Ahip Sally S, Ghazali Sazlina S, Theou Olga, Samad Azah A, Lukas Sabrina, Mustapha Ummu K, Thompson Mark Q, Visvanathan Renuka
Kota Samarahan Health Clinic, Sarawak, Malaysia.
National Health and Medical Research Council Centre of Research Excellence, Adelaide Medical School and Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.
Fam Pract. 2023 Mar 28;40(2):290-299. doi: 10.1093/fampra/cmac089.
This study investigated the reliability and convergent validity of the PFFS-Malay version (PFFS-M) among patients (with varying educational levels), caregivers, and health care professionals (HCPs). PFFS-M cutoffs for frailty severity were developed.
This is a cross-sectional study from 4 primary care clinics where 240 patients aged >60 years and their caregivers were enrolled. Patients were assigned to a nurse or a health care assistant (HCA) for 2 separate PFFS-M assessments administered by HCPs of the same profession, as well as by a doctor during the first visit (inter-rater reliability). Patients were also administered the Self-Assessed Report of Personal Capacity & Healthy Ageing (SEARCH) tool, a 40-item frailty index, by a research officer. The correlation between patients' PFFS-M scores and SEARCH tool scores determined convergent validity. Patients returned 1 week later for PFFS-M reassessment by the same HCPs (test-retest reliability). Caregivers completed the PFFS-M for the patient at both clinic visits. Classification cut-points for the PFFS-M were derived against frailty categories defined through the SEARCH tool.
The inter-rater (intraclass correlation coefficient [ICC] = 0.92 [95% CI, 0.90-0.93)] and test-retest (ICC = 0.94 [95% CI, 0.92-0.95]) reliability between all raters was excellent, including by patients' education levels. The convergent validity was moderate (r = 0.637, p < 0.001), including for varying educational background. PFFS-M categories were identified as: 0-3, no frailty; 4-5, at risk of frailty; 6-8, mild frailty; 9-12, moderate frailty; and >13, severe frailty.
PFFS-M is a reliable and valid tool with frailty severity scores now established for use of this tool in primary care clinics.
本研究调查了患者（教育水平各异）、护理人员和医疗保健专业人员（HCPs）中马来语版老年人身体功能与衰弱量表（PFFS-M）的可靠性和收敛效度。制定了PFFS-M衰弱严重程度的临界值。
这是一项来自4家初级保健诊所的横断面研究，纳入了240名年龄大于60岁的患者及其护理人员。患者被分配给一名护士或一名医疗保健助理（HCA），由同专业的HCPs进行2次独立的PFFS-M评估，以及在首次就诊时由一名医生进行评估（评分者间信度）。还由一名研究人员对患者进行了个人能力与健康老龄化自我评估报告（SEARCH）工具（一个包含40个条目的衰弱指数）的评估。患者的PFFS-M评分与SEARCH工具评分之间的相关性确定了收敛效度。患者1周后返回，由相同的HCPs进行PFFS-M重新评估（重测信度）。护理人员在两次诊所就诊时均为患者完成PFFS-M评估。根据通过SEARCH工具定义的衰弱类别得出PFFS-M的分类切点。
所有评分者之间的评分者间（组内相关系数[ICC]=0.92[95%CI，0.90-0.93]）和重测（ICC=0.94[95%CI，0.92-0.95]）信度都非常好，包括按患者教育水平分层。收敛效度为中等（r=0.637，p<0.001），包括不同教育背景的情况。PFFS-M类别被确定为：0-3，无衰弱；4-5，有衰弱风险；6-8，轻度衰弱；9-12，中度衰弱；>13，重度衰弱。
PFFS-M是一种可靠且有效的工具，现已确定了衰弱严重程度评分，可用于初级保健诊所使用该工具。
