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Measuring functional ability in hospitalized older adults : A validation study

Wales, Kylie
Lannin, Natasha A.
Clemson, Lindy
Cameron, Ian D.
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Abstract
Purpose: To examine the internal consistency, construct validity and responsiveness of functional assessments tools when used with hospitalized older adults. Materials and methods: The functional ability of 66 patients was assessed using a semi-structured interview scale (n = 16 tools). The assessment of motor and process skills was administered during hospital admission and again at three months post-discharge. Results: Tools showed poor-to-excellent internal consistency (α = 0.27–0.92). Of the tools that were internally consistent, only two demonstrated change: the Groningen activity restriction scale (GARS) (smallest detectable change [SDC] 11.68, effect size −1.59) and the modified reintegration to normal living scale (SDC 7.04, effect size −1.20). Validity was supported by strong correlations between the functional independence measure™ (FIM™) and the GARS, FIM™ and Sunnaas activity daily living (ADL) index. Conclusions: Findings suggest that the GARS and the modified reintegration to normal living index (mRNLI) are internally consistent, valid and responsive to change over time when applied to a sample of hospitalized older adults. Further investigation of these tools in terms of inter and intra rater reliability in clinical practice is warranted. Implications for Rehabilitation • Therapists and researchers need to choose standardized functional assessments carefully when working with hospitalized older adults, as not all assessments are reliable and valid in this population. • The GARS and mRNLI are valid and responsive functional assessments for hospitalized older adults. • Activity and participation have been viewed traditionally as only one component of function. Therapists and researchers can use standardized assessments of function that are activity or participation-based.
Keywords
aged, activities of daily living, patient outcome assessment, occupational therapy
Date
2018
Type
Journal article
Journal
Disability and Rehabilitation
Book
Volume
40
Issue
16
Page Range
1972-1978
Article Number
ACU Department
School of Allied Health
Faculty of Health Sciences
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Open Access Status
License
All rights reserved
File Access
Controlled
Notes
© 2017 Informa UK Limited, trading as Taylor & Francis Group.