BackgroundFrail older people are at high risk of developing adverse outcomes, such as disability, mortality, hospitalization, and institutionalization. Previous research suggests that the Tilburg Frailty Indicator (TFI) is a valid and reliable instrument for measuring frailty. The aim of this study was to adapt and to test the reliability of the Polish version of the TFI.MethodA standard guideline was used for translation and cultural adaptation of the English version of the TFI into Polish. The study included 100 Polish patients (mean age 68.2±6.5 years), among them 42 men and 58 women. Cronbach’s alpha was used for analysis of the internal consistency of the TFI.ResultsThe mean total TFI score was 6.7±3.1. Forty patients scored ≥5, which corresponded to being frail. Cronbach’s alpha reliability coefficients of the instrument ranged from 0.68 to 0.72 and item-total correlation ranged from 0.12 to 0.52.ConclusionThe TFI is valid and reproducible for assessment of frailty syndrome among a Polish population. The Polish adaptation of the TFI proved a useful and fast tool for assessing frailty.

Considering the increasing age of individuals affected with heart failure (HF), a specific approach to their treatment is required, with more attention paid to geriatric conditions such as poor mobility, multiple disabilities, and cognitive impairment. Frailty is a distinct biological syndrome reflecting decreased physiologic reserve and resistance to stressors. It was shown to occur frequently in patients with heart failure, with the prevalence ranging from 15 to 74 %, depending on the studied population and the method of assessment. We reviewed literature data on the influence of frailty, skeletal abnormalities, comorbidities and geriatric condition on diagnosis, treatment, and outcomes in elderly patients with HF. Identification of frailty in patients with HF is important from the clinical point of view, as this condition exerts unfavorable effects on the course of heart failure. Frailty contributes to a higher frequency of visits to emergency departments, hospitalizations, and mortality in patients with HF. Exercise may improve mobility, and nursing support can be implemented to help the patients adhere to medications. Therefore, frail patients should be diagnosed and treated according to available guidelines, and successfully educated about their condition.

Frailty Syndrome (FS) is one of the key health problems in geriatrics, strongly affecting poor prognosis. There is a growing interest in the relevance of this syndrome in cardiovascular disease.The diagnosis of FS in the elderly cardiac population is essential for an accurate risk stratification and for making therapeutic decisions. Most risk assessment systems used in cardiology are based on chronological age, which does not always reflect the biological age of a patient, therefore making an inadequate risk estimation. This paper discusses the definitions of FS and research tools used to identify it. We specifically address the role of FS in cardiovascular disease and the diagnostic and therapeutic difficulties in patients with FS, emphasizing the role of the identification of FS in making therapeutic decisions and the stratification of cardiovascular risk in patients with cardiologic conditions.

BackgroundDevelopment of simple instruments for determination of self-care levels in heart failure (HF) patients is a subject of ongoing research. One such instrument, gaining growing popularity worldwide, is the European Heart Failure Self-care Behavior Scale (EHFScBS). The aim of this study was to adapt and to test reliability of the Polish version of EHFScBS.MethodA standard guideline was used for translation and cultural adaptation of the English version of EHFScBS into Polish. The study included 100 Polish HF patients aged between 24 and 91 years, among them 67 men and 33 women. Cronbach’s alpha was used for analysis of the internal consistency of EHFScBS.ResultsMean total self-care score in the study group was 34.2±8.1 points. Good or satisfactory level of self-care were documented in four out of 12 analyzed EHFScBS domains. Cronbach’s alpha for the entire questionnaire was 0.64. The value of Cronbach’s alpha after deletion of specific items ranged from 0.55 to 0.65.ConclusionPolish HF patients present significant deficits of self-care, which are to a large extent associated with inefficacy of the public health care system. Apart from cultural characteristics, the socioeconomic context of the target population should be considered during language adaptation of EHFScBS, as well as during interpretation of data obtained with this instrument. A number of self-care–related behaviors may be optimized as a result of appropriate educational activities, also those offered by nursing personnel.

(Cardiol J 2013; 20, 4: 394-401)