Article

Validación de la Escala de Independencia Funcional

Gaceta Sanitaria (Impact Factor: 1.12). 01/2009; 23:49-54. DOI: 10.1016/j.gaceta.2008.06.007

ABSTRACT Resumen:
Objetivo: Evaluar la calidad psicométrica de un instrumento diseñado para medir la independencia funcional (Escala de Independencia Funcional ,EIF) en varios dominios de actividades de la vida diaria y ser aplicado por entrevistadores entrenados no expertos en el ámbito sanitario. El estudio se realizó en población mayor no institucionalizada residente en la Comunidad de Madrid.
Métodos: Estudio transversal de validación. Se aplicaron la EIF, el test de Pfeiffer, la subescala de depresión de la Hospital Anxiety and Depression Scale, un indicador de comorbilidad, el Índice de Barthel y el EQ-5D, a población residente en medio comunitario (n = 500) y a pacientes ambulatorios en medio hospitalario (n = 100) de edad ≥ 65 años. Se analizaron los siguientes atributos psicométricos de la EIF: aceptabilidad, asunciones escalares, consistencia interna, validez de constructo y precisión.
Resultados: La escala resultó totalmente computable en el94,3% de los sujetos, con efecto techo (60,65%) y sin efecto suelo (0,22%) en el medio comunitario. En el medio hospitalario no se evidenció efecto suelo ni techo. La escala mostró asunciones escalares satisfactorias y elevada consistencia interna (correlaciones ítem-total: 0,57–0,91; alfa de Cronbach: 0,94), así como una estructura multidimensional (tres factores; 74,3% de la varianza). Los índices de validez convergente, interna y para grupos conocidos, al igual que la precisión (error estándar de la medida: 2,49; intervalo de confianza del 95%: 4,88) resultaron satisfactorios.
Conclusiones: En suma, la EIF es una escala de uso sencillo con atributos métricos apropiados, y su aplicación por parte de personal no sanitario resulta útil para muestras amplias de individuos mayores no institucionalizados.

Abstract:
Objective – To assess the psychometric quality of an instrument designed for measuring the functional independence (Functional Independence Scale, EIF) in several activities of daily living domains and to be applied by trained non-health related interviewers. The study was carried out in Madrid Region on aged people living in family housing.
Methods – Pfeiffer’s questionnaire, Depression subscale of the Hospital Anxiety and Depression Scale, Comorbidity Index, Barthel Index, and EuroQoL were used in addition to the EIF. These measures were applied to community dwelling (CDS, n=500) and outpatients assisted in a general hospital (HS=100) subjects aged ≥65. The following EIF psychometric attributes were analysed: acceptability, scaling assumptions, internal consistency, construct validity, and precision.
Results - Full computable EIF total score was obtained in 94.3% of subjects. Ceiling effect (60.65%), but no floor effect (0.22%), was evident in the CDS. No floor or ceiling effect were detected in the HS. Scaling assumptions and internal consistency resulted satisfactory (item-total correlations= 0.57-0.91; Cronbach’s alpha= 0.94). Factor analysis identified 3 factors, explaining 74.3% of the variance). Indexes of convergent, internal, and known-groups validity resulted satisfactory. EIF precision, determined by the standard error of measurement (2.49; 95%CI= 4.88), also resulted appropriate.
Conclusion - The EIF is an easy-to-use instrument with appropriate metric attributes. It is useful for application in wide samples of not institutionalized aged individuals by non-health related personnel.

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