Análise Psicométrica do Índice de Vulnerabilidade Clínico Funcional 20

• Ano de defesa: 2018
• Autor(a) principal: Edmar Geraldo Ribeiro
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: Validade dos Testes; Saúde do Idoso; Idoso Fragilizado; Psicometria; Vulnerabilidade e Saúde; Centros de Saúde; Reprodutibilidade dos Testes; Enfermagem; Inquéritos e Questionários; Vulnerabilidade em Saúde
• Link de acesso: http://hdl.handle.net/1843/ENFC-B74LTS

Introduction: Measuring instruments play an important role in research, clinical practice and health assessment. Studies on the quality of these instruments provide evidence of the behavior of the psychometric properties evaluated, which helps the researcher and professional in choosing the best tool for use. In the elderly population, fragility can be identified in those elderly who present a state of physiological vulnerability, resulting from a reduced homeostatic reserve. For this purpose the Functional Clinical Vulnerability Index - 20 (IVCF-20) was constructed, whose conceptual basis on fragility is considered as a multidimensional syndrome. Overall objective: To evaluate the psychometric properties of IVCF-20 by the Item Response Theory (TRI). Method: A methodological, analytical, quantitative approach developed with 396 elderly people from the South Central region of Belo Horizonte / Minas Gerais. The instrument was analyzed through the Theory of Response to Item (TRI), using the Logistic Model of 2 Parameters. Results: Overall Cronbach's Alpha was 0.73 and the removal of any item did not cause significant change in IVCF-20. There was a positive bisserial correlation with the latent variable. Instrumental Daily Life Activities presented the highest correlation (r = 0.60) with the latent trait. Age, hearing problems and falls had the lowest bisserial correlation with the latent trait (r = 0.27). The item discouragement, sadness or hopelessness ( = 0.61) and falls ( = 0.39) presented a low discrimination parameter, and the items related to financial control ( = 6.69) and bathing alone ( = 9,56) presented the highest discrimination parameter, in relation to the latent trait. Regarding difficulty, urinary incontinence (0.05) and forgetfulness (-0.71) had a lower parameter of difficulty. In oposition, the items age (3.08) and hearing problems (3.50) presented higher difficulty parameters. The correlation between IVCF-20 and the Edmonton Fragility Scale was r = 0.77 (p = 0.000). Discussion: The evaluation of instrument measurement properties is useful to support the selection of valid and reliable instruments, in order to ensure the quality of the results of the studies. The results of the performance of the elderly in TRI were calculated by the logistic model of two parameters. In summary, these results point to a positive evaluation of IVCF-20, with the exception of two items that presented lower discrimination values; the instrument in general presented items with good discrimination and many levels of difficulty. The unidimensionality was verified through Factorial Analysis, obtaining satisfactory value and the main adjustment adequacy indexes of the model were attended. Conclusion: IVCF-20 is an instrument with satisfactory psychometric properties for the screening of the fragility of the elderly in Primary Health Care (PHC). The use of IVCF-20 in PHC for the promotion of health, prevention of diseases and strategies of quality of multiprofessional assistance to the elderly is of paramount importance.