Investigating the feasibility and reliability of the Pictorial Fit-Frail Scale

Lisa Mcgarrigle; Emma Squires; Lindsay M.K. Wallace; Judith Godin; Mary Gorman; Kenneth Rockwood; Olga Theou

doi:10.1093/ageing/afz111

Investigating the feasibility and reliability of the Pictorial Fit-Frail Scale

Lisa Mcgarrigle, Emma Squires, Lindsay M.K. Wallace, Judith Godin, Mary Gorman, Kenneth Rockwood, Olga Theou

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

Abstract

Background: the Pictorial Fit-Frail Scale (PFFS) was designed as a simple and practical approach to the identification of frailty. Objectives: To investigate the feasibility and reliability of this visual image-based tool, when used by patients, caregivers and healthcare professionals (HCPs) in clinical settings. Design: observational study. Setting: three outpatient geriatric healthcare settings. Subjects: patients (n = 132), caregivers (n = 84), clinic nurses (n = 7) and physicians (n = 10). Methods: the PFFS was administered to all patients. Where available, HCPs and caregivers completed the scale based on the patients' health. In the geriatric day hospital, the PFFS was completed on admission and administered again within 7-14 days. Time and level of assistance needed to complete the scale were recorded. Intraclass correlation coefficients (ICCs) and 95% confidence intervals (CIs) were used to assess test-retest and inter-rater reliability. Results: mean time to complete the scale (minutes:seconds ± SD) was 4:30 ± 1:54 for patients, 3:13 ± 1:34 for caregivers, 1:28 ± 0:57 for nurses and 1:32 ± 1:40 for physicians. Most patients were able to complete the scale unassisted (64%). Mean patient PFFS score was 11.1 ± 5.3, mean caregiver score was 13.2 ± 6.3, mean nurse score was 10.7 ± 4.5 and mean physician score was 11.1 ± 5.6; caregiver scores were significantly higher than patient (P < 0.01), nurse (P < 0.001) and physician (P < 0.01) scores. Test-retest reliability was good for patients (ICC = 0.78, [95%CI = 0.67-0.86]) and nurses (ICC = 0.88 [0.80-0.93]). Inter-rater reliability between HCPs was also good (ICC = 0.75 [0.63-0.83]). Conclusion: the PFFS is a feasible and reliable tool for use with patients, caregivers and HCPs in clinical settings. Further research on the validity and responsiveness of the tool is necessary.

Original language	English
Pages (from-to)	832-837
Number of pages	6
Journal	Age and Ageing
Volume	48
Issue number	6
DOIs	https://doi.org/10.1093/ageing/afz111
Publication status	Published - Nov 1 2019

Bibliographical note

Funding Information:
L.M. received support from the Mitacs Elevate Program as the recipient of a Postdoctoral Fellowship award (IT09427) to complete this project. L.M.K.W. is supported by a Canadian Institutes of Health Research Doctoral Scholarship (GSD-154170). O.T. was supported by the Canadian Frailty Network (Transformative Grant Pilot Study Award TG2015-24PC) and the Nova Scotia Health Authority Research Fund (2016-Theou). K.R.'s work on frailty is supported by the Canadian Institutes of Health Research, the Dalhousie Medical Research Foundation Kathryn Allen Weldon Chair of Alzheimer Disease Research, and the Fountain Family Innovation Fund of the Queen Elizabeth II Health Research Foundation.

Funding Information:
K.R. is the President and Chief Science Officer of DGI Clinical, which in the last 5 years has contracts with pharma and device manufacturers (Baxter, Baxalta, Shire, Hollister, Nutricia, Roche, Otsuka) on individualized outcome measurement. In 2017, he attended an advisory board meeting with Lundbeck. Otherwise, any personal fees are for invited guest lectures and academic symposia, received directly from event organizers, chiefly for presentations on frailty. He is Associate Director of the Canadian Consortium on Neu-rodegeneration in Aging, which is funded by the Canadian Institutes of Health Research, and with additional funding from the Alzheimer Society of Canada and several other charities, as well as, in its first phase (2013–2018), from Pfizer Canada and Sanofi Canada. He receives career support from the Dalhousie Medical Research Foundation as the Kathryn Allen Weldon Professor of Alzheimer Research, and research support from the Canadian Institutes of Health Research, the QEII Health Science Centre Foundation, the Capital Health Research Fund and the Fountain Family Innovation Fund of the QEII Health Science Centre Foundation. O.T. and K.R. have asserted copyright of the Pictorial Fit-Frail Scale. It will be made freely available for research, education and not-for-profit care.

