of falling fell once, repeated falling was recorded for 1 patient. Most of the events of falling in the hospital occurred in the patient rooms (61.5%). Most of the patients who fell were female (58.3%). The İtaki Risk of Falling Evaluation Scale had a calculated sensitivity of 75.0 and a specificity of 63.7 while the Hendrich II Risk of Falling Evaluation Scale had a sensitivity of 83.3 and a specificity of 50.4 and the Morse Falling Evaluation Scale had a sensitivity of 91.7 and a specificity of 73.5. According to the evaluation results of the ROC analysis, the cut off values of the scales were 14 for the İtaki Risk of Falling Evaluation Scale, 4.5 for the Hendrich II Risk of Falling Evaluation Scale, and 66.2 for the Morse Falling Evaluation Scale. As a result, the Morse Falling Scale was suggested for use in stroke in patients because of its higher sensitivity and selectivity compared to the other scales. Key Words: Stroke, risk of falling, nursing, sensitivity, specificity