Reliability and validity of the Chinese version of the Nutritional Form For the Elderly

Abstract

Objective: The present study aimed to translate the English version of the Nutritional Form For the Elderly into Simplified Chinese, as well as to test the reliability (homogeneity and stability) and validity (content and construct validity) of the Chinese version of the Nutritional Form For the Elderly (NUFFE-CHI). Design: The study adopted a cross-sectional design. The English version of the NUFFE was translated into Simplified Chinese and a questionnaire survey was conducted. The data were analysed with statistical methods to estimate the homogeneity, stability, content and construct validity. Setting: Jinzhou City, China. Subjects: A total number of 701 community-dwelling older adults answered the questionnaire, including background variables and the NUFFE-CHI. A small group of the participants (n 50) completed the NUFFE-CHI twice for test-retest reliability. Results: Cronbach's α was 0·65 and the split-half reliability was 0·67. Item-to-total correlation analyses showed that the scale has sufficient internal consistency. The test-retest reliability regarding the total scores of NUFFE-CHI was reflected in an intra-class correlation coefficient of 0·88. The intra-class correlation coefficients between the test and retest of the NUFFE-CHI items varied between 0·43 and 0·98. A content validity index of 0·83 explained good content validity. Construct validity was demonstrated in an exploratory factor analysis with a six-factor solution, explaining 57·65 % of the variance. Conclusions: This first testing of the NUFFE-CHI indicates sufficient evidence for reliability, content and construct validity. Further testing studies regarding homogeneity, concurrent validity, sensitivity and specificity are required before the NUFFE-CHI can be used as a screening instrument in clinical settings and in research. Keywords Instrument testing Nutrition Older people Screening instrumentThe prevalence of older people who are undernourished or at risk of undernutrition is high; for example, the prevalence rate was 27 % among geriatric in-and out-patients in a French study (1) and 22 % among older home-dwelling people in a Swedish study (2) . However, among older community-dwelling Chinese people, the prevalence rate was found to be 44 % (3) , and it was as high as 76 % among very old (90 + years) Chinese community-dwelling people (4) . In other Chinese studies performed among hospitalised patients, the prevalence has been found to vary between 20 % and 40 % (5,6) .To be undernourished or at risk of undernutrition among older people is an extensive problem, since it is associated with several serious factors including morbidity, longer hospital stays, mortality, deteriorated functional ability (7) , mobility impairment (8) , cognitive dysfunction (4,7,8) , reduced well-being (7) and poor self-rated health (2,4) . Moreover, older people who are widowed (3) , living alone (2,9) and of advanced age (3,4,8) are especially vulnerable for being at risk for undernutrition.In order to find potential and existing nutritional problem...

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