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Hu FW, Li YP, Chang CM, Lin TY, Lai PH, Lin CY. Development and testing of a four-item version of the physical resilience instrument for older adults (PRIFOR-4). J Nutr Health Aging 2024; 28:100250. [PMID: 38677078 DOI: 10.1016/j.jnha.2024.100250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/17/2024] [Accepted: 04/17/2024] [Indexed: 04/29/2024]
Abstract
The 16-item Physical Resilience Instrument for Older Adults (PRIFOR) has good clinimetric properties; however, a shortened PRIFOR would greatly enhance physical resilience measurements in clinical settings. The current analysis aimed to reduce the number of PRIFOR while maintaining its clinimetric properties, emphasizing on its factor structure and convergent validity. A longitudinal study was conducted among 863 patients aged 65 years or older. Four PRIFOR items with high factor loadings were selected to generate the short version of PRIFOR (PRIFOR-4). The PRIFOR-4 was found to have a unidimensional structure (comparative fit index = 0.999; Tucker-Lewis index = 0.998 in the confirmatory factor analysis results) with good convergent validity with various external measures (absolute r = 0.109-0.597; p-values<0.01). Because the PRIFOR-4 contains only four items, the completion time for the respondents reduced three fourths from the original PRIFOR, which may have a marked reduction in the response burden. The PRIFOR-4 is thus an easy-to-use measurement that saves time for healthcare professionals in clinical practice.
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Affiliation(s)
- Fang-Wen Hu
- School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yueh-Ping Li
- Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan
| | - Chia-Ming Chang
- Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzu-Yu Lin
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Master Program of Long-Term Care in Aging, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Hsuan Lai
- Department of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Fan CW, Li YP, Chang CM, Hu FW, Lin CY. The psychometric properties of the Physical Resilience Instrument for Older Adults (PRIFOR): a Rasch analysis. Aging Clin Exp Res 2023; 35:2721-2728. [PMID: 37668840 DOI: 10.1007/s40520-023-02547-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/22/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Prior psychometric evidence of the Physical Resilience Instrument for Older Adults (PRIFOR) showed good criterion-related validity, concurrent validity, known-group validity, predictive validity, and internal consistency. However, it is unclear whether older patients with different treatment diagnoses interpret the PRIFOR similarly. AIMS This study aimed to test the psychometric properties of the PRIFOR scores among different treatment diagnoses of older patients. METHODS We recruited 413 hospitalized older patients with a medical diagnosis and 207 with a surgical diagnosis in a 1343-bed tertiary-care medical center in Taiwan. Data analyses included Rasch models, Principal Components Analysis (PCA), and Pearson correlations. RESULTS The Rasch analyses showed that all PRIFOR items were embedded within their belonged constructs, reflecting good construct validity and unidimensionality. Person and item separation reliability support the internal consistency of the studied samples and PRIFOR items. However, six PRIFOR items were found to have meaningful differential item functioning (DIF) problems among treatment diagnoses. CONCLUSIONS The PRIFOR is a solid measurement and can be used for monitoring the status of older adults' physical resilience. However, because six items were found to have meaningful DIF among treatment diagnosis groups, future studies should consider designing specific items for different patient populations to assess their needs in physical resilience.
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Affiliation(s)
- Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, Orlando, FL, USA
| | - Yueh-Ping Li
- Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan
| | - Chia-Ming Chang
- Department of Geriatrics and Gerontology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Fang-Wen Hu
- School of Nursing, College of Nursing, Kaohsiung Medical University, No.100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan.
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Yang TI, Kuo YJ, Huang SW, Chen YP. Minimal short-term decline in functional performance and quality of life predicts better long-term outcomes for both in older Taiwanese adults after hip fracture surgery: a prospective study. J Orthop Surg Res 2023; 18:791. [PMID: 37872535 PMCID: PMC10594772 DOI: 10.1186/s13018-023-04278-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/10/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Hip fracture can lead to long-term loss of mobility and self-care ability in older adults. Despite initial decreases in functional performance after hip fracture surgery, patients tend to gradually recover. However, recovery can vary, with some regaining their abilities quickly while others becoming functionally dependent. In this study, we investigated whether the level of short-term postoperative decline in activity of daily living (ADL) performance and quality of life (QoL) can predict the 1-year outcomes for both following hip fracture surgery in older Taiwanese adults. METHODS This prospective cohort study included 427 older adults (≥ 60 years) who underwent hip fracture surgery at a single tertiary medical center in Taiwan between November 2017 and March 2021. We collected pre-fracture data, including the patients' demographics, Charlson comorbidity index (CCI) scores, and responses to a questionnaire (Short Portable Mental State Questionnaire [SPMSQ]) for dementia screening. Moreover, their scores on the EuroQol-5D questionnaire (for evaluating QoL) and the Barthel Index (for assessing ADL performance) were collected at pre-fracture status and at 3- and 12-months following surgery. Changes in ADL and QoL three months post-surgery compared to pre-fracture status were evaluated, and the associations of these parameters (and other potential factors) with 1-year outcomes for ADL and QoL were investigated. RESULTS We analyzed the data of 318 patients with hip fracture and complete follow-up data regarding ADL performance and QoL at 3- and 12-months post-surgery. After adjusting for covariates, multivariate linear regression revealed that changes in ADL and QoL at 3 months post-surgery from pre-fracture status were positively and significantly associated with 1-year outcomes for both (p < .001 for both). Furthermore, pre-fracture CCI and SPMSQ scores were independent predictive factors associated with 1-year ADL outcomes (p = .042 and < .001, respectively). CONCLUSIONS Patients who exhibit a smaller decline in functional performance and quality of life three months after hip fracture surgery from pre-fracture status are likely to have improved long-term ADL and QoL. TRIAL REGISTRATION TMU-JIRB N201709053.
