Development And Analysis Of The Frailty Assessment Scale For Patients With COPD

Objective:To develop a frailty assessment scale for patients with COPD,and test the scale’s reliability and validity,so as to provide a special evaluation tool for the frailty of COPD patients.Methods:In this study,literature analysis,Delphi expert consultation method and cross-sectional survey were used.1.Literature analysis:Based on"Frailty Integration Model"that developed by Gobbens to define the operational definition of COPD patients’frailty.By consulting a large number of Chinese and English literature,learning from the relevant tools about frailty assessment,and combining with the characteristics of COPD disease,to extract frailty related items,and finally form the item pool of frailty assessment scale for patients with COPD.2.Delphi expert consultation method:Through three rounds of expert consultation to screen the items of the scale and form the COPD patient’frailty assessment scale(Test version).3.Cross section survey method:Two rounds of cross section survey were carried out,including pre-test and formal test.Through the pre-test survey,the survey data of350 subjects were used for the analysis of scale items to form the COPD patient’frailty assessment scale(Tentative version).Through the formal test survey,the survey data of 320 subjects were used for the reliability and validity test of the scale to form the COPD patient’frailty assessment scale(Official version).Exploratory factor analysis was used to develop the preliminary theoretical structure of COPD patients’frailty assessment,and confirmatory factor analysis was used to prove the rationality and correctness of the theoretical structure.Retest reliability,internal consistency reliability and half fold reliability were used to test the reliability of the new scale.Content validity,structure validity and convergence validity were used to test the validity of the new scale.Results:1.Through literature analysis,there were 94 items in the item pool of COPD patient’frailty assessment scale.2.In this study,20 experts were consulted for three rounds of expert consultation,forming a total of 27 items of COPD patient’frailty assessment scale(Test version).3.Through the pre-test,the COPD patient’frailty assessment scale(Tentative version)was formed.The scale consists of five dimensions,including physiological state,disease symptoms,health information,psychological emotions,social adaptation,a total of 24 items.4.Through the formal test,the COPD patient’frailty assessment scale(Formal version)was formed.The scale has a good reliability and validity.(1)Content validity:According to the evaluation of 10 experts,the I-CVI of the calculated items was 1.00,and the S-CVI of the scale was 1.00.(2)Structural validity:The cumulative variance contribution rate was 54.015%.The correlation coefficient between dimensions and the total scale was 0.606～0.710,and the correlation coefficient between dimension and dimension was 0.607～0.774.The results of confirmatory factor analysis showed that the skewness coefficient was1.917～-0.275,and the kurtosis coefficient was 0.165～2.291.The fitting index of the five dimensions model showed thatχ~2/df was 2.741,and RMSEA was 0.065.(3)Cronbach’s a coefficient:Cronbach’s a coefficient of each dimensions 0.699～0.787,and the total scale was0.742.(4)Split-half reliability:The split-half reliability of dimensions was 0.638～0.663,and the total scale was 0.791.(5)Test-retest reliability:The test-retest reliability of the scale was 0.802,and Pearson correlation coefficient was 0.712～0.807.Conclusions:The COPD patient’frailty assessment scale has five dimensions,including physiological state,disease symptoms,health information,psychological emotion and social adaptation,with a total of 24 items.The higher scale scores,the higher frailty level.The scale has a good reliability and validity.