Funding Information:
L.M. received support from the Mitacs Elevate Program as the recipient of a Postdoctoral Fellowship award (IT09427) to complete this project. L.M.K.W. is supported by a Canadian Institutes of Health Research Doctoral Scholarship (GSD-154170). O.T. was supported by the Canadian Frailty Network (Transformative Grant Pilot Study Award TG2015-24PC) and the Nova Scotia Health Authority Research Fund (2016-Theou). K.R.’s work on frailty is supported by the Canadian Institutes of Health Research, the Dalhousie Medical Research Foundation Kathryn Allen Weldon Chair of Alzheimer Disease Research, and the Fountain Family Innovation Fund of the Queen Elizabeth II Health Research Foundation.

Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

ASJC Scopus Subject Areas

Ageing
Geriatrics and Gerontology

PubMed: MeSH publication types

Journal Article
Research Support, Non-U.S. Gov't

Access to Document

10.1093/ageing/afz111

Cite this

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title = "Investigating the feasibility and reliability of the Pictorial Fit-Frail Scale",

abstract = "Background: the Pictorial Fit-Frail Scale (PFFS) was designed as a simple and practical approach to the identification of frailty. Objectives: To investigate the feasibility and reliability of this visual image-based tool, when used by patients, caregivers and healthcare professionals (HCPs) in clinical settings. Design: observational study. Setting: three outpatient geriatric healthcare settings. Subjects: patients (n = 132), caregivers (n = 84), clinic nurses (n = 7) and physicians (n = 10). Methods: the PFFS was administered to all patients. Where available, HCPs and caregivers completed the scale based on the patients' health. In the geriatric day hospital, the PFFS was completed on admission and administered again within 7-14 days. Time and level of assistance needed to complete the scale were recorded. Intraclass correlation coefficients (ICCs) and 95% confidence intervals (CIs) were used to assess test-retest and inter-rater reliability. Results: mean time to complete the scale (minutes:seconds ± SD) was 4:30 ± 1:54 for patients, 3:13 ± 1:34 for caregivers, 1:28 ± 0:57 for nurses and 1:32 ± 1:40 for physicians. Most patients were able to complete the scale unassisted (64%). Mean patient PFFS score was 11.1 ± 5.3, mean caregiver score was 13.2 ± 6.3, mean nurse score was 10.7 ± 4.5 and mean physician score was 11.1 ± 5.6; caregiver scores were significantly higher than patient (P < 0.01), nurse (P < 0.001) and physician (P < 0.01) scores. Test-retest reliability was good for patients (ICC = 0.78, [95%CI = 0.67-0.86]) and nurses (ICC = 0.88 [0.80-0.93]). Inter-rater reliability between HCPs was also good (ICC = 0.75 [0.63-0.83]). Conclusion: the PFFS is a feasible and reliable tool for use with patients, caregivers and HCPs in clinical settings. Further research on the validity and responsiveness of the tool is necessary.",

author = "Lisa Mcgarrigle and Emma Squires and Wallace, {Lindsay M.K.} and Judith Godin and Mary Gorman and Kenneth Rockwood and Olga Theou",

