Validity of an Activities of Daily Living Questionnaire Among Older Patients in the Emergency Department (original) (raw)
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Development of a functional status assessment of seniors visiting emergency department
Archives of Gerontology and Geriatrics, 2009
The purpose of this paper is to describe the development and initial piloting of a Functional Status Assessment of Seniors in Emergency Department (FSAS-ED). The methodology of development of the tool included (1) specifying the underlying construct based on the conceptual framework of the International Classification of Functioning, Disability and Health (ICF), (2) deciding on an interview-based format appropriate for addressing functioning pre-and post-ED, (3) developing an initial 63-item pool and reviewing it through a consensus group with seven experts, (4) piloting the prototype with 23 subjects (mean age = 76 years) and (5) subsequently revising its rating scales. The final 40 items tool consists of three theoretically derived components. First, activity and participation (n = 23 items) address nine ICF domains using a 4-level scale combining levels of difficulty and help required. Second, body functions (n = 10 items) cover eight ICF domains with a 3-level scale of impairment. And third, environmental factors (n = 7 items) address four ICF domains assessed as facilitators or barriers. In conclusion, the FSAS-ED provides a clinical assessment of senior's functional status that is feasible to use in ED. It has potential utility for identifying unmet needs and obstacles for a safe return to the community. ß
BMC geriatrics, 2006
We evaluated the accuracy of physician recognition of functional status impairment in older emergency departments (ED) patients. In particular, we evaluated the accuracy of medical records (a comparison of the information in the medical record with the functional status based on proxy interviews), and the accuracy of physician knowledge (a comparison of the information obtained from the responsible physician with the functional status based on proxy interviews). Cross-sectional study on 101 frail older patients selected at random from among those attending ED, their ED physicians, and respondents. The study was conducted at ED in four general university teaching hospitals in a city, from July through November 2003. Functional data shown on patients' medical records were compared against functional data obtained from respondents (family members), using Kendall's Tau-b statistic. In addition patients' Katz Indices (which assesses six basic activities of daily living--basic...
International Journal of Older People Nursing, 2007
Assessment of a patient’s functional ability to perform activities of daily living is an essential part of nursing. Measuring the functional ability of older adults is a potent predictor of a patient’s morbidity and hospital outcome. The information generated from assessment scales is only constructive if the information generated is clinically useful and scientifically reliable. The Katz activities of daily living and the Barthel Index are two of the oldest competing indices for assessing activities of daily living. The Katz activities of daily living and the Barthel Index evaluate a patient’s function in terms of level of independence or dependence when performing certain activities required for daily living. This paper will compare their significance and usefulness to nursing practice of the older adult. As information is gathered and interpreted to complete these assessment scales, the relative merits in specific situations of these two oldest competing indices need to be considered to ensure their appropriateness and sensitivity. Often, with the use of assessment scales for activities of daily living, the results often tend to be subjective and lack a systematic approach. Subjective assessment of patients makes it difficult to evaluate the effectiveness of treatments, leading to bias and the misinterpretation of data. This may be critical in the care of older adults, where presenting problems are often complex and multi-dimensional. As assessment of functional ability has become more important to nursing practice, this paper will investigate the Katz activities of daily living and the Barthel Index for reliability and explore the variations that exist between the two indices. Although research on assessment scales has been ongoing since the work of Katz et al. (1963) there remains conceptual issues as to what constitutes activities of daily living and defining terminology associated with the measurement.
Journal of the American Geriatrics Society, 2011
Objective: To investigate the level of agreement between patient-proxy ratings concerning the (Instrumental) Activities of Daily Living ((I)ADL) of hospitalized older patients and to investigate which factors are associated with any disagreements in these ratings. Design: A prospective cohort study was designed. Setting: A tertiary university teaching hospital was the setting. Participants: The participants were patients aged 65 years and older who were acutely hospitalized for at least 48 hours and their proxies. Measurements: All of the patients and proxies were interviewed using the modified Katz ADL index. The global cognitive functioning of all of the participants was assessed using the Mini-Mental State Examination (MMSE), and each patient's level of delirium was measured using the Confusion Assessment Method (CAM). Results: Overall, 460 acutely admitted older patients (mean age = 78 years) and their proxies were included in the present study. The patients and proxies exhibited moderate to good levels of agreement on the patients' (I)ADL (70-90%, p< 0.001). The differences in the patient-proxy reporting for the (I)ADL were greater (p< 0.001) for the patients with severe cognitive impairments (MMSE≤ 15) than for the patients with mild cognitive impairments (a MMSE score between 16 and 23 points) to no cognitive impairment (MMSE ≥ 24). A lower MMSE score (OR= 0.95; 95% CI 0.91 to 0.99) and a lower level of delirium (OR=2.56; (1.38 to 4.75) were associated with a greater level of disagreement between the patients and proxies ratings regarding (I)ADL. Conclusion: For the patients with mild cognitive impairments at the time of the hospital admission, the results indicate that the self-report of (I)ADL is accurate and can be used for assessing (I)ADL functioning. For patients with a severe cognitive impairment or prevalent delirium, the nearest proxy may provide valid information about the patient's (I)ADL functioning.
