Cross-cultural Adaptation Of The Edmonton Frail Scale And The Current Situation Of Frailty In Elderly Patients With Diabetes

Objective: To translate the English version of Edmonton Frail Scale into Chinese version and to test its reliability and validity in Chinese hospitalized elderly people.The Chinese version of Edmonton Frail Scale is applied to investigate the current situation of frailty and its influencing factors in hospitalized elderly patients with diabetes,which could provide theoretical basis for clinical nursing intervention.Methods: 1.The translation and cross-cultural adaptation of the English version of Edmonton Frail Scale were generated by Beaton's translation and back-translation method.From April to August of 2019,at the department of geratology in a tertiary hospital in Shenyang,a sample of 303 hospitalized elderly adults who met the inclusion and exclusion criteria were selected via convenience sampling method,and were interviewed by self-designed general information questionnaire,the Chinese version of Edmonton Frail Scale and the Tilburg Frailty Indicator,to test its psychometric properties including content validity,criterion validity,known-group divergent validity,internal consistency and test-retest reliability.2.From July to December of 2019,at the department of endocrinology in a tertiary hospital in Shenyang,a sample of 221 hospitalized elderly patients with diabetes who met the inclusion and exclusion criteria were selected via convenience sampling method,and were interviewed by selfdesigned general information questionnaire,the Chinese version of Edmonton Frail Scale,the scale of diabetes self-care activities and the short form geriatric depression scale.Results: 1.The Chinese version of the Edmonton Frail Scale achieved semantic,idiomatic and experiential equivalence.The S-CVI and I-CVI of the Chinese version of the Edmonton Frail Scale were both 1.0.The criterion validity between the Chinese version of Edmonton Frail Scale and the Tilburg Frailty Indicator was 0.723(P<0.01),confirmed by Pearson correlation coefficients.Using the Tilburg Frailty Indicator as an external criterion,the Edmonton Frail Scale showed satisfactory diagnostic accuracy for frailty(area under the curve=0.924).The optimal cut-point for frailty was 6(sensitivity: 77.6%,specificity: 94.7%).More frail individuals were recognized by the Chinese version of Edmonton Frail Scale among older and female participants than their counterparts(P<0.05).The Cronbach'? of the Chinese version of Edmonton Frail Scale was 0.599,the test-retest reliability within a 7-day interval of the scale was 0.822.2.Totally 221 valid questionnaires were collected.The median frailty score of the elderly patients with diabetes was 6,the quartile range was 5 to 9.A total of 137 cases suffered from frailty and the prevalence was 62.0%,62 cases were mild frailty(28.1%),30 cases were moderate frailty(13.6%),45 cases were severe frailty(20.4%).Multiple linear regression showed that depression,age,polypharmacy,masticatory of tooth,insulin injection,personal monthly income were the major influential factors(P<0.05).Conclusions: 1.The Chinese version of Edmonton Frail Scale presents good validity and reliability and can apply to Chinese hospitalized elderly people.2.The prevalence of frailty in elderly patients with diabetes was at a high level,the situation of frailty was serious.The frailty of elderly patients with diabetes was affected by depression,age,polypharmacy,masticatory of tooth,insulin injection,personal monthly income.In clinical practice,we should pay more attention to the frailty of elderly patients with diabetes,do a good job of screening,develop personalized frailty intervention strategies,delay the process of weakness.