Agaplesion Bethanien Hospital Heidelberg/Geriatric Center at the Heidelberg University, and Center of Geriatric Medicine, Heidelberg University, 69126 Heidelberg, Germany.
Network Aging Research (NAR), Heidelberg University, 69115 Heidelberg, Germany.
Int J Environ Res Public Health. 2021 Apr 7;18(8):3872. doi: 10.3390/ijerph18083872.
(1) Background: Life-space mobility assessments for institutionalized settings are scarce and there is a lack of comprehensive validation and focus on persons with cognitive impairment (CI). This study aims to evaluate the psychometric properties of the Life-Space Assessment for Institutionalized Settings by proxy informants (LSA-IS-proxy) for institutionalized, older persons, with and without CI. (2) Methods: Concurrent validity against the self-reported version of the LSA-IS, construct validity with established construct variables, test-retest reliability, sensitivity to change during early multidisciplinary geriatric rehabilitation treatment, and feasibility (completion rate, floor/ceiling effects) of the LSA-IS-proxy, were assessed in 94 hospitalized geriatric patients (83.3 ± 6.1 years), with and without CI. (3) Results: The LSA-IS-proxy total score showed good-to-excellent agreement with the self-reported LSA-IS (Intraclass Correlations Coefficient, ICC = 0.77), predominantly expected small-to-high correlations with construct variables ( = 0.21-0.59), good test-retest reliability (ICC = 0.74), significant sensitivity to change over the treatment period (18.5 ± 7.9 days; < 0.001, standardized response mean = 0.44), and excellent completion rates (100%) with no floor/ceiling effects. These results were predominantly confirmed for the sub-scores of the LSA-IS-proxy and were comparable between the sub-groups with different cognitive status. (4) Conclusions: The LSA-IS-proxy has proven to be feasible, valid, reliable, and sensitive to change in hospitalized, geriatric patients with and without CI.
（1）背景：针对机构环境的生活空间流动性评估很少，并且缺乏针对认知障碍（CI）患者的全面验证和关注。本研究旨在评估通过代理报告者对机构化环境下的生活空间评估（LSA-IS-proxy）对有和没有 CI 的机构化老年患者的心理测量特性。（2）方法：在 94 名住院老年患者（83.3 ± 6.1 岁）中，评估了 LSA-IS-proxy 与自我报告的 LSA-IS 的同时效性、与既定结构变量的结构有效性、测试-再测试可靠性、在早期多学科老年康复治疗过程中的变化敏感性，以及 LSA-IS-proxy 的可行性（完成率、地板/天花板效应），这些患者中有和没有 CI。（3）结果：LSA-IS-proxy 总分与自我报告的 LSA-IS 具有良好到极好的一致性（组内相关系数，ICC = 0.77），与结构变量主要呈现预期的小到高相关性（ = 0.21-0.59），测试-再测试可靠性良好（ICC = 0.74），在治疗期间变化敏感（18.5 ± 7.9 天； < 0.001，标准化反应均值 = 0.44），并且完成率很高（100%），没有地板/天花板效应。这些结果主要在 LSA-IS-proxy 的子量表中得到证实，并且在不同认知状态的亚组之间具有可比性。（4）结论：LSA-IS-proxy 已被证明在有和没有 CI 的住院老年患者中是可行的、有效的、可靠的和对变化敏感的。