Functional Disability for Basic Activities of Daily Lives of the Elderly : A Population Study 1
2016
The aim of the study was to identify factors associated with functional disability for basic activities of daily living in older adults. This is a cross-sectional, population-based study with a probabilistic sample, performed in Goiania, Brazil. The older adults were interviewed in their homes. The basic activities of daily living (BADL) were evaluated using the Katz Index. Difficulty in performing at least one BADL was considered to be a functional disability. The independent variables included socioeconomic, demographic, health and lifestyle conditions. The Chi-square or Fisher's tests and multiple logistic regression were used for the analysis (p value <0.05). The factors associated with functional disability Were being aged = 80 years (OR: 2:49, 1:14 to 7:14), widowed (OR: 2.89; 1.25-6.75), history of stroke (OR: 2.85; 1:14 to 7:13), hospitalization (2:07; 1:02 to 4:21), cognitive impairment (OR: 2:07 ; 1:45 to 6:06) and physical inactivity (OR 2.64, 1.03-6.75). The preva...
Geriatrics & gerontology international, 2015
To present practical predictors for the difficulty of carrying out basic activities of daily living (ADL) among the old-old during a 2-year period. Assessment was carried out using data obtained from the Tosa Longitudinal Aging Study, a community-based cohort survey on geriatric functions in the elderly. Predictor variables measured at baseline included age; sex; height; weight; blood pressure; oxygen saturation; neurobehavioral functions, such as Mini-Mental State Examination, Kohs Block Design test, Timed Up and Go test, button score, functional reach test, geriatric depression scale, cardio-ankle vascular index, ankle brachial pressure index; and blood chemical results, such as hemoglobin, fasting blood sugar, hemoglobin A1c, serum lipids, serum albumin and serum creatinine. The outcome variable was the presence of difficulties while carrying out basic ADL after 2 years. Age of ≥85 years, Timed Up and Go test of ≥15 s, button score of >17 s and presence of knee pain were indep...
The selected aspects of geriatric patients’ functioning evaluation
Medical and Biological Sciences, 2012
S u m m a r y I n t r o d u c t i o n. As time passes by and the aging proceeds, the state of one's health also changes. Chronic, progressive illnesses appear and limit one's self-reliance. The aim of this study was to evaluate chosen functional fitness factors in geriatric patients and to analyze problems in caring. M a t e r i a l a n d m e t h o d s. The study was conducted in 2010 among 109 patients from the Department and Clinic of Geriatrics. Research tools included: the Care Dependency Scale questionnaire (the CDS); Polish version, Katz Activities of Daily Living Scale (ADL) questionnaire, Lawton Instrumental Activities of Daily Living (IADL) Scale questionnaire. R e s u l t s. Everyday and instrumental activities in the surveyed group were estimated at medium to high level. The brought to you by CORE View metadata, citation and similar papers at core.ac.uk
DOAJ (DOAJ: Directory of Open Access Journals), 2013
Objective: To evaluate the elderly persons' functionality, based on the International Classification of Functionality. Methods: a cross-sectional, descriptive study; a stratified random sample of 903 elderly persons; a confidence level of 95%; and a margin of error of 2.5%. Questionnaire based on the International Classification of Functionality; data was collected based on structured interviews undertaken by health professionals in the health centers in the Alentejo region of Portugal. Results: 30.7% of the elderly persons stated that they were illiterate, and 22.9% lived alone. Feeding/dietary (18.7%), housing (19.2%) and health needs (26.0%) were not met. Orientation functions were maintained in 83.4%; 58% of the elderly persons referred to pain so intense that it required care; 73.3% of the elderly persons did not have functional dentition. Levels of performance were superior to 80% in the participation activities: washing oneself (82.6%), toileting (92.2%), dressing, eating, and drinking (89%). Conclusion: although a progressive decline in functionality is observed as age advances, the majority of dimensions are preserved until around 75 years of age.