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中华老年病研究电子杂志 ›› 2023, Vol. 10 ›› Issue (01) : 41 -47. doi: 10.3877/cma.j.issn.2095-8757.2023.01.008

护理园地

老年人内在能力综合评价指标体系的构建
杨舒岚, 江碧艳, 叶蕾, 金肖青, 王钧正, 黄金月, 刘彩霞()   
  1. 310013 杭州,浙江医院护理部
    100872 香港,香港理工大学护理学院
  • 收稿日期:2022-11-30 出版日期:2023-02-28
  • 通信作者: 刘彩霞
  • 基金资助:
    国家科技部重点研发计划项目(2019YFE0113100); 浙江省软科学研究计划项目(2021C35095); 浙江省医药卫生科研计划面上项目(2021KY008); 浙江医院院级项目(2020KYB014)

Construction of a comprehensive evaluation system for assessing intrinsic capacity in community older adults

Shulan Yang, Biyan Jiang, Lei Ye, Xiaoqing Jin, Junzheng Wang, Jinyue Huang, Caixia Liu()   

  1. Nursing Department, Zhejiang Hospital, Hangzhou 310013, China
    School of Nursing, The Hong Kong Polytechnic University, Hongkong 999077, China
  • Received:2022-11-30 Published:2023-02-28
  • Corresponding author: Caixia Liu
引用本文:

杨舒岚, 江碧艳, 叶蕾, 金肖青, 王钧正, 黄金月, 刘彩霞. 老年人内在能力综合评价指标体系的构建[J/OL]. 中华老年病研究电子杂志, 2023, 10(01): 41-47.

Shulan Yang, Biyan Jiang, Lei Ye, Xiaoqing Jin, Junzheng Wang, Jinyue Huang, Caixia Liu. Construction of a comprehensive evaluation system for assessing intrinsic capacity in community older adults[J/OL]. Chinese Journal of Geriatrics Research(Electronic Edition), 2023, 10(01): 41-47.

目的

构建老年人内在能力综合评价指标体系,为老年人内在能力综合情况的评定提供科学依据。

方法

以健康老龄化相关研究为理论基础,通过文献分析法构建初级条目池,采用德尔菲法专家咨询确立指标条目,运用层次分析法确定指标权重,形成老年人内在能力综合评价指标体系。

结果

遴选邀请18名专家进行函询,专家问卷有效回收率分别为88.89%、93.75%,专家权威系数分别为0.882、0.900,肯德尔和谐系数分别为0.225、0.227。通过两轮函询构建了老年人内在能力综合评价指标体系,包括5个一级指标、14个二级指标。一级指标的权重从高到低依次为认知功能(0.310)、移动能力(0.184)、视力听力(0.183)、心理社会(0.172)、机体活力(0.151);其中认知功能对应的二级指标权重依次为时间与空间定向(0.116)、记忆力(0.072)、语言能力(0.064)、计算力(0.058),视力听力对应的二级指标权重依次为视力障碍(0.091)、听力障碍(0.091),移动能力对应的二级指标权重依次为行动受限(0.107)、跌倒风险(0.076),心理社会对应的二级指标权重依次为主观感知社会隔离(0.067)、兴趣减退(0.056)、情绪低落(0.050),机体活力对应的二级指标权重依次为营养不良(0.062)、口腔衰弱(0.050)、食欲减退(0.040)。

结论

本研究初步构建了老年人内在能力综合评价指标,为综合评价老年人内在能力提供了可行方案,也为未来基于综合评价进行及早干预奠定了基础。

Objective

To construct a scoring system for assessing intrinsic capacity in older adults, thus to provide scientific guidance on defining the intrinsic capacity among older adults.

Methods

Adopting the theoretical concepts from previous research on healthy aging, the primary set of indexes is constructed through literature analysis. And the content of intrinsic capacity evaluation index system for older adults is determined through Delphi experts consultation. The weighted values of the evaluation indexes are established by the analytic hierarchy process.

