Development and validation of the social frailty scale for the older adult in China.

OBJECTIVES

Existing social frailty instruments are not tailored to the linguistic and cultural characteristics of Chinese-speaking patients; a version addressing this gap will increase clinical understanding of their healthcare experience and may help guide social frailty. To develop a Chinese version of a Social Frailty Scale (CVSFS) for the older adult and to examine the psychometric properties of this instrument.

METHOD

Based on the recommendations of the COSMIN guidelines, the scale development inclued three phases: development of the initial scale, optimisation of scale items, and validation test for scale. The initial CVSFS 1.0 version was developed through literature review, semi-structured interviews, research team discussion, and Delphi method. Then, cross-sectional survey was conducted ( = 265) and scale items were optimized based on the survey results using item analysis and exploratory factor analysis (EFA) to form CVSFS 2.0 version. Lastly, the cross-sectional survey ( = 287) was repeated using CVSFS 2.0 version, and the reliability and validity of the scale's measurement properties were tested.

RESULTS

The initial scale stage of development formed a 42-item CVSFS 1.0 version. After item analysis and EFA, six items were excluded to form a four-dimension with 36-item CVSFS 2.0 version including individual level, family level, interpersonal level, community and social level. The CVSFS 2.0 version demonstrated good reliability and validity, with a Cronbach's α coefficient of 0.926 and a McDonald's ω estimate of 0.931, split-half reliability of 0.928, and test-retest reliability of 0.978. The I-CVI of the scale was calculated to be 0.889~1.000, and the S-CVI/Ave was 0.930. Confirmatory factor analysis results indicated satisfactory fit indices: χ2/df = 2.17, GFI = 0.813, TLI = 0.932, CFI = 0.937, RMSEA = 0.064.

CONCLUSIONS

The CVSFS 2.0 version developed in this study based on a social-ecological framework has high reliability and validity, making it a suitable instrument for evaluating social frailty among the older adult in China.