Geriatric Medicine Research, Centre for Health Care of the Elderly, Nova Scotia Health Authority, Halifax B3H 2E1, Nova Scotia, Canada.
Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax B3H 2E1, Nova Scotia, Canada.
Age Ageing. 2019 Nov 1;48(6):832-837. doi: 10.1093/ageing/afz111.
the Pictorial Fit-Frail Scale (PFFS) was designed as a simple and practical approach to the identification of frailty.
To investigate the feasibility and reliability of this visual image-based tool, when used by patients, caregivers and healthcare professionals (HCPs) in clinical settings.
observational study.
three outpatient geriatric healthcare settings.
patients (n = 132), caregivers (n = 84), clinic nurses (n = 7) and physicians (n = 10).
the PFFS was administered to all patients. Where available, HCPs and caregivers completed the scale based on the patients' health. In the geriatric day hospital, the PFFS was completed on admission and administered again within 7-14 days. Time and level of assistance needed to complete the scale were recorded. Intraclass correlation coefficients (ICCs) and 95% confidence intervals (CIs) were used to assess test-retest and inter-rater reliability.
mean time to complete the scale (minutes:seconds ± SD) was 4:30 ± 1:54 for patients, 3:13 ± 1:34 for caregivers, 1:28 ± 0:57 for nurses and 1:32 ± 1:40 for physicians. Most patients were able to complete the scale unassisted (64%). Mean patient PFFS score was 11.1 ± 5.3, mean caregiver score was 13.2 ± 6.3, mean nurse score was 10.7 ± 4.5 and mean physician score was 11.1 ± 5.6; caregiver scores were significantly higher than patient (P < 0.01), nurse (P < 0.001) and physician (P < 0.01) scores. Test-retest reliability was good for patients (ICC = 0.78, [95%CI = 0.67-0.86]) and nurses (ICC = 0.88 [0.80-0.93]). Inter-rater reliability between HCPs was also good (ICC = 0.75 [0.63-0.83]).
the PFFS is a feasible and reliable tool for use with patients, caregivers and HCPs in clinical settings. Further research on the validity and responsiveness of the tool is necessary.
画框衰弱量表（PFFS）是一种简单实用的衰弱识别方法。
调查患者、照护者和医护人员（HCP）在临床环境中使用这种基于视觉图像的工具的可行性和可靠性。
观察性研究。
三家门诊老年保健医疗机构。
患者（n=132）、照护者（n=84）、诊所护士（n=7）和医生（n=10）。
对所有患者进行 PFFS 评估。有条件的情况下，HCP 和照护者根据患者的健康状况完成量表。在老年日间医院，入院时完成 PFFS 并在 7-14 天内再次进行。记录完成量表所需的时间和辅助程度。使用组内相关系数（ICC）和 95%置信区间（CI）评估重测信度和评分者间信度。
患者完成量表的平均时间（分钟：秒±SD）为 4 分 30 秒±1 分 54 秒，照护者为 3 分 13 秒±1 分 34 秒，护士为 1 分 28 秒±0 分 57 秒，医生为 1 分 32 秒±1 分 40 秒。大多数患者无需辅助即可完成量表（64%）。患者的平均 PFFS 评分为 11.1±5.3，照护者为 13.2±6.3，护士为 10.7±4.5，医生为 11.1±5.6；照护者评分明显高于患者（P<0.01）、护士（P<0.001）和医生（P<0.01）评分。患者和护士的重测信度均良好（ICC=0.78[0.67-0.86]）。HCP 之间的评分者间信度也较好（ICC=0.75[0.63-0.83]）。
PFFS 是一种在临床环境中患者、照护者和 HCP 使用可行且可靠的工具。需要进一步研究该工具的有效性和反应性。
