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Measurement of Activities of Daily Living in Hospitalized Elderly: A Comparison of Self‐Report and Performance‐Based Methods
Author(s) -
Sager Mark A.,
Dunham Nancy Cross,
Schwantes Amy,
Mecum Laurie,
Halverson Kaia,
Harlowe Diane
Publication year - 1992
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1992.tb02011.x
Subject(s) - bathing , medicine , toileting , activities of daily living , physical therapy , gerontology , emergency medicine , pathology
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.