斯里兰卡语版虚弱非失能工具（FiND）的文化调适与验证。
Cultural adaptation and validation of the Sinhala version of the Frail Non-disabled tool (FiND).
机构信息
Department of Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
Department of Medicine, Faculty of Medicine, Sabaragamuwa University of Sri Lanka, Ratnapura, Sri Lanka.
出版信息
BMC Geriatr. 2024 Feb 14;24(1):154. doi: 10.1186/s12877-024-04749-0.
BACKGROUND
Frailty, a common geriatric syndrome of vulnerability, is associated with a decline in health and function. The most problematic expression of population ageing is associated with weakness, slowing, decreased energy, lower activity and when severe, unintended weight loss. Frailty is not consciously identified in clinical practice and is not widely studied in Sri Lanka. A validated tool for screening frailty in a busy clinical setting is therefore much needed. This study was done as a part of validating the Sinhala version of the Frail Non-Disabled (S-FiND) tool.
METHODS
The FiND tool was translated from English to Sinhala by two translators, blinded to each other. They were combined and translated back to the original language by two separate translators. After verifying the content validity, unambiguity and clarity of items in a focused group discussion, the pre-final version was piloted among 30 volunteers. After assessing the psychometric properties of the pre-final version, the final version was tested among 100 adults older than 65 years from the Colombo South Teaching Hospital. The tool was compared with Fried's frailty phenotype taken as the gold standard.
RESULTS
Data were analysed for the agreement with the reference standard, the Fried Phenotype. The mean (SD) age of subjects was 73.9 (7.8) years. The overall time taken to fill out the questionnaire was 2 min. The agreement (Kappa) between the S-FiND questionnaire and the Fried phenotype was 0.7 (P < 001). The sensitivity and specificity of FiND in detecting frailty were 92% and 74%, respectively. The agreements (Kappa) between the individual items of S-Find: involuntary loss of weight/ more than 4.5 kg over one year, the feeling of effort/ not getting going and level of physical activity, with the Fried phenotype, were 0.28 (p = 0.001), 0.06 (p = 0.045) and 0.339 (p < 0.001). respectively. When subjects were categorized frail and robust based on FiND, frail subjects reported a higher incidence of falls (50%) during the previous 12 months, compared to those robust (13%) (p < 0.001 for Chi stat).
CONCLUSION
The S-FiND is a reliable, valid and well-received tool that can be used in detecting the frailty of non-disabled Sinhala-speaking older adults.
背景
衰弱是一种常见的脆弱性老年综合征，与健康和功能下降有关。人口老龄化最成问题的表现是虚弱、行动缓慢、精力下降、活动量减少，严重时还会出现非故意的体重减轻。衰弱在临床实践中并未被有意识地识别出来，在斯里兰卡也没有得到广泛研究。因此，非常需要一种在繁忙的临床环境中筛查衰弱的经过验证的工具。本研究是验证英文版衰弱非残疾（S-FiND）工具的斯里兰卡语版本的一部分。
方法
FiND 工具由两名翻译员分别将其从英文翻译为僧伽罗语，然后将两人的译文合并，由两名独立的翻译员再翻译回原文。在焦点小组讨论中验证了内容的有效性、项目的明确性和清晰度之后，预终版在 30 名志愿者中进行了试点。在评估了预终版的心理测量特性后，终版在科伦坡南部教学医院的 100 名 65 岁以上的成年人中进行了测试。该工具与 Fried 的衰弱表型进行了比较，后者被视为金标准。
结果
根据与参考标准 Fried 表型的一致性对数据进行了分析。受试者的平均（标准差）年龄为 73.9（7.8）岁。填写问卷总共用时 2 分钟。S-FiND 问卷和 Fried 表型之间的一致性（Kappa）为 0.7（P<0.001）。FiND 检测衰弱的灵敏度和特异性分别为 92%和 74%。S-FiND 的个体项目（不自觉的体重减轻/1 年内超过 4.5 公斤、感到疲倦/力不从心和身体活动水平）与 Fried 表型之间的一致性（Kappa）分别为 0.28（p=0.001）、0.06（p=0.045）和 0.339（p<0.001）。当根据 FiND 将受试者归类为虚弱和健壮时，虚弱组报告在过去 12 个月内跌倒的发生率更高（50%），而健壮组为 13%（p<0.001，卡方检验）。
结论
S-FiND 是一种可靠、有效且广受欢迎的工具，可用于检测讲僧伽罗语的非残疾老年成年人的衰弱程度。
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