验证西班牙语版 Lawton IADL 量表在老年人中的应用。
Validation of the Spanish version of the Lawton IADL Scale for its application in elderly people.
机构信息
Primary Care Research Unit-Gipuzkoa, Osakidetza, Spain-Red de investigación en servicios de salud en enfermedades crónicas (REDISSEC), P, Dr Beguiristain s/n, San Sebastian, Spain.
出版信息
Health Qual Life Outcomes. 2012 Oct 30;10:130. doi: 10.1186/1477-7525-10-130.
BACKGROUND
The adequate information about the functional capacity of elderly populations is a key for the comprehensive assessment of their health status and autonomy. The Lawton IADL (instrumental activities of daily living) Scale is a very often used scale to assess independent living skills, but has never been validated for its use in Spanish-speaking populations. The purpose of this study was to assess the validity, the reliability, and responsiveness of this widely used scale.
METHODS
The validation was based on a prospective cohort of 1,965 patients aged 65 or over who suffered an accidental fall with a hip or wrist fracture as a result. These patients were followed up six months after the production of the fracture. Cronbach's alpha was used to assess reliability, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) for the construct validity. Convergent and discriminant validity were examined by the correlation of the IADL Scale with the Barthel Index, SF-12, WOMAC short form, and QuickDASH questionnaires. Known-groups validity was also studied comparing IADL Scale according to different groups, and responsiveness was assessed by means of effect sizes.
RESULTS
The mean age was 80.04 years (SD 8.04). The Cronbach alpha coefficient was 0.94. In the EFA, factor loadings ranged from 0.67 to 0.90, and CFA confirmed the homogeneity of the construct. Regarding the convergent validity, all correlation coefficients were higher than 0.40. Significant differences were found according to different groups, supporting known-groups validity. Responsiveness parameters showed moderate to large changes (effect sizes, 0.79 and 0.84 among patients classified as worsened).
CONCLUSIONS
These results confirm that the Spanish version of the Lawton IADL Scale has excellent reliability and validity and a moderate to large sensitivity to change. This study provides a proper validation, not only of the Spanish version of the Lawton IADL Scale, but also of the original instrument.
背景
充分了解老年人群的功能能力是全面评估其健康状况和自主性的关键。Lawton IADL（日常生活活动的工具性活动）量表是评估独立生活技能的常用量表，但从未在西班牙语人群中得到验证。本研究旨在评估该广泛使用量表的有效性、可靠性和反应度。
方法
该验证基于一个前瞻性队列研究，共纳入 1965 名年龄在 65 岁及以上的患者，他们因髋部或腕部骨折意外跌倒。这些患者在骨折发生后 6 个月进行了随访。采用 Cronbach's alpha 评估信度，采用探索性因子分析（EFA）和验证性因子分析（CFA）评估结构效度。通过与 Barthel 指数、SF-12、WOMAC 短表和 QuickDASH 问卷的相关性来评估聚合和判别效度。还通过比较不同组别之间的 IADL 量表，以及通过效应量评估反应度来评估已知组别的效度。
结果
平均年龄为 80.04 岁（标准差 8.04）。Cronbach's alpha 系数为 0.94。在 EFA 中，因子负荷范围为 0.67 至 0.90，CFA 证实了结构的同质性。关于聚合效度，所有相关系数均高于 0.40。根据不同组别发现了显著差异，支持已知组别的效度。反应度参数显示出中度至较大的变化（效应量，分类为恶化的患者为 0.79 和 0.84）。
结论
这些结果证实，西班牙语版的 Lawton IADL 量表具有极好的信度和效度，以及中度至较大的变化敏感性。本研究不仅对西班牙语版的 Lawton IADL 量表进行了适当的验证，还对原始量表进行了验证。
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