note = "Funding Information: L.M. received support from the Mitacs Elevate Program as the recipient of a Postdoctoral Fellowship award (IT09427) to complete this project. L.M.K.W. is supported by a Canadian Institutes of Health Research Doctoral Scholarship (GSD-154170). O.T. was supported by the Canadian Frailty Network (Transformative Grant Pilot Study Award TG2015-24PC) and the Nova Scotia Health Authority Research Fund (2016-Theou). K.R.'s work on frailty is supported by the Canadian Institutes of Health Research, the Dalhousie Medical Research Foundation Kathryn Allen Weldon Chair of Alzheimer Disease Research, and the Fountain Family Innovation Fund of the Queen Elizabeth II Health Research Foundation. Funding Information: K.R. is the President and Chief Science Officer of DGI Clinical, which in the last 5 years has contracts with pharma and device manufacturers (Baxter, Baxalta, Shire, Hollister, Nutricia, Roche, Otsuka) on individualized outcome measurement. In 2017, he attended an advisory board meeting with Lundbeck. Otherwise, any personal fees are for invited guest lectures and academic symposia, received directly from event organizers, chiefly for presentations on frailty. He is Associate Director of the Canadian Consortium on Neu-rodegeneration in Aging, which is funded by the Canadian Institutes of Health Research, and with additional funding from the Alzheimer Society of Canada and several other charities, as well as, in its first phase (2013–2018), from Pfizer Canada and Sanofi Canada. He receives career support from the Dalhousie Medical Research Foundation as the Kathryn Allen Weldon Professor of Alzheimer Research, and research support from the Canadian Institutes of Health Research, the QEII Health Science Centre Foundation, the Capital Health Research Fund and the Fountain Family Innovation Fund of the QEII Health Science Centre Foundation. O.T. and K.R. have asserted copyright of the Pictorial Fit-Frail Scale. It will be made freely available for research, education and not-for-profit care. Funding Information: L.M. received support from the Mitacs Elevate Program as the recipient of a Postdoctoral Fellowship award (IT09427) to complete this project. L.M.K.W. is supported by a Canadian Institutes of Health Research Doctoral Scholarship (GSD-154170). O.T. was supported by the Canadian Frailty Network (Transformative Grant Pilot Study Award TG2015-24PC) and the Nova Scotia Health Authority Research Fund (2016-Theou). K.R.{\textquoteright}s work on frailty is supported by the Canadian Institutes of Health Research, the Dalhousie Medical Research Foundation Kathryn Allen Weldon Chair of Alzheimer Disease Research, and the Fountain Family Innovation Fund of the Queen Elizabeth II Health Research Foundation. Publisher Copyright: {\textcopyright} 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.",

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doi = "10.1093/ageing/afz111",

language = "English",

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T1 - Investigating the feasibility and reliability of the Pictorial Fit-Frail Scale

AU - Mcgarrigle, Lisa

AU - Squires, Emma

AU - Wallace, Lindsay M.K.

