Postural Balance and Gait Parameters of Independent Older Adults: A Sex Difference Analysis.

Postural balance and gait are important factors in the functional status of older people; however, few studies have addressed differences by sex. The objective of this study was to analyze the postural balance and temporal−spatial parameters of gait in independent older adults by sex. A cross-sectional study was conducted. Thirty-eight independent older women (69 ± 5 years), and 33 men (71 ± 5 years) were evaluated. The postural balance test with open and closed eyes was performed on two surfaces (hard/soft) on a force platform. Gait was recorded with cameras to analyze cycle duration and speed, step length, stride length, and foot clearance. The area of postural balance was greater in men in all tests (p < 0.001). Foot clearance height and cycle duration were lower in women (p < 0.05). Men showed a negative correlation between the area of balance and gait parameters. In women, a positive correlation was observed between foot clearance and balance with eyes closed. The postural balance and gait suggest discrepancies by sex, showing that older men behave differently according to the requirement of the motor task compared to women. These findings suggest being corroborated in more complex studies in the future.

Effects of frailty status on happiness and life satisfaction: The mediating role of self-perceived health / Efectos del estado de fragilidad en la felicidad y la satisfacción con la vida: el papel mediador de la salud autopercibida

Abstract During the past decade, the frail syndrome has acquired great importance due to its detrimental social and psychological consequences. In the present study, we investigate the association between frailty status and well-being (happiness and life satisfaction) among older adults, and we test the role of self-perceived health as potential mediator in such relations. We recruited 1205 older Chilean adults who responded to measures about their objective health status (frailtyrelated indicators), well-being, and self-perceived health. Overall, path analyses showed that frailty status is negatively associated to life satisfaction and happiness, and that self-perceived health works as a mediator for such relations. The social and psychological consequences of the frail syndrome in older adults are discussed.

Resumen: Durante la última década, el síndrome de fragilidad ha adquirido gran importancia debido a sus consecuencias sociales y psicológicas perjudiciales. En el presente estudio, investigamos la asociación entre el estado de fragilidad y el bienestar (felicidad y satisfacción con la vida) en los adultos mayores, y evaluamos el papel de la salud autopercibida como potencial mediador de dichas relaciones. Reclutamos a 1205 adultos mayores chilenos que respondieron preguntas acerca de su estado de salud objetivo (indicadores relacionados con el estado de fragilidad), bienestar y autopercepción de salud. En términos generales, los análisis mostraron que el estado de fragilidad se asocia negativamente con la satisfacción vital y la felicidad, y que la salud autopercibida tiene un papel mediador en tales relaciones. Se discuten las consecuencias sociales y psicológicas del síndrome de fragilidad en adultos mayores.

Función sexual y calidad de vida relacionada con la salud en mujeres climatéricas con prolapso genital en Centros de Salud Familiar de la región de Ñuble / Sexual function and health related quality of life in climacteric women with genital prolapse in Family Health Centers of the Ñuble region

RESUMEN Introducción y objetivos: Los síntomas de climaterio junto con el prolapso genital en la mujer que envejece, afectan la función sexual y la calidad de vida relacionada con la salud. El objetivo de este estudio fue describir la función sexual y la calidad de vida relacionada con la salud en mujeres climatéricas con prolapso genital según características sociodemográficas y clínicas. Métodos: Diseño descriptivo de corte transversal, sobre una muestra consecutiva de 45 mujeres climatéricas inscritas en dos Centros de Salud Familiar de la región de Ñuble, se seleccionaron a todas aquellas entre 42 y 60 años de edad, con diagnóstico clínico o ecográfico de prolapso genital, con vida sexual activa los últimos 6 meses y sin terapia hormonal de reemplazo. Para evaluar la función sexual se aplicó el Índice de Función Sexual Femenina y para la calidad de vida relacionada con la salud el Menopause Rating Scale. Se utilizó estadística descriptiva, y para analizar la diferencia entre las variables se aplicaron las pruebas estadísticas Chi-cuadrado y Test Exacto de Fisher. En todos los casos se consideró un nivel de significancia p<0,05. Los datos fueron analizados con el software estadístico SPSS v. 23. Resultados: Se observó una diferencia estadísticamente significativa entre escolaridad y función sexual (p= 0,005) y el tipo de parto y la calidad de vida relacionada con la salud (p=0,034). Conclusiones: El nivel educacional se podría considerar como factor protector de la función sexual.

