评估心力衰竭三种虚弱表型版本的会聚和判别有效性：FRAME-HF 研究结果。

Evaluating the convergent and discriminant validity of three versions of the frailty phenotype in heart failure: results from the FRAME-HF study.

机构信息

Faculty of Health, University of Technology Sydney, Australia.

School of Nursing and Midwifery, Western Sydney University, Australia.

出版信息

Eur J Cardiovasc Nurs. 2020 Jan;19(1):55-63. doi: 10.1177/1474515119865150. Epub 2019 Jul 21.

DOI:10.1177/1474515119865150

PMID:31328532

Abstract

BACKGROUND

Frailty is an important predictive measure of mortality and rehospitalisation in people with heart failure. To date, there are no frailty instruments validated for use in people with heart failure.

AIM

The aim of this study was to evaluate the convergent and discriminant validity of three versions of the frailty phenotype in those with heart failure.

METHODS

A single site, prospective cohort study was undertaken among individuals with a confirmed diagnosis of heart failure. Frailty was assessed concurrently using three versions of the frailty phenotype: the original frailty phenotype and two modified versions; the Survey of Health, Ageing and Retirement in Europe frailty instrument (SHARE-FI) and the St Vincent's frailty instrument. Convergent and discriminant validity were assessed by reporting the correlations between each version and related heart failure subconstructs, and by evaluating the ability of each version to discriminate between normal and abnormal scores of other physical and psychosocial scales specific to heart failure-related subconstructs.

RESULTS

The New York Heart Association classes were moderately correlated with the St Vincent's frailty instrument (=0.47, ⩽0.001), SHARE-FI (=0.42, ⩽0.001) and the frailty phenotype (=0.42, ⩽0.001). The SHARE-FI and the St Vincent's frailty instrument were both able to discriminate consistently between normal and abnormal scores in three out of five of the physical and psychosocial subconstructs that were assessed. The SHARE-FI was also able to discriminate between inpatients and outpatients who were classified as frail.

CONCLUSIONS

Both the SHARE-FI and the St Vincent's frailty instrument displayed good convergent and discriminant validity.

摘要

背景

衰弱是预测心力衰竭患者死亡率和再住院率的重要指标。迄今为止，尚无针对心力衰竭患者的衰弱量表得到验证。

目的

本研究旨在评估三种衰弱表型版本在心力衰竭患者中的收敛和判别效度。

方法

采用单站点前瞻性队列研究，纳入确诊为心力衰竭的患者。同时使用三种衰弱表型版本评估衰弱：原始衰弱表型和两种改良版本；欧洲健康、老龄化和退休调查（SHARE-FI）衰弱量表和圣文森特衰弱量表。通过报告每个版本与相关心力衰竭亚结构之间的相关性，以及评估每个版本区分正常和异常的心力衰竭相关亚结构的特定物理和心理社会量表的能力，评估收敛和判别效度。

结果

纽约心脏协会（NYHA）分级与圣文森特衰弱量表（=0.47，P<0.001）、SHARE-FI（=0.42，P<0.001）和衰弱表型（=0.42，P<0.001）中度相关。SHARE-FI 和圣文森特衰弱量表都能够在五个物理和心理社会亚结构中的三个亚结构中，一致地区分正常和异常评分。SHARE-FI 还能够区分被归类为衰弱的住院患者和门诊患者。