Development of the Japanese version of the Westmead Home Safety Assessment for the elderly in Japan.
Aya Hasegawa, Tomoko Kamimura
PMID 30186082WHAT IT FOUND
A Japanese home safety checklist for older adults was best supported for 49 items, including stairs, seating, bathroom, bath, toilet, footwear, and floors.
The full 71-item version was not fully supported, especially household tasks like laundry, cleaning, cooking, medication, and safety calls.
Key findings
01Only 49 items of the Japanese Westmead Home Safety Assessment had adequate agreement between raters and adequate relevance ratings from OTs.
02Rater agreement was strong for most items: 48 were excellent and 18 were fair to good, with none rated poor; 5 items could not be checked because no hazards were found.
03The most frequent hazards identified by therapist raters were internal steps or stairs (32; 64%) and seating (32; 64%), followed by bathroom (26; 52%) and bath (24; 48%).
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study used a convenience sample of only 50 older adults, and many were selected before hospital discharge and had Berg Balance Scale scores below 45, so it may not represent older people in the community. Most OTs who rated item relevance worked in hospitals, so accepted items may fit impaired older adults more than the general older population. The relevance panel was asked whether items were relevant, not whether important hazards were missing from the checklist. The expert rater trained the therapist raters and could know their results, which may have made agreement look better. Past-year fall counts relied on memory, and cognitive status was not assessed, so fall history may be inaccurate. The study checked agreement and relevance, not whether the checklist reduced falls.
The easy way to misread this
Do not treat the whole WeHSA-J as validated. Only 49 items had adequate reliability and content validity, and the study did not test whether using the tool reduced falls.