SUMMARY Introduction and objectives: The climacteric symptoms together with genital prolapse in the aging woman, affects the sexual function and the health related quality of life. The objective of this study was to describe sexual function and health related quality of life in climacteric women with genital prolapse according to sociodemographic and clinical characteristics. Methods: Descriptive cross-sectional design, on a consecutive sample of 45 climacteric women enrolled in two Family Health Centers of the Ñuble region, were selected all those between 42 and 60 years of age, with a clinical or ultrasound diagnosis of genital prolapse, with active sexual life the last 6 months and without hormone replacement therapy. To evaluate sexual function the Index of Feminine Sexual Function was applied and for the health related quality of life the Menopause Rating Scale was applied. Descriptive statistics were used, and to analyze the difference between the variables, the Chi-square and Fisher's Exact test were applied. In all cases a level of significance was considered p <0.05. The data was analyzed with the statistical software SPSS v. 23. Results: A statistically significant difference was observed between schooling and sexual function (p = 0.005) and type of delivery and health related quality of life (p = 0.034). Conclusions: The educational level could be considered as a protective factor of sexual function.

Sobrecarga en cuidadores principales de adultos mayores con dependencia severa en atención primaria de salud / Burden on primary caregivers of elderly people with severe dependence on Primary Health Care

Objetivo: Evaluar la relación entre las características sociodemográficas y del cuidado con la sobrecarga de los cuidadores principales de adultos mayores con dependencia severa. Metodología: Estudio correlacional de corte transversal, sobre una muestra consecutiva de 43 cuidadores principales de adultos mayores con dependencia severa pertenecientes al Programa de Atención Domiciliaria de un centro de salud familiar de Chile. Para evaluar el nivel de sobrecarga se utilizó la Escala de sobrecarga del cuidador de Zarit; además, se registraron variables sociodemográficas y del cuidado. La recogida de datos se realizó mediante visita domiciliaria. Se aplicó estadística descriptiva, y para analizar la relación entre las variables se aplicaron las pruebas estadísticas χ2 y prueba exacta de Fisher. En todos los casos se consideró un nivel de significación p < 0,05. Los datos fueron analizados con el software estadístico SPSS v. 23. Resultados: El 69,77% de los cuidadores presentó sobrecarga. La edad media fue de 58,33 ± 12,98 años, el mayor porcentaje fueron mujeres con un 74,42% y el 46,51% estaba soltero. El 86,05% de los cuidadores principales cuidaba 24 horas al adulto mayor y el 55,81% eran hijas/os. El abandono de una actividad por el cuidado alcanzó una diferencia estadísticamente significativa con la presencia de sobrecarga del cuidador (p < 0,05). Conclusiones: Las políticas públicas deben apoyar a los cuidadores en la actividad del cuidado, con la finalidad de disminuir la carga mejorando así su calidad de vida y su estado de salud

Objective: To evaluate the relationship between sociodemographic and care characteristics with the burden of the primary caregivers of the elderly with severe dependence. Methodology: Crosssectional correlational study on a consecutive sample of 43 primary caregivers of severely dependent seniors belonging to the Home Care Program of a Family Health Center of Chile. To assess the level of overload, the Zarit Caregiver Burden Scale was used, and sociodemographic and care variables were recorded. The data collection was done by home visits. Descriptive statistics were applied, and to analyze the relationship between the variables, the Chi-square and Fisher's Exact Test were applied. In all cases the level of significance considered was p<0.05. The data was analyzed with the statistical software SPSS v. 23. Results: 69,77% of the caregivers presented burden. The average age was 58,33 + 12,98 years, and the highest percentage were women with 74,42% and 46,51% were single. 86,05% of the main caregivers cared 24 hours to the elderly and 55,91% were sons or daughters. The abandonment of an activity by care reached a statistically significant difference with the presence of caregiver overload (p<0,05). Conclusions: Public Politics should support caregivers in this activity, in order to reduce the burden, thus improving their quality of life and health status

