Research On Construction Of Health-Related Physical Fitness Examination And Assessment Index System In Old People

BackgroundPhysical Fitness means that individual won’t be too tired dealing with daily work and leaving leisure time and the ability to cope with emergencies (World Health Organization definition). "Health-related Physical Fitness" concepts derived from Physical Fitness research, refers to improve health and prevent some diseases which have special effect quality, including cardiopulmonary endurance, body composition, muscle strength, endurance, flexibility, etc. Compared with the United States, Japan and other developed countries, Health-related Physical Fitness testing of the old in our country is still exist some problems like single project and evaluation method, lack of evaluation standard, narrow detection range (only for 60～69 years).According to the sixth national population census in April 2010, China has been in the stage of an aging population, and the number and proportion of the elderly people increased further. Ageing population in our country characterized by the large elderly population base, the degree and speed of that beyond the world level, aging ahead of modernization, "not rich before old", unbalanced regional development, urban and rural inversion significantly and so on.The rapid population ageing will bring some problems that labor decrease, social wealth creation deceleration, the increase of rate of disable in the elderly and increased medical expenses. Meanwhile, the characteristics of easy to disable, will increase the burden of pension, medical insurance. However, the current system of medical and health services in China, as well as health insurance for the elderly are still not perfected, such as elderly welfare agencies in the primary stage of development, etc., is still not enough to cope with an aging population.An ageing population, therefore, need some measures such as improve the social security system, optimize the elderly health management services, change the concept of pension, popularize knowledge of health literacy and so on. Our study aims to build evaluation index system of the elderly Health-related Physical Fitness monitoring and complete a method copy with the aging of the population feasibly.ObjectiveThis study aims to build a set of testing evaluation index system which is accord with the real conditions in our country, suitable for the elderly aged 60 and older elderly, practical for in the health management service of Health-related Physical Fitness, and explore a feasible to cope with the aging of the population.Contents1. The determination of detection index:Mainly based on the concept of Health-related Physical Fitness. The detection index mainly include the body configuration, composition, muscle strength, endurance, cardiorespiratory fitness, flexibility and balance coordination related indicators.2. Determining the weights of the Health-Related Physical Fitness Examination and Assessment Index System.3. The choice of evaluation method. Health-related Physical Fitness index testing of evaluation, mainly from the perspective of a single index scores and comprehensive scores, at the same time, in a way that is entirely on the five aspects of physical health comprehensive evaluation.4. The comparison with other examination and assessment index systems.Methods1. ParticipantsWith using the Delphi expert consultation method, this study preliminary chooses 28 experts in the field of health management, sports medicine, rehabilitation medicine, geriatric medicine, etc. The expert choosing standards are:first, he must be familiar to fitness test, with 3 years or above relevant working experience; second, he is with intermediate professional or above title; third, he understands the purpose of this study, and can actively complete the 2 rounds of consultation questionnaire.2. Measure2.1 Literature analysis:Through the website, this study uses literature analysis method to find and systematically analysis the Health-related Fitness related research achievements of others. Using search engines to find empirical research progress and policy documents, acquire domestic and foreign Health-related Fitness evaluation method and standard, and build a health-related fitness testing project framework and evaluation method.2.1 Brainstorm method and expert interview method:Sports experts of Southern Medicine University are invited to discuss every index of the preliminary built item pool. According to the experts’opinion, we do a further modification to select the appropriate Health-related fitness detection indexes. On this basis, we carry out the preliminary investigation, and build preliminary testing index system.2.3 Method of expert interview:one expert for the 2 round interview. Through a thorough discussion with experts, the formation of the Health-related Physical Fitness testing evaluation index pool is analyzed, detailed discuss the typicality, the feasibility and safety of evaluation index, in order to determine whether it is suitable for application in the elderly Health-related Physical Fitness test.2.4 Delphi method:In writing anonymously solicit opinions and summary experts rounds, after two rounds of consultation, finally we obtain statistically significant expert judgment result. Delphi method can make full use of consulting the expert’s knowledge and experience, to solve the problem of prediction and assessment done is of great value.3. Statistical analysisOn the choice of statistical analysis methods, this research adopts the Excel 2007 version for a double data entry, and analysis the data by SPSS 21.0. We use frequency, average, etc