基于访谈的生活空间评估在有和无认知障碍的机构老年人中的验证。
Validation of the interview-based life-space assessment in institutionalized settings (LSA-IS) for older persons with and without cognitive impairment.
机构信息
AGAPLESION Bethanien Hospital Heidelberg/Geriatric Centre of the University of Heidelberg, Rohrbacher Str. 149, 69126, Heidelberg, Germany.
Center of Geriatric Medicine, Heidelberg University, Heidelberg, Germany.
出版信息
BMC Geriatr. 2020 Dec 10;20(1):534. doi: 10.1186/s12877-020-01927-8.
BACKGROUND
Self-reported life-space assessment methods so far focus on community-dwelling persons, with a lack of validated assessment methods for institutionalized settings. This study evaluated construct validity, test-retest reliability, sensitivity to change, and feasibility of a new Life-Space Assessment for Institutionalized Settings (LSA-IS) in geriatric patients.
METHODS
Psychometric properties of the LSA-IS in 119 hospitalized geriatric patients (83.0 ± 6.2 years) with and without cognitive impairment (CI) [Mini-Mental State Examination: 22.4 ± 4.9 scores] were evaluated within a comprehensive validation design. For the total group and subgroups according to cognitive status, construct validity was assessed by calculating Spearman's rank correlation coefficients (rho) with established construct variables, test-retest reliability by intra-class correlation coefficients (ICCs), sensitivity to change by standardized response means (SRMs) calculated for effects of early ward-based rehabilitation during hospital stay.
RESULTS
The LSA-IS (total score) demonstrated good test-retest reliability (ICC = .704), and large sensitivity to change (SRM = .806), while construct validity was small to high indicated by significant correlations of the LSA-IS to construct variables (rho = .208-716), depending on relative construct association. On average results of LSA-IS sub-scores confirmed results of the total score. Subgroups according to cognitive status did not differ for most analyzed variables. A completion rate of 100% and a completion time of 3.2 ± 1.2 min documented excellent feasibility.
CONCLUSIONS
The interview-based LSA-IS has proven to be valid, reliable, sensitive, and feasible in hospitalized, multi-morbid, geriatric patients with and without CI documenting good psychometric properties for institutionalized settings.
TRIAL REGISTRATION
DRKS00016028.
背景
迄今为止，自我报告的生活空间评估方法主要关注社区居住人群，而对于机构化环境缺乏经过验证的评估方法。本研究评估了新的机构化生活空间评估（LSA-IS）在老年住院患者中的构念效度、重测信度、变化敏感性和可行性。
方法
在综合验证设计中，对 119 名患有和不患有认知障碍（CI）的住院老年患者（83.0±6.2 岁；Mini-Mental State Examination：22.4±4.9 分）进行 LSA-IS 的心理测量学特性评估。对于总组和根据认知状态的亚组，通过与既定构念变量计算 Spearman 等级相关系数（rho）来评估构念效度，通过组内相关系数（ICC）评估重测信度，通过计算住院期间早期基于病房的康复治疗效果的标准化反应均值（SRM）来评估变化敏感性。
结果
LSA-IS（总分）表现出良好的重测信度（ICC=0.704）和较大的变化敏感性（SRM=0.806），而构念效度则根据相对构念关联的大小从低到高不等，其与构念变量的相关性显著（rho=0.208-716）。LSA-IS 子量表的平均结果证实了总分的结果。根据认知状态的亚组在大多数分析变量上没有差异。100%的完成率和 3.2±1.2 分钟的完成时间记录了极好的可行性。
结论
基于访谈的 LSA-IS 在患有和不患有 CI 的住院、多病老年患者中具有有效性、可靠性、敏感性和可行性，为机构化环境提供了良好的心理测量学特性。
试验注册
DRKS00016028。
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