Content validation of the Tilburg Frailty Indicator from the perspective of frail elderly: A qualitative explorative study

The Tilburg Frailty Indicator is a questionnaire with a bio-psycho-social approach, which measures frailty by 15 questions. A questionnaire about frailty should be in alignment with experiences of frail elderly themselves as a target population is an important source of knowledge in content validation.

AIM: To validate the Tilburg Frailty Indicator on content in relation to the physical, psychological and social domain by exploring the experience of daily life of community dwelling frail elderly.

METHODS: The design was a qualitative content validation study. The participants were acutely admitted frail elderly discharged to home and interviewed one week after discharge. A deductive content analysis, with categories structured in advance, was performed.

RESULTS: A total of 422 meaning units were extracted from the transcriptions; 131 units related to the physical domain, 106 units to the psychological domain and 185 units to the social domain. 56 units were not linked into the existing structure of the questionnaire. 14 of 15 questions were confirmed from a target population perspective. The four issues pain, sleep quality, spirituality and meaningful activities that seem to be important elements for frail elderly were not directly covered by the questionnaire.

DISCUSSION: It seems likely that the majority of important items related to frailty are covered in the questionnaire. The findings add to the scientific body of knowledge in relation to the validity of the questionnaire. Future research should investigate the importance of the four issues pain, sleep quality, spirituality and meaningful activities in relation to the screening of frailty.