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Affiliation(s)
- Tzu-I Yang
- Department of Orthopedic Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Yi-Jie Kuo
- Department of Orthopedics, Wan Fang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Wenshan Dist., Taipei City, 116, Taiwan
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shu-Wei Huang
- Department of Orthopedics, Wan Fang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Wenshan Dist., Taipei City, 116, Taiwan
- Graduate Institute of Health and Biotechnology Law, Taipei Medical University, Taipei, 116, Taiwan
| | - Yu-Pin Chen
- Department of Orthopedics, Wan Fang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Wenshan Dist., Taipei City, 116, Taiwan.
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Resnick B, Boltz M, Galik E, Kuzmik A, Ellis J, Wells C. Psychometrics of the Physical Resilience Scale in Older Adults Living with Dementia: Proxy Responses. J Aging Health 2023; 35:325-334. [PMID: 36177543 PMCID: PMC10519330 DOI: 10.1177/08982643221130805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: The purpose of this study was to determine if proxies can complete the Physical Resilience Scale for older adults living with dementia. Methods: This was a descriptive study using Rasch analysis and baseline data from the Function Focused Care for Acute Care Using the Evidence Integration Triangle trial. The first 240 patients living with dementia were included in this analysis. Results: There was evidence of reliability based on person and item separation index. There was no evidence of Differential Item Functioning (DIF) between genders and a DIF by race on Item 7. Validity was supported based on items fitting the model with the exception of one item, and a significant relationship between physical resilience and pain and function. Discussion: There is some evidence that the Physical Resilience Scale is reliable and valid when completed by proxy reports. Future use should remove one of the items due to redundancy.
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Affiliation(s)
- Barbara Resnick
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Marie Boltz
- Pennsylvania State University, College of Nursing, University Park, PA, USA
| | - Elizabeth Galik
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Ashley Kuzmik
- Pennsylvania State University, College of Nursing, University Park, PA, USA
| | - Jeanette Ellis
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Chris Wells
- Department of Rehabilitation Services, University of Maryland Medical Center, Baltimore, MD, USA
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Li J, Chhetri JK, Ma L. Physical resilience in older adults: Potential use in promoting healthy aging. Ageing Res Rev 2022; 81:101701. [PMID: 35905815 DOI: 10.1016/j.arr.2022.101701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/06/2022] [Accepted: 07/25/2022] [Indexed: 01/31/2023]
Abstract
Physical resilience is a dynamic concept referring to the physiological response when the body is exposed to stressors. The level of physical resilience is the sum of underlying physiological reserves. Moreover, it may not only be determined by age, genetics, or exposure to a variety of diseases, but is also closely related to the psychological, social, and environmental factors of an individual. This paper summarizes our present understanding of the relationship between physical resilience and other concepts closely related to it. Furthermore, we illustrate the current research progress on physical resilience models and clinical resilience assessment. Besides, this paper intends to present a better understanding of physical resilience and its use in treatment decision-making, personalized diagnosis and disease management, and prevention and rehabilitation strategies.
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Affiliation(s)
- Jiatong Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China
| | - Jagadish K Chhetri
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China.
| | - Lina Ma
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China.
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Hu FW, Lin CH, Yueh FR, Lo YT, Lin CY. Development and psychometric evaluation of the Physical Resilience Instrument for Older Adults (PRIFOR). BMC Geriatr 2022; 22:229. [PMID: 35313802 PMCID: PMC8935854 DOI: 10.1186/s12877-022-02918-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 03/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Physical resilience is known to minimize the adverse outcomes of health stressors for older people. However, validated instruments that assess physical resilience in older adults are rare. Therefore, we aimed to validate the Physical Resilience Instrument for Older Adults (PRIFOR) to fill the literature gap. Methods Content analysis with content validity was first carried out to generate relevant items assessing physical resilience for older adults, and 19 items were developed. Psychometric evaluation of the 19 items was then tested on 200 older adults (mean [SD] age = 76.4 [6.6] years; 51.0% women) for item properties, factor structure, item fit, internal consistency, criterion-related validity, and known-group validity. Results All 19 items had satisfactory item properties, as they were normally distributed (skewness = -1.03 to 0.38; kurtosis = -1.05 to 0.32). However, two items were removed due to substantial ceiling effects. The retained 17 items were embedded in three factors as suggested by the exploratory factor analysis (EFA) results. All items except one had satisfactory item fit statistics in Rasch model; thus, the unidimensionality was supported for the three factors on 16 items. The retained 16 items showed promising properties in known-group validity, criterion-related validity, and internal consistency (α = 0.94). Conclusions The 16-item PRIFOR exhibits good psychometric properties. Using this instrument to measure physical resilience would be beneficial to identify factors that could protect older people from negative health consequence. With the use of the PRIFOR, intervention effects could also be evaluated. It is helpful to strengthen resilience and thereby facilitate successful aging. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02918-7.
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Affiliation(s)
- Fang-Wen Hu
- Department of Nursing, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No.138, Sheng-Li Road, Tainan, 70403, Taiwan
| | - Cheng-Han Lin
- Department of Health-Business Administration, Fooyin University, No.151, Jinxue Road, Kaohsiung, 83102, Taiwan
| | - Fang-Ru Yueh
- Department of Nursing, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No.138, Sheng-Li Road, Tainan, 70403, Taiwan
| | - Yu-Tai Lo
- Department of Geriatrics and Gerontology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No.138, Sheng-Li Road, Tainan, 70403, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan. .,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 70101, Taiwan. .,Department of Public Health, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, 70101, Taiwan. .,Biostatistics Consulting Center, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, 70101, Taiwan.
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