Development and validation of frailty and malnutrition knowledge assessment scale for community-dwelling older adults

Analysis of alterations in the composition of the intestinal microbiota in frail older individuals

BACKGROUND

Frailty is an ageing-associated geriatric syndrome that severely affects the functional status, quality of life and life expectancy of older adults. Immune dysfunction and chronic inflammation play crucial roles in frailty, and this study aimed to explore the correlation between the intestinal microbiota and frailty.

METHODS

A cross-sectional survey was conducted using a comprehensive geriatric assessment of older individuals who underwent medical checkups at the Health Management Center from April 2023 to May 2024. A total of 672 older individuals who met the inclusion criteria were included and divided into a healthy control group and a frail case group. Clinical data, as well as blood and stool samples, were collected. The data from the two groups were analysed with 16S rRNA sequencing in 20 and 30 cases, respectively. SPSS 25.0 was used for statistical analysis.

RESULTS

There were significant differences in income, smoking, and globulin levels between the two groups, while there were no differences in age or sex. There was no significant difference in the abundance or species evenness of intestinal bacteria between the two groups. However, the abundance of accessory bacteria, bifidobacteria, and Escherichia coli in the frail group was greater than that in the control group. Specifically, Escherichia-Shigella was significantly upregulated and fit well into the prediction model of frailty.

CONCLUSION

The gut microbiota of frail older individuals underwent significant changes in structural composition, and the presence of Escherichia-Shigella may be a diagnostic marker for debilitating diseases. These findings provide an essential clinical reference value for developing methods for preventing or alleviating frailty based on specific microbial communities.

Development and validation of a Chinese general practitioners' ability to recognise and manage depression assessment scale: a cross-sectional study

OBJECTIVES

There is a shortage of reliable tools to evaluate general practitioners' (GPs) ability to recognise and manage depression. The main aim of this study was to develop and validate a reliable tool for assessing the GPs' ability to recognise and manage depression.

DESIGN

A cross-sectional survey incorporating the GPs' ability to recognise and manage the depression assessment scale, the work was administered between July 2023 and June 2024. GPs' ability to recognise and manage the depression assessment scale was developed in four phases: (1) item pool construction, (2) expert consultation, (3) exploratory factor analysis for further item reduction and to identify the factor structure of the revised scale and (4) confirmatory factor analyses to confirm the factors identified within the exploratory factor analysis.

SETTING

Primary healthcare in China.

PARTICIPANTS

A total of 421 GPs participated in the study across phases 3 and 4. Phase 3 included 172 GPs, and phase 4 involved 249 GPs. They had been working in primary healthcare, with 44.42% having more than 10 years of experience. Of the participants, 57% were female.

RESULTS

The GPs' ability to recognise and manage the depression assessment scale comprised two dimensions, with 24 items. Two factors explained 66.62% of the items' variance through exploratory factor analysis. Confirmatory factor analysis confirmed two dimensions of the scale and produced appropriate Goodness of Fit Indexes. Reliability was robust, with composite reliability coefficients exceeding 0.60, Cronbach's alpha at 0.96 and a Spearman-Brown coefficient of 0.86.

CONCLUSIONS

The newly developed scale is a reliable and valid tool for assessing GPs' abilities to recognise and manage depression. It is suitable for large-scale surveys, particularly in underdeveloped regions, and can help identify gaps in knowledge. The scale results highlight areas where GPs' skills are lacking, enabling the design of targeted continuing education programmes. It can also assess the effectiveness of depression training courses, providing a foundation for tailored interventions.

Translation and Validation of the Chinese Version of the Rapid Geriatric Assessment (C-RGA): A Screening Tool for Geriatric Syndromes in Nursing Home Residents

Background: Frailty, sarcopenia, nutritional risk, and cognitive impairment are prevalent geriatric syndromes that adversely affect health outcomes in older adults, underscoring the need for an effective screen tool to enable early detection and timely intervention. Methods: This study employed a cross-sectional validation design and translated, culturally adapted, and validated the Chinese version of the Rapid Geriatric Assessment (C-RGA) among 416 nursing home residents. The C-RGA consists of four subscales: the simple frail questionnaire screening tool (FRAIL), SARC-F for sarcopenia (SARC-F), the Simplified Nutritional Assessment Questionnaire (SNAQ), and the Rapid Cognitive Screen (RCS). Results: The C-RGA demonstrated high content validity (S-CVI/Ave = 0.982) and strong internal consistency (Cronbach's α = 0.839). Factor analysis confirmed its four-domain structure, accounting for 61.497% of the variance. Model fit indices demonstrated good construct validity (χ2/df = 1.122, RMSEA = 0.024, GFI, AGFI, and CFI > 0.90), supporting the robustness of the assessment tool. Pearson correlation analysis revealed a strong association between FRAIL and SARC-F with SNAQ (r = -0.671, 95% CI: [-0.742, -0.600], p < 0.01) and a moderate correlation with RCS (r = -0.426, 95% CI: [-0.513, -0.339], p < 0.01), underscoring the interplay among nutritional deficits, muscle weakness, and cognitive impairment. Conclusions: The C-RGA demonstrates strong psychometric properties, supporting its potential use as a screening tool for the early detection of frailty, sarcopenia, nutritional risk, and cognitive impairment among nursing home residents, enabling timely and targeted interventions. Future research should further assess its applicability across diverse healthcare settings to enhance its generalizability and clinical utility.

Development and validation of knowledge, attitude, and practice scale regarding antibiotic use for Chinese medical students

AIMS AND OBJECTIVES

This study aimed to develop and validate a knowledge, attitude, and practice scale of antibiotic use for Chinese medical students.

METHOD

A five-phased procedure was adopted: (a) A item pool was constructed after literature review; (b) Delphi method was used to refine the items; (c) A pilot study was conducted to clarify the item; (d) Item analysis and exploratory factor analysis were used to finalize the scale; (e) Content validity, construct validity and reliability of the scale were analysed.

RESULTS

The scale of 32 items, respectively 15, 9, and 8 for knowledge, attitude, and practice, was finalized. The item-level content validity ranged from 0.80 to 1.00. The scale-level content validity of the scale was 0.90. Model fit indices of total scale and the three dimensions met the criteria. Cronbach's α and the split-half coefficient were respectively 0.81 and 0.65 for the total scale. For each dimension, Cronbach's α varied from 0.68 to 0.89 and the split-half coefficient varied from 0.64 to 0.83.

CONCLUSION

The scale can be used as a whole or separately, serving as an effective tool to measure medical students' knowledge, attitude, or practice regarding antibiotic use.