Development and psychometric evaluation of the Physical Resilience Instrument for Older Adults (PRIFOR)

Abstract

Background Physical resilience is known to minimize the adverse outcomes of health stressors for older people. However, validated instruments that assess physical resilience in older adults are rare. Therefore, we aimed to validate the Physical Resilience Instrument for Older Adults (PRIFOR) to fill the literature gap. Methods Content analysis with content validity was first carried out to generate relevant items assessing physical resilience for older adults, and 19 items were developed. Psychometric evaluation of the 19 items was then tested on 200 older adults (mean [SD] age = 76.4 [6.6] years; 51.0% women) for item properties, factor structure, item fit, internal consistency, criterion-related validity, and known-group validity. Results All 19 items had satisfactory item properties, as they were normally distributed (skewness = -1.03 to 0.38; kurtosis = -1.05 to 0.32). However, two items were removed due to substantial ceiling effects. The retained 17 items were embedded in three factors as suggested by the exploratory factor analysis (EFA) results. All items except one had satisfactory item fit statistics in Rasch model; thus, the unidimensionality was supported for the three factors on 16 items. The retained 16 items showed promising properties in known-group validity, criterion-related validity, and internal consistency (α = 0.94). Conclusions The 16-item PRIFOR exhibits good psychometric properties. Using this instrument to measure physical resilience would be beneficial to identify factors that could protect older people from negative health consequence. With the use of the PRIFOR, intervention effects could also be evaluated. It is helpful to strengthen resilience and thereby facilitate successful aging.

Psychometrics of the Physical Resilience Scale in Older Adults Living with Dementia: Proxy Responses

“…Testing of the 16-item measure indicated that the measure was not unidimensional in that it included three subscales: positive thinking; coping and lifestyle adjustment; and positive beliefs and a hopeful mindset. There was evidence of internal consistency of the subscales and validity of the measure based on correlations between each subscale and depression, cognition, function, and quality of life (Hu et al, 2021(Hu et al, , 2022.…”

“…There have been several measures that focus on physical resilience as a trait versus the outcome of recovery or physical performance. These include the Physical Resilience Scale (Resnick, et al, 2011) and the Physical Resilience Instrument for Older Adults (PRIFOR) (Hu et al, 2022). The Physical Resilience Scale was originally developed as a 15-item measure and testing was done with older adults living in the community.…”

“…The recently developed PRIFOR measure includes 19 items and was recently tested with 200 hospitalized older adults (Hu et al, 2021(Hu et al, , 2022 and tested for evidence of predictive validity for frailty. Three items were removed because of ceiling effects and fit of the item to the model.…”

Minimal short-term decline in functional performance and quality of life predicts better long-term outcomes for both in older Taiwanese adults after hip fracture surgery: a prospective study

“…Research has shown that patients with greater physical resilience have reduced disability and improved functional outcomes during rehabilitation [ 9 , 33 ]. In the present studies, ADL, QoL, handgrip strength, and SPMSQ score were reported as trajectories of functional recovery and related to physical resilience[ 10 , 34 , 35 ]. Furthermore, another study recognized both ADL and QoL as appropriate tools for evaluating physical resilience [ 11 ].…”

Testing a Conceptual Model of Physiologic Reserve, Intrinsic Capacity, and Physical Resilience in Hospitalized Older Patients: A Structural Equation Modelling

“…The 16 items were distributed within three factors (e.g., positive thinking, coping and adjusting lifestyle, and belief and hopeful mindsets). A high PRIFOR score indicates high physical resilience [17, 18].…”