Results

Eighteen experts were selected and invited for correspondence consultation. The effective recovery rates of the questionnaires were 88.89% and 93.75%, the expert authority coefficients were 0.882 and 0.900, and the Kendall harmony coefficients were 0.225 and 0.227. After a two-rounded Delphi experts consultation involving 18 experts, an intrinsic capacity evaluation index system for older adults was established, including five first level indexes and 14 secondary indexes. The weights of primary indicators were as follows: cognitive function (0.310), mobility (0.184), vision and hearing (0.183), psycho-social (0.172), and vitality (0.151). The corresponding secondary indicators of cognitive function were time and spatial orientation (0.116), memory (0.072), language ability (0.064), calculate ability (0.058). The corresponding secondary indicators of vision and hearing were visual impairment (0.091), hearing impairment (0.091).The weights of the secondary indicators corresponding to mobility were movement restriction (0.107) and fall risk (0.076). The corresponding secondary index weights of psycho-social were subjective perceived social isolation (0.067), loss of interest (0.056), and depressed (0.050). The corresponding secondary indicators of vitality were malnutrition (0.062), oral frailty (0.050), loss of appetite (0.040).

Conclusion

A comprehensive evaluation index for the intrinsic capacity of the older adults was established, which provides the scheme for comprehensive evaluation of the intrinsic capacity of the older adults, and provides possibility for early intervention based on comprehensive evaluation in the older adults.

表1 老年人内在能力综合评价指标函询结果(±s
第一轮函询 第二轮函询
指标 重要性评分(分) 变异系数 满分比(%) 指标 重要性评分(分) 变异系数 满分比(%)
认知 5.00±0.00 0.000 100.00 认知功能 4.87±0.35 0.072 86.67
记忆力 4.88±0.34 0.070 87.50 记忆力 4.87±0.35 0.072 86.67
时间与空间定向力 4.75±0.58 0.122 81.25 时间与空间定向力 4.80±0.41 0.086 80.00
计算力 4.25±0.86 0.201 50.00 计算力 4.33±0.49 0.113 33.33
语言能力 4.56±0.51 0.112 56.25 语言能力 4.60±0.51 0.110 60.00
心理 4.94±0.25 0.051 93.75 心理社会 4.93±0.26 0.052 93.33
抑郁心境 4.88±0.34 0.070 87.50 情绪低落 4.80±0.41 0.086 80.00
快感缺失 4.75±0.58 0.122 81.25 兴趣减退 4.53±0.52 0.114 53.33
社会隔离 4.75±0.45 0.094 75.00 主观感知社会隔离 4.73±0.46 0.097 73.33
感知觉 4.88±0.34 0.070 87.50 视力听力 4.80±0.41 0.086 80.00
视力障碍 4.81±0.54 0.113 87.50 视力障碍 4.80±0.41 0.086 80.00
听力障碍 4.63±0.62 0.134 68.75 听力障碍 4.80±0.41 0.086 80.00
活力 4.94±0.25 0.051 93.75 机体活力 4.93±0.26 0.052 93.33
体重减轻(营养状态) 4.63±0.62 0.134 68.75 营养不良 4.93±0.26 0.052 93.33
食欲减退(影响营养相关机制) 4.44±0.63 0.142 50.00 食欲减退 4.60±0.51 0.110 60.00
吞咽障碍(影响营养相关机制) 4.81±0.40 0.084 81.25 口腔衰弱 4.33±0.49 0.113 33.33
衰弱/肌少症罹患情况 4.31±1.14 0.264 62.50 - - - -
行动 4.88±0.50 0.103 93.75 移动能力 4.80±0.41 0.086 80.00
行动受限 4.94±0.25 0.051 93.75 行动受限 4.80±0.41 0.086 80.00
跌倒风险 4.88±0.50 0.103 93.75 跌倒风险 4.73±0.80 0.169 86.67
尿失禁罹患情况 4.06±1.18 0.291 43.75 - - - -
图1 老年人内在能力综合评价指标及权重赋值
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