老年综合健康评价体系构建检验及常模制定

The construction,reliability&validity test,and norm establishment of geriatric comprehensive health evaluation system

目的构建老年综合健康评价体系并制定老年综合健康评分的常模。方法采用Delphi专家咨询法构建老年综合健康评价体系,根据条目重要性评分和Saaty层次分析法对指标的权重系数进行计算和分配,进行信度、效度检验,结合验证性因子分析进行拟合优度评估;并基于2118名非住院老年人群实证研究制定老年综合健康评分划界常模。结果Delphi专家咨询及项目分析共删除9个条目,新增2个条目,最终老年综合健康评价体系包含躯体生理、精神心理、社会支持与环境三大维度共29个题项。评价体系的Cronbach'sα系数为0.709,探索性因子分析提取的10个公因子符合10个二级条目。验证性因子分析提示指标体系拟合优度较好。以0.5~1个标准差为间距将老年健康状态划分为"很差、较差、一般、较好,优秀"五个等级,制定老年综合健康评分不同年龄、性别人群的划界常模。结论老年综合健康评价体系的信度和效度均理想,该体系的构建和常模的制定为量化评定老年健康状况提供工具,为老年个体健康状态的筛查和分级提供参考依据。

Objective To construct a geriatric comprehensive health evaluation system,and establish the norm of corresponding score.Methods The methods of Delphi survey was implemented to develop the geriatric comprehensive health evaluation system.The weight coefficients of the items were calculated and assigned according to the expert-graded importance score and Saaty analytic hierarchy process.Reliability and validity of the system were examined.Goodness of fit was evaluated by confirmatory factor analysis.The demarcation norm of geriatric comprehensive health score was established based on an empirical study of 2,118 non-hospitalized elderly population.Results During the process of Delphi expert consultation and item analysis,nine items were deleted and two items were added.In the end,the 29-item comprehensive geriatric health evaluation system was developed,which included three dimensions of physiology,psychology,as well as social support and environment.The Cronbach'sαcoefficient of the evaluation system was 0.709.The exploratory factor analysis-extracted ten common factors meet ten second-level items.Confirmatory factor analysis indicated that the goodness of fit of the system was good.Geriatric health status was divided into five grades of very poor,poor,general,good and excellent by 0.5 to 1 standard deviation.The demarcation norm of geriatric comprehensive health score for different age and gender was established accordingly.Conclusions The reliability and validity of the geriatric comprehensive health evaluation system are satisfactory.The construction of comprehensive health evaluation system and the establishment of the norm can facilitate the quantitative assessment of geriatric health status,and provide a reference for the screening and grading of individual health status in the elderly.