노인에서 한국어판 단문형 국제신체활동설문(IPAQ)의 신뢰도와 타당도

Abstract

OBJECTIVES: The purpose of this analysis was to examine the reliability and the validity of the IPAQ short form in elderly people.

DESIGN: A cross-sectional

SETTING: IPAQ short form was validated against accelerometer (Lifecorder) measurement as gold standard. To examine the reliability of short form IPAQ, test-retest was performed over two weeks interval.

PARTICIPANTS: A total of 55 outpatients of 65 years old or older who visited senior welfare centers located in Seoul participated in this study. The subjects who could understand the self-reported questionnaire and fill in the questionnaire exactly were included.

MEASUREMENTS: All participants were surveyed by one trained surveyor with structured questionnaire and screening tools of depression, cognitive function (MMSE), disability, any impairment. Participants were asked age, sex, education level, economic status, living arrangement, alcoholic consumption and smoking. Height, weight and blood pressure were measured. All measurements were taken in-person by trained interviewer with standard protocols. Short form of IPAQ records self-reported physical activity in the last seven days. The 7-item of IPAQ identify the total minutes over last seven days spent on moderate and vigorous-intensity physical activity, walking physical activity, and inactivity. Responses were converted to Metabolic Equivalent Task minutes per week(MET-min/week) according to the IPAQ scoring protocol. The Lifecorder(Suzuken Co. Ltd, Nagoya, Japan) is widely used as an objective measurement of physical activity. The Lifecorder is uni-axial accelerometer and it measures acceleration in the vertical direction. Participants worn the Lifecorder around the waist during consecutive three days for all waking hours, removed only for bathing or sleeping.

RESULTS: The mean age of the subjects for both women and men is 75.2±5.3 years. The proportion of the subjects who are living alone (15.0% in men, 34.3% in women) and with spouse only (70.0% in men, 42.9% in women) are higher that the subjects with offspring in both men and women (15.0% in men, 20.00% in women). The proportion of the subjects who have low income of family (under 0.5 million won/month) is higher than that of other groups (25.0% in men, 48.6 in women). The proportion of smoker (65.0% in men vs. 2.9% in women) and subjects with alcohol drinking (65.0% in men vs. 8.6% in women) in men is higher than that in women. The MMSE scores are not significantly different between men and women (28.1 ± 1.9 in men vs. 27.5 ± 2.6 in women). The self reported energy expenditure (MET-min) per week in high activity group is significantly greater than that of low and moderate activity groups. (6461.18±3474.53 MET-min/week in high activity group vs. 1581.19±620.28 MET-min/week in moderate activity group and 288.15±191.09 MET-min/week in low activity group. p<0.001). Energy expenditure for 3 days and mean 1 day measured by Lifecorder in low activity group is significantly different compared with energy expenditure in moderated and high activity group (p<0.009). The correlation between two measurements are positively significant (Person's correlation coefficient: 0.43, p<0.001). In analysis including resting metabolic rate, the correlation between energy expenditure measured by Lifecorder and the result of the IPAQ short form is significant (Person's correlation coefficient: 0.379, p=0.004). The five elements of IPAQ (Vigorous days, Vigorous minutes, Moderate days, Moderate minutes and Walk days) are significantly reliable (Spearman Rho : 0.299~0.605, Kappa : 0.308~0.418). But 2 elements of IPAQ (Walk minutes and sit minutes) are not significant. Table 6 shows test-retest reliability of short form IPAQ according to total each activity time per week (day * minutes). Vigorous activity time and walk time are significantly reliable (Spearman Rho : 0.296~0.449). But moderate activity time is not significant.

CONCLUSIONS: We examined the reliability and the validity of the IPAQ short form in elderly people. The correlation between IPAQ-reported energy expenditure (MET-min per week) and energy expenditure measured by Lifecorder was positively significant. The five elements of IPAQ (Vigorous days, Vigorous minutes, Moderate days, Moderate minutes and Walk days) were significantly reliable.

