UCLA Division of General Internal Medicine, Department of Medicine, Los Angeles, CA.
RAND Corporation, Santa Monica, CA.
Arch Phys Med Rehabil. 2024 Apr;105(4):696-703. doi: 10.1016/j.apmr.2023.11.005. Epub 2023 Nov 21.
Assessing functional limitations for adults at high risk of frailty yields valuable information for identifying those in need of therapy. We evaluate a self-report measure used to assess physical function among Medicare recipients in the United States.
Secondary analysis of the 2020 Medicare Health Outcomes Survey.
A random sample of adult enrollees of 510 managed care plans.
287,476 adults (37% completion rate): 58% women; 16% were <65 years old (entitled via disability), 50% 65-74, and 34% 75 or older; 77% White, 14% Black, and 8% another race; 19% had <high school education.
Not applicable.
We evaluate item distributions, dimensionality, monotonicity of response options, reliability, and validity of the 8-item Physical Functioning Activities of Daily Living (PFADL) scale.
Most reported they could do 6 basic activities of daily living without difficulty. More limitations were reported for the other 2 PFADL items: 32% were not limited at all in climbing several flights of stairs and 40% in moderate activities. Product-moment correlations among the 8 items ranged from r=0.19 between the easiest-to-do (eating) and most difficult-to-do (climbing several flights of stairs) items to r=0.73 between bathing and dressing. The coefficient alpha and omega for the 8-item scale were both 0.86. Item slopes ranged from 2.6 (climbing several flights of stairs and eating) to 4.8 (dressing). Item characteristic curves revealed that response options were most likely to be selected in the appropriate order along the physical functioning continuum. The PFADL had at least 0.80 reliability between about -3 SDs below the mean to the mean. It was negatively correlated with comorbid condition count, disability days, problems with balance or walking, falling, and obesity.
The PFADL is useful for assessing average or below physical function in Medicare recipients.
评估高脆弱风险成年人的功能障碍，可以为识别需要治疗的人群提供有价值的信息。我们评估了一种用于评估美国医疗保险接受者身体功能的自我报告测量方法。
对 2020 年医疗保险健康结果调查的二次分析。
510 个管理式医疗计划的成年参保者的随机样本。
287476 名成年人（完成率 37%）：58%为女性；16%年龄<65 岁（因残疾而有资格），50%为 65-74 岁，34%为 75 岁或以上；77%为白人，14%为黑人，8%为其他种族；19%未完成高中学业。
不适用。
我们评估了 8 项日常生活活动身体功能（PFADL）量表的项目分布、维度、反应选项的单调性、信度和效度。
大多数人报告说他们可以毫不费力地完成 6 项基本日常生活活动。对于其他 2 项 PFADL 项目，报告的限制更多：32%的人在爬几段楼梯时完全不受限制，40%的人在进行中等活动时不受限制。8 个项目之间的积矩相关系数范围从最容易完成的项目（进食）和最难完成的项目（爬几段楼梯）之间的 r=0.19 到洗澡和穿衣之间的 r=0.73。8 项量表的克朗巴赫α系数和奥克姆 omega 系数均为 0.86。项目斜率范围从 2.6（爬几段楼梯和进食）到 4.8（穿衣）。项目特征曲线表明，在身体功能连续体上，反应选项最有可能按适当顺序选择。PFADL 在大约 -3 个标准差低于平均值到平均值之间的可靠性至少为 0.80。它与共病数量、残疾天数、平衡或行走问题、跌倒和肥胖呈负相关。
PFADL 可用于评估医疗保险接受者的平均或以下身体功能。