to describe the degree of statistics concentration, and standard deviation, coefficient of variation, etc to describe the dispersion degree of statistics. Hypothesis testing standards a=0.05.In this study, to effectively guarantee the index system is scientific and reliability, expert positive factor, the degree of authority coefficient, opinion coordination coefficient and opinion variation coefficient are used to measure the reliability of the questionnaire results.3.1. Expert positive factor:In this research, questionnaire recovery is used to reflect the expert positive factor3.2 The degree of authority coefficient:Generally, experts’criterion and familiar degree of the indexes constitute the degree of authority coefficient.3.3 The coordination coefficients of experts:The Kendall’s coordination coefficients show the level of the coherence among experts. We used the Kendall’s coordination coefficients to evaluate the coherence among experts after every rounds recycle, co means the Kendall’s coordination coefficients. The values of ω vary from to 1. The bigger figure shows the better coherence. The coefficients were tested using chi-squared tests (a=0.05). In present study,0.7 was set as the cutoff value to select the first-level indexes.3.4 The coefficient of variation (CV):Delphi survey means that the experts judge the indexes among the pool based on their own theoretical knowledge and practical experiences and the authorization coefficients were calculated based on their questionnaires. Therefore, there was subjectivity bias among the evaluation results inevitably. As a result, we designed two Likert five-level grades including importance and operability as well as three-dimensional percentile index weight score graded by experts. Then, we calculated the CV of every second-level index and discriminated the abnormal value.3.5 The system weight of indexes:The system weight of index is a method to determine the first-level index weight according to the coordination coefficients of experts. When the coordination coefficients of experts bigger than 0.7, we calculated the mean of experts scores(Pij), which were regarded as index weight(Ki); when the coordination coefficients of experts smaller than 0.7, the index weight included two parameters:experts’score (Pij) and the authorization coefficients (Aa).Results1. Preliminary screening indicatorsFrom policy documents, literature research and practice research preliminary screening we get pool content and connotation of indicators including five primary index and 28 secondary indicators respectively.2. Pilot surveyAfter a pilot survey, there were still five level indicators, with secondary indexes are reduced to 23.3. Result of Expert Consultation3.1 Characteristics of the experts:Of the 25 experts finishing two rounds of consultation,5 are from medical health management organizations,5 are from physical education and research field,4 specializes in physical fitness,1 studied in public health,2 studied in gereology, and 2 are from other clinical fields. The average age of the experts consulted is 47.92.21 experts, making up 84% of all, had sub-senior professional title or senior professional title, and 80% possessed master degree or above. The response rate of questionnaires are 92.86% and 100%..3.2 Opinions of Expert Consultation3.2.1 In the first round of expert consultation, Expert opinion’s coordination coefficient of first grade index weight is 0.253, and expert opinion’s coordination coefficient of second grade index weight id 0.561. The total coordination of coefficient is 0.516. Result of X2 test shows P<0.01.above all the suggestions binged by experts,7 meets the criteria of deletion or modify.The mean value of significance evaluation of each second grade index is between 4.24～4.80, coefficient of variation is between 0.10-0.19, under 0.25. The mean value of feasibility evaluation of each second grade index is between 3.76-4.88 and coefficient of variation is between 0.10-0.22, except the Visceral fat index, which is higher than 0.25. The mean value of weight evaluation of each second grade index is between 13.28～35.16 and coefficient of variation is between 0.20～0.32, under 0.40.3.2.2 In the second round of expert consultation, expert opinion’s coordination coefficients of first grade index weight is 0.595, and expert opinion’s coordination coefficient of second grade index weight is 0.622. The total coordination of coefficient is 0.686. Result of X2 test shows P<0.01. The mean value of significance evaluation of each second grade index is between 4.16～4.68, coefficient of variation is between 0.10-0.18, under 0.25. The mean value of feasibility evaluation of each second grade index is between 4.08～4.76 and coefficient of variation is between 0.11-0.23, under 0.25. The mean value of weight evaluation of each second grade index is between 23.48-54.20 and coefficient of variation is between0.14-0.27, under 0.40.ConclusionBased on the current situation of China’s aging population, this study chose 25 Health-related Physical Fitness experts who familiar to the area, after two expert consultation, we build the evaluation index system of the elderly Health-related Physical Fitness test and each index weight coefficients. The index system for a total of five first-level indicators, including 15 secondary indexes. The index system has reliability and feasibility to practical application in health management service of Health-related Physical Fitness testing evaluation index system, scientific and accurate evaluation for the future elderly Health-related Physical Fitness status; provide reference to improve the elderly health literacy.