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Discriminative validity of the Core outcome set functional independence in a population of older adults

BACKGROUND: Clinicians are currently challenged to support older adults to maintain a certain level of Functional Independence (FI). FI is defined as “functioning physically safely and independent from another person, within one’s own context”. A Core Outcome Set was developed to measure FI. The pur...

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Autores principales: Dockx, Yvonne J. C., Molenaar, Esther A. L. M., Barten, Di-Janne J. A., Veenhof, Cindy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7450554/
https://www.ncbi.nlm.nih.gov/pubmed/32847518
http://dx.doi.org/10.1186/s12877-020-01705-6
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author Dockx, Yvonne J. C.
Molenaar, Esther A. L. M.
Barten, Di-Janne J. A.
Veenhof, Cindy
author_facet Dockx, Yvonne J. C.
Molenaar, Esther A. L. M.
Barten, Di-Janne J. A.
Veenhof, Cindy
author_sort Dockx, Yvonne J. C.
collection PubMed
description BACKGROUND: Clinicians are currently challenged to support older adults to maintain a certain level of Functional Independence (FI). FI is defined as “functioning physically safely and independent from another person, within one’s own context”. A Core Outcome Set was developed to measure FI. The purpose of this study was to assess discriminative validity of the Core Outcome Set FI (COSFI) in a population of Dutch older adults (≥ 65 years) with different levels of FI. Secondary objective was to assess to what extent the underlying domains ‘coping’, ‘empowerment’ and ‘health literacy’ contribute to the COSFI in addition to the domain ‘physical capacity’. METHODS: A population of 200 community-dwelling older adults and older adults living in residential care facilities were evaluated by the COSFI. The COSFI contains measurements on the four domains of FI: physical capacity, coping, empowerment and health literacy. In line with the COSMIN Study Design checklist for Patient-reported outcome measurement instruments, predefined hypotheses regarding prediction accuracy and differences between three subgroups of FI were tested. Testing included ordinal logistic regression analysis, with main outcome prediction accuracy of the COSFI on a proxy indicator for FI. RESULTS: Overall, the prediction accuracy of the COSFI was 68%. For older adults living at home and depending on help in (i)ADL, prediction accuracy was 58%. 60% of the preset hypotheses were confirmed. Only physical capacity measured with Short Physical Performance Battery was significantly associated with group membership. Adding health literacy with coping or empowerment to a model with physical capacity improved the model significantly (p < 0.01). CONCLUSIONS: The current composition of the COSFI, did not yet meet the COSMIN criteria for discriminative validity. However, with some adjustments, the COSFI potentially becomes a valuable instrument for clinical practice. Context-related factors, like the presence of a spouse, also may be a determining factor in this population. It is recommended to include context-related factors in further research on determining FI in subgroups of older people.
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spelling pubmed-74505542020-08-28 Discriminative validity of the Core outcome set functional independence in a population of older adults Dockx, Yvonne J. C. Molenaar, Esther A. L. M. Barten, Di-Janne J. A. Veenhof, Cindy BMC Geriatr Research Article BACKGROUND: Clinicians are currently challenged to support older adults to maintain a certain level of Functional Independence (FI). FI is defined as “functioning physically safely and independent from another person, within one’s own context”. A Core Outcome Set was developed to measure FI. The purpose of this study was to assess discriminative validity of the Core Outcome Set FI (COSFI) in a population of Dutch older adults (≥ 65 years) with different levels of FI. Secondary objective was to assess to what extent the underlying domains ‘coping’, ‘empowerment’ and ‘health literacy’ contribute to the COSFI in addition to the domain ‘physical capacity’. METHODS: A population of 200 community-dwelling older adults and older adults living in residential care facilities were evaluated by the COSFI. The COSFI contains measurements on the four domains of FI: physical capacity, coping, empowerment and health literacy. In line with the COSMIN Study Design checklist for Patient-reported outcome measurement instruments, predefined hypotheses regarding prediction accuracy and differences between three subgroups of FI were tested. Testing included ordinal logistic regression analysis, with main outcome prediction accuracy of the COSFI on a proxy indicator for FI. RESULTS: Overall, the prediction accuracy of the COSFI was 68%. For older adults living at home and depending on help in (i)ADL, prediction accuracy was 58%. 60% of the preset hypotheses were confirmed. Only physical capacity measured with Short Physical Performance Battery was significantly associated with group membership. Adding health literacy with coping or empowerment to a model with physical capacity improved the model significantly (p < 0.01). CONCLUSIONS: The current composition of the COSFI, did not yet meet the COSMIN criteria for discriminative validity. However, with some adjustments, the COSFI potentially becomes a valuable instrument for clinical practice. Context-related factors, like the presence of a spouse, also may be a determining factor in this population. It is recommended to include context-related factors in further research on determining FI in subgroups of older people. BioMed Central 2020-08-26 /pmc/articles/PMC7450554/ /pubmed/32847518 http://dx.doi.org/10.1186/s12877-020-01705-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Dockx, Yvonne J. C.
Molenaar, Esther A. L. M.
Barten, Di-Janne J. A.
Veenhof, Cindy
Discriminative validity of the Core outcome set functional independence in a population of older adults
title Discriminative validity of the Core outcome set functional independence in a population of older adults
title_full Discriminative validity of the Core outcome set functional independence in a population of older adults
title_fullStr Discriminative validity of the Core outcome set functional independence in a population of older adults
title_full_unstemmed Discriminative validity of the Core outcome set functional independence in a population of older adults
title_short Discriminative validity of the Core outcome set functional independence in a population of older adults
title_sort discriminative validity of the core outcome set functional independence in a population of older adults
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7450554/
https://www.ncbi.nlm.nih.gov/pubmed/32847518
http://dx.doi.org/10.1186/s12877-020-01705-6
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