Ferreira Ana Rita, Martins Sonia, Ribeiro Orquidea, Fernandes Lia
Faculty of Medicine, University of Porto, Al. Hernani Monteiro, 4200-319 Porto, Portugal.
Research and Education Unit on Aging (UNIFAI), University of Porto, Rua Jorge de Viterbo Ferreira, no. 228, 4050-313 Porto, Portugal.
J Clin Med Res. 2015 Jan;7(1):21-8. doi: 10.14740/jocmr1959w. Epub 2014 Oct 16.
Neuropsychiatric symptoms are very common in dementia and have been associated with patient and caregiver distress, increased risk of institutionalization and higher costs of care. In this context, the neuropsychiatric inventory (NPI) is the most widely used comprehensive tool designed to measure neuropsychiatric Symptoms in geriatric patients with dementia. The aim of this study was to present the validity and reliability of the European Portuguese version of NPI.
A cross-sectional study was carried out with a convenience sample of institutionalized patients (≥ 50 years old) in three nursing homes in Portugal. All patients were also assessed with mini-mental state examination (MMSE) (cognition), geriatric depression scale (GDS) (depression) and adults and older adults functional assessment inventory (IAFAI) (functionality). NPI was administered to a formal caregiver, usually from the clinical staff. Inter-rater and test-retest reliability were assessed in a subsample of 25 randomly selected subjects.
The sample included 166 elderly, with a mean age of 80.9 (standard deviation: 10.2) years. Three out of the NPI behavioral items had negative correlations with MMSE: delusions (rs = -0.177, P = 0.024), disinhibition (rs = -0.174, P = 0.026) and aberrant motor activity (rs = -0.182, P = 0.020). The NPI subsection of depression/dysphoria correlated positively with GDS total score (rs = 0.166, P = 0.038). NPI showed good internal consistency (overall α = 0.766; frequency α = 0.737; severity α = 0.734). The inter-rater reliability was excellent (intraclass correlation coefficient (ICC): 1.00, 95% confidence interval (CI) 1.00 - 1.00), as well as test-retest reliability (ICC: 0.91, 95% CI 0.80 - 0.96).
The results found for convergent validity, inter-rater and test-retest reliability, showed that this version appears to be a valid and reliable instrument for evaluation of neuropsychiatric symptoms in institutionalized elderly.
神经精神症状在痴呆症中非常常见，与患者及照料者的痛苦、入住机构的风险增加以及更高的护理成本相关。在此背景下，神经精神科问卷（NPI）是用于测量老年痴呆症患者神经精神症状的最广泛使用的综合工具。本研究的目的是呈现欧洲葡萄牙语版NPI的效度和信度。
对葡萄牙三家养老院中≥50岁的机构化患者便利样本进行横断面研究。所有患者还接受了简易精神状态检查表（MMSE）（认知）、老年抑郁量表（GDS）（抑郁）以及成人及老年人功能评估量表（IAFAI）（功能）评估。NPI由通常来自临床工作人员的正式照料者进行评定。在25名随机选取的受试者子样本中评估评分者间信度和重测信度。
样本包括166名老年人，平均年龄为80.9（标准差：10.2）岁。NPI行为项目中的三项与MMSE呈负相关：妄想（rs = -0.177，P = 0.024）、脱抑制（rs = -0.174，P = 0.026）和异常运动行为（rs = -0.182，P = 0.020）。抑郁/烦躁不安的NPI子部分与GDS总分呈正相关（rs = 0.166，P = 0.038）。NPI显示出良好的内部一致性（总体α = 0.766；频率α = 0.737；严重程度α = 0.734）。评分者间信度极佳（组内相关系数（ICC）：1.00，95%置信区间（CI）1.00 - 1.00），重测信度也如此（ICC：0.91，95% CI 0.80 - 0.96）。
所发现的关于收敛效度、评分者间信度和重测信度的结果表明，该版本似乎是评估机构化老年人神经精神症状的有效且可靠的工具。
