The Reported Edmonton Frail Scale-Thai version: Development and Validation of a Culturally-Sensitive Instrument.
Inthira Roopsawang, Hilaire Thompson, Oleg Zaslavsky and 1 others
PMID 32170828WHAT IT FOUND
A Thai frailty screening questionnaire for older hospital patients took about 6.5 min and was generally reliable, but its cognition item was weak.
Use it to flag frailty risk, not to judge thinking alone.
Key findings
01Expert content validation of the Thai REFS was excellent (I-CVI 0.97, S-CVI/UA 0.92).
02In 100 hospitalized older adults, the Thai REFS had acceptable internal consistency (Cronbach's alpha 0.728) and averaged 6.5 min to complete.
03The cognition domain showed a weak association with frailty in construct validation (r2 0.015).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in a single tertiary hospital, and most participants lived in urban areas and were Buddhist, so it may not fit other Thai settings. It excluded people with emergency surgery, Mini-Cog score below 3, acute psychiatric conditions, stroke, brain injury, Parkinson's disease, bedridden status, or therapy, so it does not apply to those patients. Main psychometric testing was in 100 participants and inter-rater testing in 31, so the results are limited by sample size. The factor model fit was fair, and the cognition domain was weakly associated with frailty, so the total score should not be treated as a single reliable measure of all domains.
The easy way to misread this
Do not use the Thai REFS alone to identify cognitive impairment. The cognition domain showed a weak association with frailty, and the clock-drawing item was influenced by pain or possible distraction.