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Psychometrische eigenschappen van drie screeningsinstrumenten voor kwetsbaarheid bij thuiswonende ouderen

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Tijdschrift voor Gerontologie en Geriatrie

Samenvatting

Achtergrond Kwetsbaarheid kan leiden tot negatieve gezondheidsuitkomsten zoals beperkingen. Om deze te voorkomen zijn valide screeningsinstrumenten nodig om kwetsbare ouderen op te sporen. Doel van deze studie was de evaluatie en vergelijking van drie instrumenten: de Groningen Frailty Indicator (GFI), de Tilburg Frailty Indicator (TFI) en de Sherbrooke Postal Questionnaire (SPQ). Voor constructvalidering was de Groningen Activiteiten Restrictie Schaal (GARS) toegevoegd. Methode Een vragenlijst werd naar 687 ouderen (≥70 jaar) gestuurd. Geëvalueerd werden (1) de prevalentie van kwetsbaarheid, (2) de betrouwbaarheid, (3) de cumulatieve schaalbaarheid volgens het schaalmodel van Mokken, en (4) de constructvaliditeit.

Resultaten De respons bedroeg 77%. Prevalentieschattingen varieerden van 40% tot 59%. De grootste overeenstemming in kwetsbaarheid bestond tussen de GFI en TFI (Cohens kappa=0,74). Cronbachs alpha voor de GFI, TFI en SPQ bedroeg respectievelijk 0,73, 0,79 en 0,26. Geen van de ‘frailty’-instrumenten vormt een monotoon homogene set van items met een hiërarchie in de moeilijkheidsgraad van de items (Loevingers H-coëfficiënten voor GFI, TFI en SPQ: 0,28, 0,30 en 0,09). Er werden significante correlaties gevonden tussen de scores voor kwetsbaarheid onderling en tussen deze scores en die op de GARS.

Conclusie Vooral de GFI en TFI lijken bruikbaar voor het opsporen van kwetsbare ouderen. Aanvullend onderzoek naar het voorspellend vermogen van deze ‘frailty’-instrumenten voor beperkingen in het dagelijks leven is echter nog nodig.

De oorspronkelijke versie van dit vertaalde en bewerkte artikel van deze auteurs is verschenen in BMC Public Health, 2010;10:176.

The psychometric properties of three self-report screening instruments for identifying frail older people in the community

Background Frailty can lead towards serious adverse consequences, such as disability. With regard to prevention valid screening instruments are needed to identify frail older people. The aim was to evaluate and compare the psychometric properties of three screening instruments: the Groningen Frailty Indicator (GFI), the Tilburg Frailty Indicator (TFI) and the Sherbrooke Postal Questionnaire (SPQ). For validation purposes the Groningen Activity Restriction Scale (GARS) was added. Methods A questionnaire was sent to 687 older people (≥70 years). (1) Agreement between instruments, (2) internal consistency, (3) cumulative scalability according to Mokken scale analysis and (4) construct validity were evaluated. Results The response rate was 77%. Prevalence estimates of frailty ranged from 40% to 59%. The highest agreement was found between the GFI and TFI (Cohen's kappa = 0.74). Cronbach's alpha for the GFI, TFI and SPQ was 0.73, 0.79 and 0.26, respectively. The scalability of the three instruments was inadequate (Loevinger's H: 0.28, 0.30 and 0.09 for GFI, TFI and SPQ, respectively). Frailty scores correlated significantly with each other and with the GARS scores. Conclusion Especially the GFI and TFI seem to be useful to identify frail older people. Further research regarding their predictive validity is still needed. This paper is a translated and updated version of a publication in BMC Public Health, 2010; 10: 176.

Tijdschr Gerontol Geriatr 2011; 42: 120-130

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Authors and Affiliations

  1. vakgroep Verpleging en Verzorging, CAPHRI School for Public Health and Primary Care, Universiteit Maastricht, Maastricht, The Netherlands

    S. F. Metzelthin

  2. Hogeschool Zuyd Heerlen, Heerlen, The Netherlands

    R. Daniels

  3. vakgroep Verpleging en Verzorging, CAPHRI School for Public Health and Primary Care, Hogeschool Zuyd Heerlen, Universiteit Maastricht, Heerlen, Maastricht, The Netherlands

    E. van Rossum

  4. vakgroep Sociale Geneeskunde, CAPHRI School for Public Health and Primary Care, Hogeschool Zuyd Heerlen, Universiteit Maastricht, Maastricht, Heerlen, The Netherlands

    L. P. de Witte

  5. vakgroep Zorgwetenschappen, Universiteit Groningen, Groningen, The Netherlands

    W. J. A. van den Heuvel

  6. vakgroep Verpleging en Verzorging, CAPHRI School for Public Health and Primary Care, Universiteit Maastricht, Maastricht, The Netherlands

    G. I. J. M. Kempen

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Onderzoeker Kenniskring Autonomie en Participatie

Lector ouderenzorg binnen Kenniskring Autonomie en Participatie, senior onderzoeker

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Metzelthin, S.F., Daniels, R., van Rossum, E. et al. Psychometrische eigenschappen van drie screeningsinstrumenten voor kwetsbaarheid bij thuiswonende ouderen. TIJDSCHR. GERONTOLOGIE GER. 42, 120–130 (2011). https://doi.org/10.1007/s12439-011-0022-5

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