Rathnayake Nirmala, Karunadasa Ruvini, Abeygunasekara Thilina, De Zoysa Warsha, Palangasinghe Dhammika, Lekamwasam Sarath
Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Sri Lanka.
Department of Medicine, Faculty of Medicine, University of Ruhuna, Sri Lanka.
Dialogues Health. 2023 Apr 20;2:100134. doi: 10.1016/j.dialog.2023.100134. eCollection 2023 Dec.
This study evaluated the reliability and validity of the Sinhala version of Katz index of activities of daily living (ADL) in assessing the functional status of older people aged >65 years.
The Katz index was translated to Sinhala, cross-culturally adapted and administered in two stages. In stage 01, 200 patients aged ≥65 years, selected randomly from out-patient medical clinics, were asked to fill the Sinhala version of Katz index along with the Sinhala version of the 10-item Barthel index (BI). The Katz index was re-administered after two weeks among a subgroup of 45 patients selected randomly. In stage 02, Katz index was administered among randomly selected 200 community dwelling older people, aged ≥65 years. In addition, performance-based physical functions [gait speed (GS) and short physical performance battery (SPPB)] were also measured.
The analysis of stage 01 data showed internal consistency measured with Cronbach's alpha of 0.82 and test-retest reliability evaluated with intra-class correlation (ICC) (95% CI) of 0.94 (0.89-0.96) ( < 0.001). Exploratory Factor Analysis with the Principal Component Analysis revealed the presence of two factors with Eigen value exceeding 01, explaining 75.9% of cumulative variance. Further, the Sinhala version of Katz index total score showed a strong correlation with the BI total score ( = 0.91, < 0.001) indicating strong concurrent validity. The stage 02 data revealed that older people with poor perception of general health status had lower mean (SD) Katz index score (3.58 ± 1.82) compared to those with good perception of health (5.56 ± 0.79) ( < 0.001). Similarly older people with prevalent diseases had comparatively lower scores of Katz index, compared to those without, indicating the known group validity ( < 0.05). Further, moderate correlations between the Katz index and performance based physical functions were observed showing the agreement (with GS - r; -0.26, < 0.001, with SPPB - r; 0.31, p < 0.001).
We conclude that the Sinhala version of Katz index has satisfactory psychometric properties and it is a reliable and valid tool to assess the functional status of Sinhala conversant older people in Sri Lanka.
本研究评估了僧伽罗语版日常生活活动能力（ADL）的卡茨指数在评估65岁以上老年人功能状态方面的可靠性和有效性。
卡茨指数被翻译成僧伽罗语，并分两个阶段进行跨文化改编和应用。在第一阶段，从门诊随机选取200名年龄≥65岁的患者，要求他们填写僧伽罗语版的卡茨指数以及10项巴氏指数（BI）的僧伽罗语版。在随机选取的45名患者亚组中，两周后再次进行卡茨指数评估。在第二阶段，对随机选取的200名年龄≥65岁的社区居住老年人进行卡茨指数评估。此外，还测量了基于表现的身体功能[步速（GS）和简短身体表现量表（SPPB）]。
第一阶段数据分析显示，用Cronbach's alpha测得的内部一致性为0.82，用组内相关系数（ICC）（95%CI）评估的重测信度为0.94（0.89 - 0.96）（P < 0.001）。主成分分析的探索性因子分析显示存在两个特征值超过0.1的因子，解释了75.9%的累积方差。此外，僧伽罗语版卡茨指数总分与BI总分显示出强相关性（r = 0.91，P < 0.001），表明具有强同时效度。第二阶段数据显示，与健康状况感知良好的老年人（5.56 ± 0.79）相比，总体健康状况感知较差的老年人卡茨指数平均（标准差）得分较低（3.58 ± 1.82）（P < 0.001）。同样，与无疾病的老年人相比，患有常见疾病的老年人卡茨指数得分相对较低，表明具有已知组效度（P < 0.05）。此外，观察到卡茨指数与基于表现的身体功能之间存在中度相关性，显示出一致性（与GS - r；-0.26，P < 0.001，与SPPB - r；0.31，P < 0.001）。
我们得出结论，僧伽罗语版卡茨指数具有令人满意的心理测量特性，是评估斯里兰卡说僧伽罗语的老年人功能状态的可靠且有效的工具。