Confiabilidad y validez de criterio del cuestionario del sentido de la vida en pacientes chilenos en hemodiálisis crónica / Reliability and criterion validity of the meaning in life scale in chilean chronic hemodialysis patients

RESUMEN Objetivo: Evaluar la confiabilidad y validez de criterio de la versión española del Cuestionario del Sentido de la Vida (Meaning in Life Scale, MiLS) en pacientes chilenos en hemodiálisis crónica. Material y método: Estudio descriptivo transversal, sobre una muestra consecutiva de 244 personas en hemodiálisis crónica, beneficiarios del Servicio de Salud de la Región de Ñuble. El cuestionario MiLS consta de 21 ítems y cuatro dimensiones: Propósito de Vida, Falta de Significado, Paz Interior y Beneficios de la Espiritualidad. Se aplicó estadística descriptiva y análisis correlacional. La consistencia interna se determinó mediante el a de Cronbach. Los datos fueron analizados con el software estadístico SPSS v. 23. Resultados: La consistencia interna del cuestionario fue de 0,82. La puntuación global normalizada fue de 6,3. La puntuación global del cuestionario al igual que sus dimensiones correlacionan significativamente con todas las subvariables de bienestar subjetivo (p <0,01). Conclusión: El Cuestionario del Sentido de la Vida ha mostrado ser un instrumento viable, fiable y presentar apropiada validez de criterio para evaluar el bienestar espiritual de las personas en hemodiálisis. La evaluación del bienestar espiritual puede ser de utilidad para la práctica clínica.

ABSTRACT Objective: To evaluate the reliability and criterion validity of the Spanish version of the Meaning in Life Scale (MiLS) in Chilean chronic hemodialysis patients. Materials and methods: Cross-sectional descriptive study on a consecutive sample of 244 patients under chronic hemodialysis in the Ñuble Region Health Service. The MiLS questionnaire consists of 21 items and 4 dimensions: Life Purpose, Lack of Meaning, Inner Peace and Benefits of Spirituality. Descriptive statistics and correlational analysis were applied. Internal consistency was determined using Cronbach's a. Data were analyzed with the statistical software SPSS v. 23. Results: Internal consistency of the questionnaire was 0.82. Standard global score was 6.3. The overall questionnaire score as well as the dimensions correlate significantly with all subjective well-being variables (p <0.01). Conclusions: The Meaning in Life Questionnaire has been shown to be a viable, reliable instrument and to present appropriate criterion validity to evaluate the spiritual well-being of patients under hemodialysis therapy. Consequently, the evaluation of spiritual well-being may be useful for clinical practice.

What do older people understand by mobility-related difficulties?

UNLABELLED: Despite the centrality of the difficulty concept in the study of disability, there has been little research on its significance from the point of view of people with functional limitations. The main objective of this study was to describe what older people understand when asked about difficulty in undertaking mobility activities. As a secondary objective, we considered whether there are any differences depending on the type of activities, according to the International Classification of Functioning (ICF) mobility domains. METHODS: Seventeen community-dwelling men and women aged 70 years old or over were interviewed by means of a questionnaire containing 55 items covering the ICF mobility domains. The participants responded to the items while thinking aloud, saying what led them to give a specific answer about their level of difficulty. Inductive content analysis was conducted and categories, subthemes and themes were identified. RESULTS: Causes of difficulty (pathologies, impairments, symptoms) and accommodations (task modifications and use of aids) were the two themes identified; and their importance (and that of the subthemes included) varied across the types of activity. All the participants said that they had no difficulty in at least one task, despite mentioning changes in the way they performed them. CONCLUSIONS: Older people's opinions were consistent with theoretical models of disability and with the standard practice of measuring functional limitations by asking about the degree of difficulty; however, the design of these measures needs to be improved in order to detect perceptions of no difficulty in the presence of task modification.

