Time care profile: an evaluation of a new method of assessing ADL dependence

Valid and reliable measures of dependency in activities of daily living (ADL) remain a critical area in rehabilitation medicine for determining the patient's progress and assessing program effectiveness. This paper describes a new approach to ADL evaluation which utilizes a diary method to record the amount of time the patient receives assistance during the course of a normal day as an index of dependency. Results from a validity study using this approach on hospitalized patients in which staff members made on-the-spot time recordings of assistance provided suggest the following conclusions: (1) a diary-type record of information indicating the length of time (time measurements) an activity lasted is relatively inaccurate; and (2) the same kind of diary approach provides a highly accurate record of the number of times (frequency measurements) an activity occurred and the distribution of assistance throughout the day. In five of six activities studied, frequency measurements recorded by staff members agreed with those of an independent observer 84 percent or more of the time. Frequency measurements in a diary format appear to represent a feasible and useful method for quantifying and evaluating patient performance in nontest situations.