Assistant Professor, Nursing, School of Nursing and Healthcare Professions, The College of New Rochelle, New Rochelle, NY, USA.
Professor and Chair, Department of Behavioral Sciences, Teachers College, Columbia University, New York, NY, USA.
J Nurs Scholarsh. 2018 Jan;50(1):65-73. doi: 10.1111/jnu.12351. Epub 2017 Oct 25.
To conduct an integrated review of the performance and implementation of two physical activity (PA) assessment tools, the exercise vital sign (EVS) and the physical activity vital sign (PAVS), in U.S. primary care practice.
An integrative review following Whittemore and Knafl's methodology.
Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched. Search terms were "exercise vital sign" OR "physical activity vital sign" AND "primary care". Additional inclusion criteria were studies conducted in the United States, published in English, in primary care, between 2010 and 2016.
Nine studies met inclusion criteria. Five studies reported validity data of the EVS tool, while four studies reported data from the PAVS tool. Compared with the accelerometer, the EVS tool overestimated moderate-vigorous PA, while the PAVS tool demonstrated moderate agreement in identifying those not meeting national PA guidelines. The EVS tool was successfully implemented in large, integrated practices utilizing electronic health record systems. PA documentation increased compared to non-EVS practices. The predictive ability of the PAVS tool for clinical outcomes was shown. Studies of PA assessment tool use in children were not found.
Preliminary evidence on the validity of both the EVS and PAVS tools support cautious use of each as a screening tool in primary care. There were no data on reliability, with limited data on tool use in diverse populations or settings. Data in children, older adults, and diverse population subgroups were lacking.
Two brief exercise vital signs tools have each shown some initial validity for use by primary care clinicians as measures to identify patients not meeting PA guidelines.
综合评估两种体力活动（PA）评估工具——运动生命体征（EVS）和体力活动生命体征（PAVS）——在美国初级保健实践中的表现和实施情况。
遵循 Whittemore 和 Knafl 方法的综合回顾。
在 Medline 和 Cumulative Index to Nursing and Allied Health Literature（CINAHL）数据库中进行检索。搜索词为“exercise vital sign”或“physical activity vital sign”AND“primary care”。其他纳入标准是在美国进行的研究，发表于 2010 年至 2016 年期间的英文文献，且发表于初级保健领域。
符合纳入标准的研究有 9 项。其中 5 项研究报告了 EVS 工具的有效性数据，4 项研究报告了 PAVS 工具的数据。与加速度计相比，EVS 工具高估了中度到剧烈强度的 PA，而 PAVS 工具在识别不符合国家 PA 指南的人群方面表现出中等程度的一致性。EVS 工具在利用电子健康记录系统的大型综合实践中成功实施。与非 EVS 实践相比，PA 记录有所增加。还展示了 PAVS 工具对临床结果的预测能力。未发现有关儿童使用 PA 评估工具的研究。
关于 EVS 和 PAVS 工具的有效性的初步证据支持谨慎地将其作为初级保健中的筛查工具使用。没有关于可靠性的数据，关于工具在不同人群或环境中的使用的有限数据。在儿童、老年人和不同人群亚组中缺乏数据。
两种简短的运动生命体征工具都显示出一些初步的有效性，可由初级保健临床医生作为识别不符合 PA 指南的患者的衡量标准。