Validation of a mobility item bank for older patients in primary care.

BACKGROUND: To develop and validate an item bank to measure mobility in older people in primary care and to analyse differential item functioning (DIF) and differential bundle functioning (DBF) by sex. METHODS: A pool of 48 mobility items was administered by interview to 593 older people attending primary health care practices. The pool contained four domains based on the International Classification of Functioning: changing and maintaining body position, carrying, lifting and pushing, walking and going up and down stairs. RESULTS: The Late Life Mobility item bank consisted of 35 items, and measured with a reliability of 0.90 or more across the full spectrum of mobility, except at the higher end of better functioning. No evidence was found of non-uniform DIF but uniform DIF was observed, mainly for items in the changing and maintaining body position and carrying, lifting and pushing domains. The walking domain did not display DBF, but the other three domains did, principally the carrying, lifting and pushing items. CONCLUSIONS: During the design and validation of an item bank to measure mobility in older people, we found that strength (carrying, lifting and pushing) items formed a secondary dimension that produced DBF. More research is needed to determine how best to include strength items in a mobility measure, or whether it would be more appropriate to design separate measures for each construct.

Clinical pathway intervention compliance and effectiveness when used in the treatment of patients with severe sepsis and septic shock at an Intensive Care Unit in Spain.

The purpose of this quasi-experimental study was to assess levels of compliance with the intervention bundles contained in a clinical pathway used in the treatment of patients with severe sepsis and septic shock, and to analyze the pathway's impact on survival and duration of hospital stays. We used data on 125 patients in an Intensive Care Unit, divided into a control group (N=84) and an intervention group (N=41). Levels of compliance increased from 13.1% to 29.3% in 5 resuscitation bundle interventions and from 14.3% to 22% in 3 monitoring bundle interventions. In-hospital mortality at 28 days decreased by 11.2% and the duration of hospital stay was reduced by 5 days. Although compliance was low, the intervention enhanced adherence to the instructions given in the clinical pathway and we observed a decline in mortality at 28 days and shorter hospital stays.

Valores de referencia de la Short Physical Performance Battery para pacientes de 70 y más años en atención primaria de salud / Short Physical Performance Battery reference values for patients 70 years-old and over in primary health care

Objetivo: Aportar nuevos valores de referencia de la Short Physical Performance Battery (SPPB) para personas de 70 y más años, en atención primaria de salud (APS), y analizar su asociación con variables demográficas, de función física, estado de salud y clínicas. Diseño: Entrevistas y observaciones basales de un estudio longitudinal sobre función física y resultados adversos de salud. Emplazamiento: 5 centros de atención primaria de las provincias de Alicante y Valencia. Participantes: 593 personas de 70 y más años. Mediciones principales: La SPPB se aplicó mediante observación directa y el resto de variables mediante entrevista. Se calcularon valores de referencia según sexo y 3 grupos de edad (70-75, 76-80, > 80 años) y se examinó la validez de la batería mediante estadísticos de asociación con variables demográficas, clínicas y de funcionamiento. Resultados: Los valores de referencia indicaron peor desempeño en las mujeres y progresivamente peor desempeño a través de los 3 grupos de edad. La batería SPPB se asoció significativamente (p<0,01) con la edad, sexo, número de fármacos consumidos, morbilidad, índice de masa corporal, dependencia en actividades básicas de la vida diaria (ABVD), dependencia en actividades instrumentales de la vida diaria (AIVD) por motivos de salud, Physical Functioning Scale (PF-10), depresión y percepción de salud. Conclusiones: Se aportan valores de referencia de la batería completa SPPB por edad y sexo, basadas en las puntuaciones categóricas, para personas de 70 y más años en atención primaria. La batería mostró además su validez como medida objetiva de funcionamiento físico. Estos resultados pueden favorecer la valoración rápida y válida del estado funcional de las personas mayores en atención primaria(AU)

