Abstract：Objective To assess the reliability of Barthel index (BI) in the assessment of daily living ability of elderly patients with hip fracture.Methods A total of 52 elderly patients with hip fracture from August 2019 to May 2020 were included. The nurses were divided into ABC groups, each group containing one trained and one untrained nursing staff. At 1 week postoperatively, one nursing team was randomly selected to evaluate the patients, and the nurses in the group were required to complete the Barthel index assessment within 4 hours for each patient. The intraclass correlation coefficient (ICC)was used to evaluate the inter observer reliability of the Barthel index.Results The overall mean of the BI at 1 week after surgery was 42.72±5.13, and there was no statistical difference within each group (P>0.05).All patients did not reach the level of mild dependence and above (>60 points) at 1 week after surgery, and there was no statistical difference in the proportions of the level of heavy/moderate dependence within each group (P>0.05)."Stairs", "Bathing", and "Feeding" were the consistent judgment items for all the enrolled patients, which might be related with the characteristics of hip fractures.The intraclass correlation coefficients of the 3 groups were all greater than 0.90 (ICCGroup1=0.903, ICCGroup2=0.957, ICCGroup3=0.905). The results showed that the inter-rater reliability of BI was sufficient.Conclusions The Barthel index is reliable in measuring the daily living ability of elderly patients with hip fractures.
高影, 娜日苏, 李娜, 王方, 李通, 范娟. Barthel指数评估老年髋部骨折患者生活自理能力[J]. 武警医学, 2022, 33(6): 489-492.
GAO Ying, NA Risu, LI Na, WANG Fang, LI Tong, FAN Juan. Barthel index in assessment of daily Living ability of elderly patients with hip fracture. Med. J. Chin. Peop. Armed Poli. Forc., 2022, 33(6): 489-492.
Zhao H, Wei P, Feng Y. Association between frailty and clinical outcomes and quality of life in older adults following hip fracture surgery: a retrospective cohort study [J]. Anesth Analg, 2021,12(24):1210-1213.
[2]
Zhang C, Feng J, Wang S, et al. Incidence of and trends in hip fracture among adults in urban China: a nationwide retrospective cohort study [J]. PLoS Med, 2020, 17(8): e1003180.
[3]
Nishioka S, Wakabayashi H, Momosaki R. Nutritional status changes and activities of daily living after hip fracture in convalescent rehabilitation units: a retrospective observational cohort study from the Japan rehabilitation nutrition database [J]. J Acad Nutr Diet, 2018, 118(7): 1270-1276.
Karlsson A, Lindelof N, Olofsson B, et al. Effects of geriatric interdisciplinary home rehabilitation on independence in activities of daily living in older people with hip fracture: a randomized controlled trial [J]. Arch Phys Med Rehabil, 2020, 101(4): 571-578.
Tornero-Quinones I, Saez-Padilla J, Espina Diaz A, et al. Functional ability, frailty and risk of falls in the elderly: relations with autonomy in daily living [J]. Int J Environ Res Public Health, 2020, 17(3): 1006-1007.
[8]
Moore J L, Nordvik J E, Erichsen A, et al. Implementation of high-intensity stepping training during inpatient stroke rehabilitation improves functional outcomes [J]. Stroke, 2020, 51(2): 563-570.
[9]
Hulsbaek S, Larsen R F, Rosthoj S, et al. The Barthel index and the cumulated ambulation score are superior to the de morton mobility index for the early assessment of outcome in patients with a hip fracture admitted to an acute geriatric ward [J]. Disabil Rehabil, 2019, 41(11): 1351-1359.
[10]
Knauf T, Buecking B, Hack J, et al. Development of the Barthel index 5 years after hip fracture: results of a prospective study [J]. Geriatr Gerontol Int, 2019, 19(8): 809-814.
[11]
Mahoney F I, Barthel D W. Functional evaluation: the Barthel index [J]. Md State Med J, 1965, 14(2): 61-65.
[12]
Grill E, Stucki G, Scheuringer M, et al. Validation of International Classification of Functioning, Disability, and Health (ICF) core sets for early postacute rehabilitation facilities: comparisons with three other functional measures [J]. Am J Phys Med Rehabil, 2006, 85(8): 640-649.
[13]
Quinn T J, McArthur K, Ellis G, et al. Functional assessment in older people [J]. BMJ, 2011, 14(2): 343-344.
[14]
Zou G Y. Sample size formulas for estimating intraclass correlation coefficients with precision and assurance [J]. Stat Med, 2012, 31(29): 3972-3981.
[15]
Geis B, Tulka S, Knippschild S, et al. Introduction of a user-oriented application for biometrical sample size calculation in clinical and epidemiological trials [J]. Klin Monbl Augenheilkd, 2021, 238(2): 179-185.
[16]
Jia B, Lynn H S. A sample size planning approach that considers both statistical significance and clinical significance [J]. Trials, 2015, 16(1): 1-6.
[17]
Shrout P E, Fleiss J L. Intraclass correlations: uses in assessing rater reliability [J]. Psychol Bull, 1979, 86(2): 420-428.
[18]
Leendert J A A, Linkens A, Poeze M, et al. Mortality in hip fracture patients after implementation of a nurse practitioner-led orthogeriatric care program: results of a 1-year follow-up [J]. Age Ageing, 2021, 50(5): 1744-1750.
[19]
Ocagli H, Cella N, Stivanello L, et al. The Barthel index as an indicator of hospital outcomes: a retrospective cross-sectional study with healthcare data from older people [J]. J Adv Nurs, 2021, 77(4): 1751-1761.
Duffy L, Gajree S, Langhorne P, et al. Reliability (inter-rater agreement) of the Barthel index for assessment of stroke survivors: systematic review and meta-analysis [J]. Stroke, 2013, 44(2): 462-468.
[22]
Vitacca M, Malovini A, Balbi B, et al. Minimal clinically important difference in Barthel index dyspnea in patients with COPD [J]. Int J Chron Obstruct Pulmon Dis, 2020, 15(1): 2591-2599.
[23]
Johr J, Halimi F, Pasquier J, et al. Recovery in cognitive motor dissociation after severe brain injury: a cohort study [J]. PLoS One, 2020, 15(2): e0228474.
[24]
O′Connor R J, Cano S J, Thompson A J, et al. Exploring rating scale responsiveness: does the total score reflect the sum of its parts? [J]. Neurology, 2004, 62(10): 1842-1844.
[25]
Mayhew E, Beresford B, Laver-Fawcett A, et al. The Hopkins Rehabilitation Engagement Rating Scale-Reablement Version (HRERS-RV): development and psychometric properties [J]. Health Soc Care Community, 2019, 27(3): 777-787.
[26]
Tago M, Katsuki N E, Yaita S, et al. High inter-rater reliability of Japanese bedriddenness ranks and cognitive function scores: a hospital-based prospective observational study [J]. BMC Geriatr, 2021, 21(1): 168.
[27]
Bouwstra H, Smit E B, Wattel E M, et al. Measurement properties of the Barthel Index in geriatric rehabilitation [J]. J Am Med Dir Assoc, 2019, 20(4): 420-425.
[28]
Nursiswati N, Halfens R J G, Lohrmann C. Psychometric properties of the care dependency scale in stroke survivors in indonesian hospitals [J]. Int J Nurs Sci, 2020, 7(3): 330-336.
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