社区老年人衰弱与生存质量的关系研究

发布时间：2018-03-08 17:58

本文选题：老年人　切入点：衰弱　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的翻译蒂尔堡衰弱指标量表(TFI)形成中文版,检验该量表在中国社区老年人群中的适用性和信效度,探寻中文版TFI量表的衰弱临界值。应用中文版TFI量表探讨衰弱与生存质量之间的关系,以期为衰弱的预防与干预提供可靠依据。方法取得TFI量表作者的同意与授权后,采用标准的量表翻译方法对TFI量表进行翻译与回译,最后由专家讨论形成最终的中文版TFI量表。根据分层抽样法从济南市选取的历下区、市中区、天桥区的共917名60岁及以上的社区老年人为调研对象。应用一般资料问卷、采用简易认知状态量表(SPMSQ)、日常生活能力量表(ADL)和工具性日常生活能力量表(IADL)、老年人抑郁评定量表(GDS-15)、站起走试验(TUG)、肖水源社会支持评定量表(SSRS)、家庭关怀度(APGAR)、Fried衰弱表型评估法对中文版TFI量表进行信效度检验。应用SF-12测评生存质量,研究衰弱与生存质量的相关关系。信度的检验采用Cronbach's α 一致性检验及Pearson相关分析,聚合效度采用Kappa 一致性检验与Pearson相关性分析,标准效度应用ROC曲线分析。衰弱与生存质量的关系研究采用相关性分析及多元线性回归分析。统计分析采用SPSS 21.0统计软件包及STATA 12.0。P0.05时有统计学意义。结果1.中文版本的TFI量表,其Cronbach's α系数为0.71,103位研究对象的衰弱总得分重测相关系数为0.88。2.中文版TFI量表的各条目与其相对应的替代性测量之间的Kappa 一致性系数均具有统计学意义(P0.01)。以Fried表型为标准的曲线下面积为0.87,得出衰弱的最佳临界值为4。以ADL、IADL、卫生服务利用情况、抑郁为结局变量,拟合ROC曲线,曲线下面积分别为:0.73、0.68、0.65、0.69、0.83。3.TFI总分对生存质量的预测能力强,且对心理总得分MCS(35.8%)的解释贡献率大于对生理总得分PCS的(15.0%)的解释贡献率。是否衰弱对生存质量有显著性影响,对PCS的解释贡献率为10.5%,对MCS的解释贡献率为22.3%。4.TFI各条目与生存质量的多元线性回归分析中,TFI生理方面8个条目对PCS的变异解释率为25.2%,对MCS的变异解释率为20.4%;增加了心理与社会方面的条目后,对PCS于MCS的变异解释率分别增加了 1.4%、20.8%。5.TFI生理方面中对PCS的影响具有统计学意义的指标有:行走困难、自评健康、身体疲乏;对MCS的影响具有统计学意义的指标有:身体疲乏、体重下降、平衡能力。TFI心理方面的各条目对PCS均不具有显著性影响;对MCS均具有显著性影响。对PCS、MCS均具有显著性影响的TFI社会方面的指标为:社会支持;此外,社会关系也是MCS的显著性影响指标。6.TFI量表各条目对PCS贡献最大的条目为行走困难(β=-0.254,P0.001),对MCS贡献最大的条目为情绪低落(β=-0.272,P0.001)。结论1.中文版本的TFI量表信效度良好,得出的衰弱临界值更适用于我国老年人,能够用于社区老年人的衰弱状况的评测。2.TFI量表总分与是否衰弱对生存质量的影响显著。3.影响老年人生存质量的衰弱指标有:步行困难、自评健康、身体疲乏、体重下降、平衡功能差、情绪低落、焦虑、记忆力不好、应对能力弱、社会关系不良、社会支持匮乏。
[Abstract]:The purpose of translation scale index (TFI) to form weak tiburg Chinese version, test of the scale in the community elderly population Chinese the applicability and validity, explore the Chinese version of the TFI scale. The critical value of application. Chinese version of the TFI scale to explore the relationship between the weak and the quality of life, in order to provide a reliable basis for the prevention of with the intervention of weakening. Methods TFI scale the author's consent and authorization, the TFI scale translation and back translation scale translation method based on the standard, finally discussed by experts to form the final version of the TFI Chinese scale. According to the stratified sampling method to select from Ji'nan, Lixia District, Central City flyover. The total of 917 elderly aged 60 and above as the research objects. With the general information questionnaire, the Mini Mental State Scale (SPMSQ), activity of daily living scale (ADL) and instrumental activities of daily living scale (IADL), the elderly depression rating Quantitative table (GDS-15), then walk test (TUG), Xiao of social support rating scale (SSRS), family care (APGAR), Fried weak phenotypic evaluation method for the Chinese version of the TFI scale test of the validity. The quality of life assessment using SF-12, a study on the relationship between weak reliability and life quality. A consistency test using Cronbach's test and Pearson correlation analysis, Kappa correlation analysis of polymerization consistency test and the validity of Pearson by using ROC curve analysis, criterion validity. The research on the relationship between weak and quality of life by using correlation analysis and multivariate linear regression analysis. Statistical analysis using SPSS 21 statistical software package STATA and 12.0.P0.05 had statistical significance. TFI 1. Chinese version of the table, the Cronbach's alpha coefficient for the total score of 0.71103 subjects. The test-retest correlation coefficient is 0.88.2. Chinese version of each item of the TFI scale and The consistency coefficient Kappa between alternative corresponding to the measurements were statistically significant (P0.01). The area to Fried phenotype as the standard curve was 0.87, the optimal critical value of weak to 4. to ADL, IADL, utilization of health services, depression is the outcome variable fitting ROC curve, the area under the curve respectively. The total score of 0.73,0.68,0.65,0.69,0.83.3.TFI: the ability to predict the quality of life, and the total score of MCS (35.8%) psychological explanation on the physiological contribution rate is more than the total PCS score (15%) interpretation of the contribution rate. Whether the weak significant impact on the quality of life, to explain the contribution to PCS was 10.5%, explain the contribution to MCS the rate for each item and multiple linear regression analysis of the quality of life of 22.3%.4.TFI TFI, the physiological aspects of 8 items to the interpretation of the PCS mutation rate was 25.2%, the variance of MCS accounted for 20.4%; increase the psychological and social aspects. At present, the variation of PCS in MCS explain increased by 1.4% respectively, with significant impact on PCS 20.8%.5.TFI in physiological indicators are: walking difficulties, self-rated health, physical fatigue; statistically significant effect on MCS index: body fatigue, weight loss, each item.TFI psychological balance on the PCS does not have a significant effect; have a significant effect on the MCS. The PCS TFI, the social aspects of the MCS index are significant for social support; in addition, the social relationship is also MCS significant effect index of.6.TFI scale of each entry the largest contribution to the PCS entry for difficult to walk (beta =-0.254, P0.001), the largest contribution to the MCS entry for depression (beta =-0.272, P0.001). Conclusion: 1. Chinese version of TFI had good reliability and validity, the critical value of weakness for the elderly in China, can be used for community elderly The debilitating condition evaluation score of.2.TFI scale and whether the impact on the quality of life significantly weakened the influence of.3. weak indicators of quality of life of the elderly people are walking difficulties, self-rated health, body fatigue, weight loss, poor balance, depression, anxiety, poor memory, coping ability is weak, poor social relations, the lack of social support.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.2

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