Proposal for an instrument for the admission of the elderly to long-term care facilities: elaboration and validation

Abstract Objective: To elaborate and validate an instrument for the admission of the elderly to long-term care facilities. Method: A methodological study was performed, divided into two phases, the first of which was the elaboration of the instrument based on a literature review of research published in journals indexed in SciELO and in databases such as Medline, LILACS, IBECS, Embase and books related to gerontology, defining theoretical dimensionality through relevant information to support individualized and integral care for the elderly. The second phase of the study involved validation by nine experts from a multidisciplinary field. Six criteria were used to validate the construct, for which the experts chose one of the following options: adequate, inadequate or requires greater adequacy and also, when necessary, added suggestions. The decision to maintain, reformulate or exclude items was based on the Percentage of Consensus (PC) among the experts, for which consensus of more than 80% was adopted as the value of statistical significance. Results: The scientific evidence base for the construction of the instrument consisted of anamnesis and physical examination domains, segmented in ten and four sections, respectively. Half of the sections achieved a score above that proposed, four of which received a maximum consensus score in all criteria. Conclusion: The instrument was developed and proved to be consistent for applicability by different professionals in the area, with the aim of promoting geriatric care focused on the health of the institutionalized patient.

### 摘要
**研究目的**：研制并验证一款用于老年人入住长期照护机构（long-term care facilities）的评估工具（instrument）。
**研究方法**：本研究为方法学研究，分为两个阶段。第一阶段通过对SciELO收录期刊、Medline、LILACS、IBECS、Embase等数据库的发表文献及老年医学（gerontology）相关专著开展文献综述，研制该评估工具，并依托相关研究信息明确其理论维度，以支撑老年人个体化整合照护。第二阶段由9名多学科领域专家开展结构效度验证：本次验证采用6项标准，专家需从“符合要求”“不符合要求”“需进一步完善”三个选项中选择其一，必要时可补充修改建议。条目保留、重新表述或剔除的决策依据为专家的共识率（Percentage of Consensus, PC），本研究将超过80%的共识率作为统计学显著性判定阈值。
**研究结果**：本工具构建的科学依据涵盖病史采集（anamnesis）与体格检查两个维度，分别划分为10个与4个小节。其中半数小节的共识率达到预设阈值以上，4个小节在全部验证标准中获得满分共识。
**研究结论**：本研究成功研制该评估工具，经验证其具备良好的一致性，可被该领域不同专业人员应用，旨在推动以机构入住老年患者健康为核心的老年照护服务。