Objective: To provide new reference values for the Short Physical Performance Battery (SPPB) for patients 70 years-old and over in primary health care (PHC), and analyse their relationship with demographic data, physical function, health and clinical status. Design: Baseline interviews and observations of a longitudinal study on physical function and adverse health results. Setting: Five Primary Care Centres in the provinces of Alicante and Valencia. Participants: A total of 593 persons 70 years-old and over. Main measurements: The SPPB was applied using direct observation, and the rest of the variables by interview. Reference values were calculated according to sex and three age groups (70-75, 76-80, > 80 years), and the validity of the Battery was analysed using association statistics with the demographic, clinical, and function data. Results: The reference values showed a poor performance in women, and a gradually poorer performance through the three age groups. The SPPB was significantly associated (P < 0.01) with age, sex, number of drugs taken, morbidity, body mass index, dependency in basic activities of daily living (BADL), instrumental activities of daily living (IADL) for health reasons, the 10-item Physical Functioning Scale (PF-10), depression and health perception. Conclusions: The reference values of the complete SPPB by age and sex are provided, based category scores in Primary Care patients 70 years-old and over. The Battery results can give a rapid and valid assessment of the functional state of elderly patient in Primary Care(AU)

Clinical pathway intervention compliance and effectiveness when used in the treatment of patients with severe sepsis and septic shock at an Intensive Care Unit in Spain / Observância e efetividade das intervenções de um protocolo clínico utilizado para pacientes com sepse grave e choque séptico de uma Unidade de Cuidados Intensivos da Espanha / Cumplimiento y efectividad de las intervenciones de un protocolo clínico utilizado en pacientes con sepsis grave y shock séptico en una Unidad de Cuidados Intensivos en España

The purpose of this quasi-experimental study was to assess levels of compliance with the intervention bundles contained in a clinical pathway used in the treatment of patients with severe sepsis and septic shock, and to analyze the pathway's impact on survival and duration of hospital stays. We used data on 125 patients in an Intensive Care Unit, divided into a control group (N=84) and an intervention group (N=41). Levels of compliance increased from 13.1% to 29.3% in 5 resuscitation bundle interventions and from 14.3% to 22% in 3 monitoring bundle interventions. In-hospital mortality at 28 days decreased by 11.2% and the duration of hospital stay was reduced by 5 days. Although compliance was low, the intervention enhanced adherence to the instructions given in the clinical pathway and we observed a decline in mortality at 28 days and shorter hospital stays.

O objetivo deste estudo quase-experimental foi avaliar o grau de cumprimento das intervenções de um pacote de medidas, em um protocolo clínico proposto para pacientes com sepse grave e choque séptico, e analisar o seu impacto na sobrevivência e duração das permanências hospitalares. Foram incluídos 125 pacientes, alocados no grupo controle (n=84) e intervenção (n=41) de uma Unidade de Cuidados Intensivos, na Espanha. O nível de adesão aumentou em pelo menos 5 intervenções do pacote de reanimação (de 13,1 para 29,3%) e em pelo menos 3 intervenções do pacote de acompanhamento (de 14,3 para 22%). A mortalidade hospitalar aos 28 dias diminuiu em 11,2% e a duração da permanência hospitalar foi reduzida em 5 dias. Embora o cumprimento tenha sido baixo, a intervenção aumentou a adesão às indicações do protocolo clínico e foram observadas queda da mortalidade aos 28 dias e menor duração da permanência hospitalar.

El objetivo de este estudio cuasiexperimental fue valorar el nivel de cumplimiento de las intervenciones de los paquetes de medidas de un protocolo clínico para pacientes con sepsis grave y shock séptico y analizar su impacto sobre la supervivencia y la duración de estancias hospitalarias. Se incluyeron los datos de 125 pacientes divididos en grupo control (N=84) e intervención (N=41) de una Unidad de Cuidados Intensivos. El nivel de cumplimiento aumentó de 13,1% a 29,3% en 5 intervenciones del paquete de reanimación y de 14,3% a 22% en 3 intervenciones del paquete de seguimiento. La mortalidad hospitalaria a los 28 días disminuyó un 11,2% y la duración de la estancia hospitalaria se redujo en 5 días. Aunque el cumplimiento fue bajo, la intervención aumentó la adhesión a las indicaciones del protocolo clínico y se observó un descenso de la mortalidad a los 28 días y menor duración de estancias hospitalarias.

