Abstract

BackgroundThe Reintegration to Normal Living Index (RNLI) was developed to measure reintegration to normal living after major traumas/illnesses. Its psychometric properties remain unknown when used to measure participation restriction under the World Health Organization’s International Classification of Functioning, Disability, and Health (WHO-ICF) framework. This study examines the psychometric properties of the Chinese version-RNLI to measure WHO-ICF participation restriction among community-dwelling pre-frail and frail older people.MethodsA cross-sectional study was conducted in community and day-care centres in Hong Kong between May 2015 and January 2016. Through face-to-face interviews, information was collected on the participants’ demographic background, medical history, frailty status, depressive mood, functional performance in daily activities, and participation restriction. The internal consistency, test-retest reliability, and construct and convergent validity of the C-RNLI were assessed.ResultsTwo hundred and ninety-nine pre-frail or frail community-dwelling older people with a mean age of 79.53 were recruited. A confirmatory factor analysis showed that the C-RNLI has a two-factor structure comprised of “participation in physical activities” and “participation in social events”. The test-retest coefficient was 0.71. The Cronbach’s alpha of the total C-RNLI score, and those of the factors “participation in physical activities” and “participation in social events” were 0.88, 0.82 and 0.84, respectively. Pre-frail older people had significantly higher scores for the factors “participation in physical activities” (z = −5.05, <0.01) and “participation in social events” (z = −6.04, p < 0.01) than frail older people. Older people from community centres had significantly higher scores for the factors “participation in physical activities” (z = −4.48, <0.01) and “participation in social events” (z = −4.03, p < 0.01) than older people from day-care centres. The factors “participation in physical activities” and “participation in social events” of the C-RNLI were significantly convergent with depressive mood (rs = −0.25 and rs = −0.39, respectively) and functional performance in daily activities (rs = 0.28 and rs = 0.45, respectively).ConclusionsThe C-RNLI is a two-factor structured scale with acceptable level of reliability and validity to measure WHO-ICF participation restriction among community-dwelling pre-frail and frail older people.

Highlights

  • The Reintegration to Normal Living Index (RNLI) was developed to measure reintegration to normal living after major traumas/illnesses

  • The mean age of the participants was 79.53 (SD 7.33), their mean C-RNLI score was 68.31 (SD 19.64), 223 (74.58%) of the participants were female, 151 (50.50%) were widowed, 157 (52.51%) had received a primary education, and 139 (46.49%) were identified as frail according to the FFI (Table 1) [20]

  • Construct validity–structural validity There were no missing values in the responses to the CRNLI items, so all of the data were used in establishing construct validity

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Summary

Introduction

The Reintegration to Normal Living Index (RNLI) was developed to measure reintegration to normal living after major traumas/illnesses. Its psychometric properties remain unknown when used to measure participation restriction under the World Health Organization’s International Classification of Functioning, Disability, and Health (WHO-ICF) framework. This study examines the psychometric properties of the Chinese version-RNLI to measure WHO-ICF participation restriction among community-dwelling pre-frail and frail older people. The International Classification of Functioning, Disability, and Health (WHO-ICF) model offers a framework for classifying and understanding the influences on people’s physiopsycho-social health and how disability can impact the daily life of sufferers on three levels: through impaired body functions or structures, activity limitations, and participation restriction [1]. Participation restriction refers to how the disability is limiting a sufferer’s involvement in valued life events [1]. Participation restriction is strongly associated with many health problems such as pain, anxiety, depression, cognitive impairment, and disability [4], eventually leading to early institutionalization and social isolation for older people

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