AU - Godin, Judith

AU - Gorman, Mary

AU - Rockwood, Kenneth

AU - Theou, Olga

N1 - Funding Information: L.M. received support from the Mitacs Elevate Program as the recipient of a Postdoctoral Fellowship award (IT09427) to complete this project. L.M.K.W. is supported by a Canadian Institutes of Health Research Doctoral Scholarship (GSD-154170). O.T. was supported by the Canadian Frailty Network (Transformative Grant Pilot Study Award TG2015-24PC) and the Nova Scotia Health Authority Research Fund (2016-Theou). K.R.'s work on frailty is supported by the Canadian Institutes of Health Research, the Dalhousie Medical Research Foundation Kathryn Allen Weldon Chair of Alzheimer Disease Research, and the Fountain Family Innovation Fund of the Queen Elizabeth II Health Research Foundation. Funding Information: K.R. is the President and Chief Science Officer of DGI Clinical, which in the last 5 years has contracts with pharma and device manufacturers (Baxter, Baxalta, Shire, Hollister, Nutricia, Roche, Otsuka) on individualized outcome measurement. In 2017, he attended an advisory board meeting with Lundbeck. Otherwise, any personal fees are for invited guest lectures and academic symposia, received directly from event organizers, chiefly for presentations on frailty. He is Associate Director of the Canadian Consortium on Neu-rodegeneration in Aging, which is funded by the Canadian Institutes of Health Research, and with additional funding from the Alzheimer Society of Canada and several other charities, as well as, in its first phase (2013–2018), from Pfizer Canada and Sanofi Canada. He receives career support from the Dalhousie Medical Research Foundation as the Kathryn Allen Weldon Professor of Alzheimer Research, and research support from the Canadian Institutes of Health Research, the QEII Health Science Centre Foundation, the Capital Health Research Fund and the Fountain Family Innovation Fund of the QEII Health Science Centre Foundation. O.T. and K.R. have asserted copyright of the Pictorial Fit-Frail Scale. It will be made freely available for research, education and not-for-profit care. Funding Information: L.M. received support from the Mitacs Elevate Program as the recipient of a Postdoctoral Fellowship award (IT09427) to complete this project. L.M.K.W. is supported by a Canadian Institutes of Health Research Doctoral Scholarship (GSD-154170). O.T. was supported by the Canadian Frailty Network (Transformative Grant Pilot Study Award TG2015-24PC) and the Nova Scotia Health Authority Research Fund (2016-Theou). K.R.’s work on frailty is supported by the Canadian Institutes of Health Research, the Dalhousie Medical Research Foundation Kathryn Allen Weldon Chair of Alzheimer Disease Research, and the Fountain Family Innovation Fund of the Queen Elizabeth II Health Research Foundation. Publisher Copyright: © 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Background: the Pictorial Fit-Frail Scale (PFFS) was designed as a simple and practical approach to the identification of frailty. Objectives: To investigate the feasibility and reliability of this visual image-based tool, when used by patients, caregivers and healthcare professionals (HCPs) in clinical settings. Design: observational study. Setting: three outpatient geriatric healthcare settings. Subjects: patients (n = 132), caregivers (n = 84), clinic nurses (n = 7) and physicians (n = 10). Methods: the PFFS was administered to all patients. Where available, HCPs and caregivers completed the scale based on the patients' health. In the geriatric day hospital, the PFFS was completed on admission and administered again within 7-14 days. Time and level of assistance needed to complete the scale were recorded. Intraclass correlation coefficients (ICCs) and 95% confidence intervals (CIs) were used to assess test-retest and inter-rater reliability. Results: mean time to complete the scale (minutes:seconds ± SD) was 4:30 ± 1:54 for patients, 3:13 ± 1:34 for caregivers, 1:28 ± 0:57 for nurses and 1:32 ± 1:40 for physicians. Most patients were able to complete the scale unassisted (64%). Mean patient PFFS score was 11.1 ± 5.3, mean caregiver score was 13.2 ± 6.3, mean nurse score was 10.7 ± 4.5 and mean physician score was 11.1 ± 5.6; caregiver scores were significantly higher than patient (P < 0.01), nurse (P < 0.001) and physician (P < 0.01) scores. Test-retest reliability was good for patients (ICC = 0.78, [95%CI = 0.67-0.86]) and nurses (ICC = 0.88 [0.80-0.93]). Inter-rater reliability between HCPs was also good (ICC = 0.75 [0.63-0.83]). Conclusion: the PFFS is a feasible and reliable tool for use with patients, caregivers and HCPs in clinical settings. Further research on the validity and responsiveness of the tool is necessary.

AB - Background: the Pictorial Fit-Frail Scale (PFFS) was designed as a simple and practical approach to the identification of frailty. Objectives: To investigate the feasibility and reliability of this visual image-based tool, when used by patients, caregivers and healthcare professionals (HCPs) in clinical settings. Design: observational study. Setting: three outpatient geriatric healthcare settings. Subjects: patients (n = 132), caregivers (n = 84), clinic nurses (n = 7) and physicians (n = 10). Methods: the PFFS was administered to all patients. Where available, HCPs and caregivers completed the scale based on the patients' health. In the geriatric day hospital, the PFFS was completed on admission and administered again within 7-14 days. Time and level of assistance needed to complete the scale were recorded. Intraclass correlation coefficients (ICCs) and 95% confidence intervals (CIs) were used to assess test-retest and inter-rater reliability. Results: mean time to complete the scale (minutes:seconds ± SD) was 4:30 ± 1:54 for patients, 3:13 ± 1:34 for caregivers, 1:28 ± 0:57 for nurses and 1:32 ± 1:40 for physicians. Most patients were able to complete the scale unassisted (64%). Mean patient PFFS score was 11.1 ± 5.3, mean caregiver score was 13.2 ± 6.3, mean nurse score was 10.7 ± 4.5 and mean physician score was 11.1 ± 5.6; caregiver scores were significantly higher than patient (P < 0.01), nurse (P < 0.001) and physician (P < 0.01) scores. Test-retest reliability was good for patients (ICC = 0.78, [95%CI = 0.67-0.86]) and nurses (ICC = 0.88 [0.80-0.93]). Inter-rater reliability between HCPs was also good (ICC = 0.75 [0.63-0.83]). Conclusion: the PFFS is a feasible and reliable tool for use with patients, caregivers and HCPs in clinical settings. Further research on the validity and responsiveness of the tool is necessary.

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Investigating the feasibility and reliability of the Pictorial Fit-Frail Scale

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Bibliographical note

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PubMed: MeSH publication types

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