MEASUREMENT OF ACTIVITIES OF DAILY LIVING IN HOSPITALIZED ELDERLY - A COMPARISON OF SELF-REPORT AND PERFORMANCE-BASED METHODS
MEASUREMENT OF ACTIVITIES OF DAILY LIVING IN HOSPITALIZED ELDERLY - A COMPARISON OF SELF-REPORT AND PERFORMANCE-BASED METHODS
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DOI：
10.1111/j.1532-5415.1992.tb02011.x
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发表时间：
1992-05-01
影响因子：
6.3
通讯作者：
HARLOWE, D
中科院分区：
文献类型：
--
作者：
SAGER, MA;DUNHAM, NC;HARLOWE, D
目的：探讨住院老年人身体功能自评的准确性。设计：两种测量方法的比较。对象和地点：美国威斯康星州麦迪逊市圣玛丽医院医学中心住院的247例内科住院患者，平均年龄78.7岁。主要观察指标：日常生活活动能力的5项自评和绩效测评的符合率最低的是沐浴和穿衣，分别为63%和。当患者报告在这两项任务中不需要帮助时，他们被测量到的穿衣时间减少了32%，洗澡时间减少了42%。当患者报告在活动中需要帮助时，患者和职业治疗师之间的符合率差异很大，从只有42%的人上厕所，到78%的人洗澡。两种日常生活能力测量之间一致性差的两个统计因素是认知障碍(P<；0.001)和住院期间发生的院前日常生活能力下降(P<；0.001)。结论：这些数据表明，住院老年患者出院时的日常生活能力评估与基于工作表现的日常生活能力测量之间可能存在显著差异。这些差异可能对收集出院计划的功能测量或医院环境中的老年研究有影响。
Objective: To determine the accuracy of self-reports of physical functioning by hospitalized elderly.Design: Comparison of two measures.Patients and Setting: Two-hundred forty-seven medical inpatients (mean age 78.7 years) hospitalized at St. Marys Hospital Medical Center, Madison, WI.Main Outcome Measures: Measures of five activities of daily living by self-report and by performance.Results: The rate of agreement between self-report and performance ADL measures was the lowest in the areas of bathing and dressing where the agreement was 63% and 64%, respectively. When patients reported needing no help in these two tasks, they were measured lower 32% of the time for dressing and 42% for bathing. When patients reported needing help in an activity the agreement rate between patient and occupational therapist varied widely, from only 42% for toileting to 78% for bathing. The two factors which were statistically associated with poor agreement between the two ADL measurements were cognitive impairment (P < 0.001) and a decline from the pre-hospital level of ADL functioning which had occurred during hospitalization (P < 0.001).Conclusions: These data suggest that there may be significant differences between patient assessments and performance-based measurements of ADL functioning in hospitalized elderly at time of discharge. These differences may have implications for the collection of functional measurements for discharge planning or for geriatric research in the hospital environment.