*University of California San Francisco, San Francisco, CA †Department of Biostatistics, School of Public Health, University of Alabama, Tuscaloosa, AL ‡Johns Hopkins Bloomberg School of Public Health, Baltimore, MD §Department of Medicine, School of Medicine, University of Alabama, Tuscaloosa, AL ∥Department of Medicine, School of Medicine, Vanderbilt University, Nashville, TN ¶Center on Aging and Health, Johns Hopkins University, Baltimore, MD.
Med Care. 2013 Oct;51(10):949-55. doi: 10.1097/MLR.0b013e3182a53d1f.
With aging, the probability of experiencing multiple chronic conditions has increased, along with symptoms associated with these conditions. Symptoms form a central component of illness burden, and distress. To date, most symptom measures have focused on a particular disease population.
We aimed to develop and evaluate a simple symptom screen using data obtained from a representative sample of community-dwelling older adults.
Psychometric analyses were conducted on 10 self-reported dichotomous symptom indicators collected during in-person interviews from a sample of 1000 community-dwelling older adults. Symptoms included shortness of breath, feeling tired or fatigued, problems with balance or dizziness, perceived weakness in legs, constipation, daily pain, stiffness, poor appetite, anxiety, and anhedonia.
Over one third of the individuals (37.4%) had 5 or more concurrent symptoms. Stiffness and feeling tired were the most common symptoms. Confirmatory factor analyses were performed on the 10 symptoms for single factor and bifactor (physical and affective) models of symptom reporting. Goodness-of-fit indices indicated better fit for the bifactor model (χdf=10=89.6; P<0.001), but the practical significance of the improvement in fit was negligible. Differential item functioning analyses showed some differences of relatively high magnitude in location parameters by race; however, because the differential item functioning was in different directions, the impact on the overall measure was most likely lessened.
Among community-dwelling older adults, a large proportion experienced multiple co-occurring symptoms. This Brief Symptom Screen can be used to quickly measure the overall symptom load in older adult populations, including those with multiple chronic conditions.
随着年龄的增长，经历多种慢性疾病的可能性增加了，同时也出现了与这些疾病相关的症状。症状是疾病负担和痛苦的核心组成部分。迄今为止，大多数症状测量方法都集中在特定的疾病人群上。
我们旨在开发和评估一种简单的症状筛查方法，该方法使用从代表性的社区居住老年人样本中获得的数据。
对从 1000 名社区居住老年人的面对面访谈中收集的 10 个自我报告的二分症状指标进行心理测量学分析。症状包括呼吸急促、感到疲倦或疲劳、平衡或头晕问题、腿部无力感、便秘、每日疼痛、僵硬、食欲不振、焦虑和快感缺失。
超过三分之一的个体（37.4%）有 5 个或更多的并发症状。僵硬和疲倦是最常见的症状。对 10 种症状进行了单因素和双因素（身体和情感）症状报告模型的验证性因子分析。拟合优度指数表明双因素模型的拟合更好（χdf=10=89.6；P<0.001），但拟合的实际改善意义不大。差异项目功能分析表明，在种族方面，位置参数存在一些相对较大的差异；然而，由于差异项目功能的方向不同，对整体测量的影响很可能减弱。
在社区居住的老年人中，很大一部分人经历了多种同时发生的症状。这种简短症状筛查可以用于快速测量老年人群的整体症状负担，包括那些患有多种慢性疾病的人群。
