School of Nursing, Shandong University, Jinan, China.
School of Nursing, Shandong University, Jinan, China.
J Am Med Dir Assoc. 2018 Jan;19(1):12-17. doi: 10.1016/j.jamda.2017.06.011. Epub 2017 Jul 27.
OBJECTIVE: To cross-culturally adapt and test the FRAIL scale in Chinese community-dwelling older adults. DESIGN: Cross-sectional study. METHODS: The Chinese FRAIL scale was generated by translation and back-translation. An urban sample of 1235 Chinese community-dwelling older adults was enrolled to test its psychometric properties, including convergent validity, criterion validity, known-group divergent validity, internal consistency and test-retest reliability. RESULTS: The Chinese FRAIL scale achieved semantic, idiomatic, and experiential equivalence. The convergent validity was confirmed by statistically significant kappa coefficients (0.209-0.401, P < .001) of each item with its corresponding alternative measurement, including the 7th item of the Center for Epidemiologic Studies-Depression Scale, the Timed Up and Go test, 4-m walking speed, polypharmacy, and the Short-Form Mini Nutritional Assessment. Using the Fried frailty phenotype as an external criterion, the Chinese FRAIL scale showed satisfactory diagnostic accuracy for frailty (area under the curve = 0.91). The optimal cut-point for frailty was 2 (sensitivity: 86.96%, specificity: 85.64%). The Chinese FRAIL scale had fair agreement with the Fried frailty phenotype (kappa = 0.274, P < .001), and classified more participants into frailty (17.2%) than the Fried frailty phenotype (3.9%). More frail individuals were recognized by the Chinese FRAIL scale among older and female participants than their counterparts (P < .001), respectively. It had low internal consistency (Kuder-Richardson formula 20 = 0.485) and good test-retest reliability within a 7- to 15-day interval (intraclass correlation coefficient = 0.708). CONCLUSIONS: The Chinese FRAIL scale presents acceptable validity and reliability and can apply to Chinese community-dwelling older adults.
目的:跨文化调适并测试中文版衰弱评估工具(FRAIL)量表于中国社区老年人。 设计:横断面研究。 方法:通过翻译和回译生成中文版 FRAIL 量表。纳入城市样本 1235 例中国社区老年人,以测试其心理测量学特性,包括聚合效度、效标效度、已知组差异效度、内部一致性和重测信度。 结果:中文版 FRAIL 量表实现了语义、惯用和经验等效性。各条目与其对应替代测量之间存在统计学显著的kappa 系数(0.209-0.401,P<.001),验证了聚合效度,包括中心抑郁量表第 7 项、计时起立行走测试、4 米行走速度、多药治疗和简短营养评估。使用 Fried 衰弱表型作为外部标准,中文版 FRAIL 量表对衰弱的诊断准确性较高(曲线下面积=0.91)。衰弱的最佳截断点为 2(灵敏度:86.96%,特异度:85.64%)。中文版 FRAIL 量表与 Fried 衰弱表型具有较好的一致性(kappa=0.274,P<.001),并将更多参与者归类为衰弱(17.2%),而 Fried 衰弱表型仅归类 3.9%。与对照组相比,中文版 FRAIL 量表在老年和女性参与者中识别出更多的衰弱个体(P<.001)。中文版 FRAIL 量表内部一致性较低(Kuder-Richardson 公式 20=0.485),7-15 天内重测信度良好(组内相关系数=0.708)。 结论:中文版 FRAIL 量表具有可接受的效度和信度,可应用于中国社区老年人。
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