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对基层医疗中使用的身体活动评估工具的系统评价。

A systematic review of the physical activity assessment tools used in primary care.

作者信息

Smith Toby O, McKenna Máire C, Salter Charlotte, Hardeman Wendy, Richardson Kathryn, Hillsdon Melvyn, Hughes Carly A, Steel Nicholas, Jones Andy P

机构信息

School of Health Sciences, University of East Anglia, Norwich, UK.

Occupational Therapy Department, Queen Elizabeth Hospital, Kings Lynn, UK.

出版信息

Fam Pract. 2017 Aug 1;34(4):384-391. doi: 10.1093/fampra/cmx011.

Abstract

BACKGROUND

Primary care is an ideal setting for physical activity interventions to prevent and manage common long-term conditions. To identify those who can benefit from such interventions and to deliver tailored support, primary care professionals (e.g. GPs, practice nurses, physiotherapists, health care assistants) need reliable and valid tools to assess physical activity. However, there is uncertainty about the best-performing tool.

OBJECTIVE

To identify the tools used in the literature to assess the physical activity in primary care and describe their psychometric properties.

METHOD

A systematic review of published and unpublished literature was undertaken up to 1 December 2016). Papers detailing physical activity measures, tools or approaches used in primary care consultations were included. A synthesis of the frequency and context of their use, and their psychometric properties, was undertaken. Studies were appraised using the Downs and Black critical appraisal tool and the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) initiative checklist.

RESULTS

Fourteen papers reported 10 physical activity assessment tools. The General Practice Physical Activity Questionnaire (GPPAQ) was most frequently reported. None of the assessment tools identified showed high reliability and validity. Intra-rater reliability ranged from kappa: 0.53 [Brief Physical Activity Assessment Tool (BPAAT)] to 0.67 (GPPAQ). Criterion validity ranged from Pearson's rho: 0.26 (GPPAQ) to 0.52 (Physical Activity Vital Sign). Concurrent validity ranged from kappa: 0.24 (GPPAQ) to 0.64 (BPAAT).

CONCLUSION

The evidence base about physical activity assessment in primary care is insufficient to inform current practice.

摘要

背景

基层医疗是开展身体活动干预以预防和管理常见慢性病的理想场所。为了确定哪些人能从此类干预中受益并提供量身定制的支持,基层医疗专业人员(如全科医生、执业护士、物理治疗师、医疗保健助理)需要可靠且有效的工具来评估身体活动。然而,对于表现最佳的工具尚无定论。

目的

确定文献中用于评估基层医疗中身体活动的工具,并描述其心理测量特性。

方法

截至2016年12月1日,对已发表和未发表的文献进行了系统综述。纳入了详细介绍基层医疗咨询中使用的身体活动测量方法、工具或途径的论文。对其使用频率、背景及其心理测量特性进行了综合分析。使用唐斯和布莱克批判性评价工具以及基于共识的健康测量工具选择标准(COSMIN)倡议清单对研究进行评价。

结果

14篇论文报告了10种身体活动评估工具。《全科医疗身体活动问卷》(GPPAQ)被提及的频率最高。所确定的评估工具均未显示出高可靠性和有效性。评分者内信度范围为kappa值:0.53[简短身体活动评估工具(BPAAT)]至0.67(GPPAQ)。效标效度范围为皮尔逊相关系数rho值:0.26(GPPAQ)至0.52(身体活动生命体征)。同时效度范围为kappa值:0.24(GPPAQ)至0.64(BPAAT)。

结论

关于基层医疗中身体活动评估的证据基础不足以指导当前实践。

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