Background: Frail older people are more likely to develop negative health outcomes. Previous studies have indicated that the Groningen Frailty Indicator is a practical frailty screening instrument with good psychometric properties; however, it has never been implemented in Chinese nursing homes.
Aims: To cross-culturally adapt and validate the Groningen Frailty Indicator in Chinese nursing home residents.
Methods: The participants were 192 residents from nursing homes. Reliability was analyzed by internal consistency and test-retest methods. Convergent validity was assessed using Spearman rank correlations between the GFI domains and activities of daily living, the mini nutritional assessment, the Mini-mental state examination, the Social Support Rating Scale, the 20-item Epidemiologic Studies Depression Scale and the Short Form 36 mental component summary. Criterion validity was investigated by performing a receiver operating characteristics curve analysis.
Results: The Chinese GFI achieved semantic, idiomatic, and experiential equivalence. It had a high response rate among nursing home elders. It also showed good internal consistency (ICC = 0.712) and excellent test-retest reliability. Regarding construct validity, it presented good known-group divergent validity based on age. The correlations between the GFI domains and their corresponding measures were consistent as hypothesized, demonstrating convergent validity of the GFI. Using the Fried frailty phenotypes as reference criteria, the Chinese GFI showed satisfactory diagnostic accuracy for frailty (AUC = 0.823) and prefrailty (AUC = 0.791). The optimal cutoff point was 4 for frailty and 3 for prefrailty.
Conclusions: The GFI was successfully adapted for Chinese nursing home residents and presented acceptable validity and reliability.
Keywords: Frailty; Instrumentation; Nursing homes; Psychometric.