The Korean Physical Activity Questionnaire for Elderly (PAQE): Development and Evaluation of Validity and Reliability

BACKGROUND: As individuals age, there is an obvious decline in their physical activity level. Thus, this is an area where an easy to use assessment instrument is needed. But presently, there is no tool that meets this need. In addition, there is no such instrument tailored for the Korean elderly. This study aimed to fill this void by developing a physical activity assessment instrument for this particular population that is easy to use. METHODS: Item collection was performed through a literature review and a survey of 100 elderly individuals residing in a community setting. Items were selected through expert consensus; and the Physical Activity Questionnaire for elderly (PAQE) was created. For validation, 120 community dwelling elderly persons were enrolled. PAQE and an accelerometer were administered to each participant, and the questionnaire was re-administered 2 weeks later. The Spearman rho between the questionnaire and the accelerometer was calculated for concurrent validity. The Cronbach's alpha was calculated for internal consistency. Test-retest reliability was assessed by calculating the Spearman rho. RESULTS: Of the 119 participants, 80.34% were female with the average age being 72.74+/-7.29 years. Energy expenditure measured by the accelerometer was 220.36+/-96.96 kcal/day compared to 368.33+/-257.29 kcal/day measured through the developed questionnaire. Although the Spearman rho between the energy expenditure measured by the accelerometer and calculated through the recreational activity report in the questionnaire was 0.235 (p=0.011), the total energy expenditure was 0.105 (p=0.259) and the energy expenditure by household activity was 0.002 (p=0.983). The Cronbach's alpha was 0.781. The Spearman rho was 0.720 (p<0.001) for test-retest reliability. CONCLUSION: Our findings show that PAQE is a reliable questionnaire, a valid instrument for estimating energy expenditure during recreational physical activity in the Korean elderly person. However, energy expenditure of household activity did not correlate well with the accelerometer. In conclusion, the PAQE questionnaire can be used to assess kinds and frequency of household activities.

Weighting the items of Korean Activities of Daily Living(K-ADL) Scale and its Validity

BACKGROUNDS: Though K-ADL was developed and validated, weighting each item of K-ADL is needed to evaluate the severity of functional disability as a whole. METHODS: Nominal group technique was used to weight individual items of K-ADL. Relevant experts were recruited; one specialist in geriatrics, one expert in elderly health service, one doctor expert in questionnarie, one nurse and two social welfare workers and one caregiver who work in nursing home for elderly, one nurse working at dementia care center. At the first round, each expert assigned the weights of each item. At the second round, those experts met, discussed, and re-evaluated each weighting. Using the newly developed weighted score, we measured its validity compared to brain-disability grade and three experts' decision of severe dysfunction. RESULTS: For inability to perform task, 7 points were given to 'dressing'and 'washing face', 6 points to 'bathing', 9 points to 'feeding', 8 points to 'transfer and toileting'. If any assistance is needed, 7 points were scored to 'dressing', 4 points were scored to 'washing face', 'feeding', 'transfer' and 'toileting', 2 points were scored to 'dressing'. Correlation coefficient between weighted K-ADL sum and brain-disability grade was -0.665(p=0.000). CONCLUSIONS: We assigned differential weighting to each of K-ADL and found that summing weighted K-ADL was excellent in some validity test.

The Functional Assessment Process in Long-Term Care System for Older Persons

This paper was written to provide informations on the functional assessment system in developing public long-term care scheme for frail older persons. Until now in Korea long-term care services tend to be provided to older persons disqualified, because there is no a formal instrument to assess. Fundamentally the scope of function covered by particular measures is composed of four domains:self-care functioning, domestic functioning, cognitive function and challenging behaviour. As a result of review of literatures and each nation's system, assessment indices were suggested 41 items. That is to say, the self-care functioning and domestic functioning are consisted of 22 items, cognitive function and challenging behaviour being 9 items. Besides, it is suggested that 10 items of nursing and rehabilitative needs should be assessed. It is desirable that assessedment should be practised by medical manpowers, for example, medical doctor or nurse and in assessment process firstly visiting examiner make an investigation of physical and cognitive function with a constructed questionnaire and secondly assessment team such as ACAT in Australia decide the level of functional severity.

The Validity and Reliability of Korean Instrumental Activities of Daily Living(K-IADL) Scale

BACKGROUND: Korean Instrumental Activities of Daily Living(K-IADL) scale was developed to measure the elderly function. The aim of the present study was to establish the validity and reliability of K-IADL scale. METHODS: Clinical validity and convergent validity was tested. Reliability was tested by internal consistency(Cronbach`s alpha), two weeks test-retest method, and interrator correlation. RESULTS: Cronbach`s alpha was 0.938. 2 weeks test-retest correlations in all 10 items were higher than 0.674. Interrator agreements were high in all 10 items(H=0.808~0.947). Normal control group had lower scores than patients group in all 10 items(p=0.000). Correlation coefficient between K-IADL score and brain-disability grade was between -0.336(laundry) and -0.663(using transportation)(p=0.000). CONCLUSIONS: Korean Instrumental Activities of Daily Living(K-IADL) scale is a valid and reliable instrument. In the future, the studies showing an association between K-IADL and mortality, prognosis are needed.