[Short physical performance battery reference values for patients 70 years-old and over in primary health care]. / Valores de referencia de la Short Physical Performance Battery para pacientes de 70 y más años en atención primaria de salud.

OBJECTIVE: To provide new reference values for the Short Physical Performance Battery (SPPB) for patients 70 years-old and over in primary health care (PHC), and analyse their relationship with demographic data, physical function, health and clinical status. DESIGN: Baseline interviews and observations of a longitudinal study on physical function and adverse health results. SETTING: Five Primary Care Centres in the provinces of Alicante and Valencia. PARTICIPANTS: A total of 593 persons 70 years-old and over. MAIN MEASUREMENTS: The SPPB was applied using direct observation, and the rest of the variables by interview. Reference values were calculated according to sex and three age groups (70-75, 76-80, > 80 years), and the validity of the Battery was analysed using association statistics with the demographic, clinical, and function data. RESULTS: The reference values showed a poor performance in women, and a gradually poorer performance through the three age groups. The SPPB was significantly associated (P < 0.01) with age, sex, number of drugs taken, morbidity, body mass index, dependency in basic activities of daily living (BADL), instrumental activities of daily living (IADL) for health reasons, the 10-item Physical Functioning Scale (PF-10), depression and health perception. CONCLUSIONS: The reference values of the complete SPPB by age and sex are provided, based category scores in Primary Care patients 70 years-old and over. The Battery results can give a rapid and valid assessment of the functional state of elderly patient in Primary Care.

[Structured review of physical activity measurement with questionnaires and scales in older adults and the elderly]. / Revisión estructurada de los cuestionarios y escalas que miden la actividad física en los adultos mayores y ancianos.

OBJECTIVE: To characterize the distinct questionnaires and scales used to measure physical activity, their conceptual frameworks, psychometric properties and application norms. METHOD: The review included original articles that used questionnaires or scales to assess physical activity in older adults or the elderly. The CINAHL and MEDLINE databases were consulted for the years 1993 to 2007. The studies selected had to provide information on the use, development and psychometric properties of the instruments. Instruments used in the population aged more than 45 years old were included. Articles that assessed physical activity by direct estimation, complex methods, or physical performance were excluded. RESULTS: The search produced 166 references and 36 instruments were identified. Most of the studies quantified physical activity, and a minority assessed self-efficacy in physical activity performance and the stage of change. Half of the instruments were self-administered. The most frequently studied reliability was test-retest. Criterion validity was studied in 14 instruments, and 11 of these used at least two alternative methods of measurement. Construct validity was assessed in 26 instruments. Responsiveness was evaluated in only three instruments (YPAS, CHAMPS and Exercise Stage of Change) in addition to reliability and validity. CONCLUSIONS: The Exercise Stage of Change questionnaire showed responsiveness and sufficient reliability to allow individual use. The 7Day PAR questionnaire and the Modified Baecke Questionnaire (Spanish version), which evaluate physical activity, can be used on an individual basis, although their responsiveness has not been studied. In general, the instruments analyzed do not assess mild intensity activities.

The Spanish versions of the Barthel index (BI) and the Katz index (KI) of activities of daily living (ADL): a structured review.

In this article, the evidence relating to the appropriateness to the target population, practicality and psychometric properties of the BI and the KI of ADL on samples of Spanish old people has been evaluated. To obtain the original documents electronic searches were carried out in Spanish databases and in international databases, MEDLINE, PsycInfo, CINAHL and EMBASE, as well as manual searches and references searches. Twenty articles met the inclusion criteria. The results show a large number of versions, for the two instruments, with weak processes of transcultural adaptation, without standards for its administration, nor for its interpretability. The most evaluated point of reliability was the interrater reproducibility. The evidence about predictive validity is extensive, but the evidence about concurrent validity and responsiveness is very scarce.