| 적절한 신체 활동은 노인들에게 건강을 유지하고, 삶의 질을 높이는데 중요하다. 그러나 현재 우리나라 노인의 신체 활동 수준은 저조한 편이며, 이를 객관적으로 평가할 수 있는 다양한 도구가 필요한 실정이다. 국제신체활동설문(IPAQ)은 신체 활동 수준을 측정하는 자기 보고식 설문으로 다양한 연구에서 활용되어 왔다. 본 논문에서는 노인에게도 IPAQ의 적용이 가능한지에 알아보기 위해, 65세 이상의 노인에서 IPAQ의 신뢰도 및 타당도를 검증하였다. 서울 지역에 거주하는 65세 이상의 복지관을 방문하는 노인 중 자기기입식 설문 조사인 IPAQ를 읽고 이해하여, 본인의 의사대로 정확히 기입할 수 있는 노인을 대상으로 2011년 3월부터 2011년 6월까지 연구를 진행하였다. 먼저 기초 설문지를 작성하고, K-MMSE와 IPAQ 평가도구를 측정하였고, 가속도계(Lifecorder)를 착용하여 3일간 신체활동량을 측정하고, IPAQ 평가도구를 측정하였다. 조사 시행 후 이주일 후에 상기 측정을 재측정 하였다. 수집된 자료를 바탕으로 IPAQ의 타당도 및 신뢰도를 산출하였다. 타당도는 가속도계를 표준으로 삼고, IPAQ와의 상관성을 조사 분석하였다. 이주일 간격의 test-retest를 이용하여 신뢰도를 분석하였다. 신뢰도는 Spearman Rho 0.299 ~ 0.549 (p<0.001), Kappa 값 0.310 ~ 0.418 정도로 신뢰할 수준이었다. 타당도는 설문 응답에 따르는 신체 활동 정도를 연속 변수로 계산하여 가속도계의 측정 결과와 비교하였을 때 Spearman Rho는 0.43 (p<0.001) 이었다. 이로써 65세 이상의 노인에서 국제신체활동설문(IPAQ) 단문형 한국판 설문지는 신뢰도와 타당도가 유의하게 확인되었다.; OBJECTIVES: The purpose of this analysis was to examine the reliability and the validity of the IPAQ short form in elderly people.

DESIGN: A cross-sectional

SETTING: IPAQ short form was validated against accelerometer (Lifecorder) measurement as gold standard. To examine the reliability of short form IPAQ, test-retest was performed over two weeks interval.

PARTICIPANTS: A total of 55 outpatients of 65 years old or older who visited senior welfare centers located in Seoul participated in this study. The subjects who could understand the self-reported questionnaire and fill in the questionnaire exactly were included.

MEASUREMENTS: All participants were surveyed by one trained surveyor with structured questionnaire and screening tools of depression, cognitive function (MMSE), disability, any impairment. Participants were asked age, sex, education level, economic status, living arrangement, alcoholic consumption and smoking. Height, weight and blood pressure were measured. All measurements were taken in-person by trained interviewer with standard protocols. Short form of IPAQ records self-reported physical activity in the last seven days. The 7-item of IPAQ identify the total minutes over last seven days spent on moderate and vigorous-intensity physical activity, walking physical activity, and inactivity. Responses were converted to Metabolic Equivalent Task minutes per week(MET-min/week) according to the IPAQ scoring protocol. The Lifecorder(Suzuken Co. Ltd, Nagoya, Japan) is widely used as an objective measurement of physical activity. The Lifecorder is uni-axial accelerometer and it measures acceleration in the vertical direction. Participants worn the Lifecorder around the waist during consecutive three days for all waking hours, removed only for bathing or sleeping.

RESULTS: The mean age of the subjects for both women and men is 75.2±5.3 years. The proportion of the subjects who are living alone (15.0% in men, 34.3% in women) and with spouse only (70.0% in men, 42.9% in women) are higher that the subjects with offspring in both men and women (15.0% in men, 20.00% in women). The proportion of the subjects who have low income of family (under 0.5 million won/month) is higher than that of other groups (25.0% in men, 48.6 in women). The proportion of smoker (65.0% in men vs. 2.9% in women) and subjects with alcohol drinking (65.0% in men vs. 8.6% in women) in men is higher than that in women. The MMSE scores are not significantly different between men and women (28.1 ± 1.9 in men vs. 27.5 ± 2.6 in women). The self reported energy expenditure (MET-min) per week in high activity group is significantly greater than that of low and moderate activity groups. (6461.18±3474.53 MET-min/week in high activity group vs. 1581.19±620.28 MET-min/week in moderate activity group and 288.15±191.09 MET-min/week in low activity group. p<0.001). Energy expenditure for 3 days and mean 1 day measured by Lifecorder in low activity group is significantly different compared with energy expenditure in moderated and high activity group (p<0.009). The correlation between two measurements are positively significant (Person's correlation coefficient: 0.43, p<0.001). In analysis including resting metabolic rate, the correlation between energy expenditure measured by Lifecorder and the result of the IPAQ short form is significant (Person's correlation coefficient: 0.379, p=0.004). The five elements of IPAQ (Vigorous days, Vigorous minutes, Moderate days, Moderate minutes and Walk days) are significantly reliable (Spearman Rho : 0.299~0.605, Kappa : 0.308~0.418). But 2 elements of IPAQ (Walk minutes and sit minutes) are not significant. Table 6 shows test-retest reliability of short form IPAQ according to total each activity time per week (day * minutes). Vigorous activity time and walk time are significantly reliable (Spearman Rho : 0.296~0.449). But moderate activity time is not significant.

CONCLUSIONS: We examined the reliability and the validity of the IPAQ short form in elderly people. The correlation between IPAQ-reported energy expenditure (MET-min per week) and energy expenditure measured by Lifecorder was positively significant. The five elements of IPAQ (Vigorous days, Vigorous minutes, Moderate days, Moderate minutes and Walk days) were significantly reliable.