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Comparing Proxy and Patients' Perceptions of Patients' Functional Status: Results from an Outpatient Geriatric Clinic
Author(s) -
Weinberger Morris,
Samsa Gregory P.,
Schmader Kenneth,
Greenberg Stanley M.,
Carr David B.,
Wildman Diane S.
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.tb02107.x
Subject(s) - medicine , concordance , activities of daily living , geriatrics , proxy (statistics) , outpatient clinic , gerontology , physical therapy , psychiatry , machine learning , computer science
Objective To compare ratings of patients referred for geriatric evaluation and their proxies with respect to patients' ability to perform activities of daily living. Design Retrospective chart audit. Setting University‐based Outpatient Geriatric Clinic. Patients Elderly medicine patients referred to a university‐based outpatient geriatrics clinic for the first time. Main Outcome Measures Modified Katz Physical Activities of Daily Living (PADL) and Instrumental Activities of Daily Living (IADL). Results With regard to PADLs, patients were generally rated as independent by both patients (91%) and proxies (87%); for IADLs, ratings of independence by both patients (68%) and proxies (51%) were significantly lower. Concordance between patient and proxy ratings was significantly ( P <0.001) greater for PADLs (92%) than for IADLs (82%). When disagreement occurred, patients consistently rated themselves as more independent than their proxies, especially for IADLs. Moreover, concordance between patients and proxies regarding IADLs was significantly ( P <0.001) worse for patients who had scores below 24 on the Folstein Mini‐Mental State Examination (72%) compared with those scoring 24 or higher (95%). Conclusions Patient and proxy ratings were concordant when rating patients' ability to perform PADLs. Moreover, concordance was extremely high on IADLs when patients' Folstein scores were 24 or higher. Concordance with respect to IADLs was relatively poor only among patients with Folstein scores below 24. In that case, patients had a more optimistic view of their independence, compared with their proxies.