Spector W D, Katz S, Murphy J B, Fulton J P
J Chronic Dis. 1987;40(6):481-9. doi: 10.1016/0021-9681(87)90004-x.
A three-level hierarchical scale including IADL (shopping and transportation) and ADL (bathing, dressing, transferring, and feeding) was tested and validated based on secondary analysis of three studies of elders in the community: a population-based sample, the Cleveland-GAO, and two service-based samples, the Alternative Health Services Project, a study of Medicaid-eligible elders in Georgia, and the Section 222 Homemaker-Day Care study, a sample of Medicare-eligible elders. Scalability analysis included evaluation of Kronbach's alpha, Guttman analysis, and analysis of the pairwise association of individual items using phi/phi max. Validation included discriminant validity and predictive validity. With respect to discriminant validity, the negative association between functional ability (as measured by the scale) and age was observed. With respect to predictive validity, the negative relationship between functional ability (as measured by the scale) and risk of decline to ADL, death, and hospitalization in a year was observed. A six-level scale similar in structure and detail to the Katz Index of ADL was examined with the three studies. This scale can be used to described a broader range of needs of elders in the community and will be particularly useful to health services planners, practitioners, and researchers.
基于对社区中老年人的三项研究的二次分析，对一个包括工具性日常生活活动能力（购物和交通）和日常生活活动能力（洗澡、穿衣、转移和进食）的三级层次量表进行了测试和验证：一个基于人群的样本，即克利夫兰-老年事务办公室研究；以及两个基于服务的样本，即替代健康服务项目（一项对佐治亚州符合医疗补助条件的老年人的研究）和第222条家政日托研究（一个符合医疗保险条件的老年人样本）。量表可扩展性分析包括对克朗巴赫α系数的评估、古特曼分析以及使用φ/φ最大值对各个项目的成对关联进行分析。验证包括区分效度和预测效度。关于区分效度，观察到功能能力（由该量表测量）与年龄之间呈负相关。关于预测效度，观察到功能能力（由该量表测量）与一年内日常生活活动能力下降、死亡和住院风险之间呈负相关。还对与卡茨日常生活活动能力指数在结构和细节上相似的六级量表进行了这三项研究的检验。该量表可用于描述社区中老年人更广泛的需求，对卫生服务规划者、从业者和研究人员将特别有用。