[Structured review of activities of daily living measures in older people]. / Revisión estructurada de las medidas de actividades de la vida diaria en personas mayores.

OBJECTIVE: the present article evaluates the evidence relating to the conceptual adaptation, applicability and psychometric properties of activities of daily living measures in Spanish elderly people. MATERIAL AND METHODS: to obtain original documents, electronic searches were carried out in Spanish (IME and ISOC) and international databases (MEDLINE, PsycInfo, CINAHL and EMBASE). Manual searches and reference searches were also conducted. RESULTS: 34 articles relating to 4 instruments met the inclusion criteria: the Barthel Index, the Katz Index, the Red Cross Scale of Physical Disability and the Subscale of Personal Care Activities from the OARS. Overall, the results show a large number of versions for each instrument with weak transcultural adaptation processes and without standards for their administration or interpretation. The most frequently evaluated reliability measure was interrater reproducibility. The evidence on predictive validity is extensive, but the evidence on concurrent validity and responsiveness is almost nil. CONCLUSIONS: one version of the Barthel index and another one of the Katz index are the two versions about which the largest quantity of information has been obtained.

Revisión estructurada de las medidas de actividades de la vida diaria en personas mayores / Structured review of activities of daily living measures in older people

Objetivo: evaluar la adecuación conceptual, la aplicabilidad y las propiedades psicométricas de las medidas de actividades de la vida diaria empleadas con personas mayores españolas. Material y métodos: se realizaron búsquedas electrónicas en bases de datos nacionales (IME e ISOC) e internacionales (MEDLINE, CINAHL, PsycInfo y EMBASE), así como búsquedas manuales y rastreo de referencias. Resultados: se incluyeron 34 estudios empíricos relativos a 4 instrumentos: el índice de Barthel, el índice de Katz, la escala de incapacidad física de la Cruz Roja y la escala de actividades de cuidado personal del OARS. Los resultados evidencian, en general, un elevado número de versiones para cada escala, con procesos de adaptación transcultural endebles y sin normas de administración ni de interpretabilidad. La reproducibilidad interobservador es el aspecto de la fiabilidad más examinado. La evidencia sobre la validez predictiva es amplia, pero las evidencias sobre la validez concurrente y la responsividad son casi nulas. Conclusiones: una versión del índice de Barthel y otra del índice de Katz son las que más evidencias han reunido

Objective: the present article evaluates the evidence relating to the conceptual adaptation, applicability and psychometric properties of activities of daily living measures in Spanish elderly people. Material and methods: to obtain original documents, electronic searches were carried out in Spanish (IME and ISOC) and international databases (MEDLINE, PsycInfo, CINAHL and EMBASE). Manual searches and reference searches were also conducted. Results: 34 articles relating to 4 instruments met the inclusion criteria: the Barthel Index, the Katz Index, the Red Cross Scale of Physical Disability and the Subscale of Personal Care Activities from the OARS. Overall, the results show a large number of versions for each instrument with weak transcultural adaptation processes and without standards for their administration or interpretation. The most frequently evaluated reliability measure was interrater reproducibility. The evidence on predictive validity is extensive, but the evidence on concurrent validity and responsiveness is almost nil. Conclusions: one version of the Barthel index and another one of the Katz index are the two versions about which the largest quantity of information has been obtained

[Review of the attributes of patient-based health outcomes instruments]. / Revisión de los atributos de las medidas de resultados de salud basados en el paciente.

Study of the quality and use of patient-based outcomes instruments has been and still is an area of growing interest in many health disciplines, including nursing. In the last 30 years, the number of measures has greatly increased. However, there is enormous disparity in their contents, hampering selection of one or other of these instruments for use in clinical medicine or research. The aim of this article was to describe the quality attributes that patient-based health instruments should meet before being used. For that purpose, we provide a detailed description of the attributes on which there is both national and international consensus. These instruments are grouped in 3 main axes: conceptual adequacy, applicability, and psychometric properties.