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[Interobserver concordance in functional assessment by Barthel Index].
1UFISS Geriatría-Servicio de Medicina Interna, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona. fformiga@csub.scs.es
Revista Clinica Espanola
|July 28, 2006
Summary
Interobserver agreement for the Barthel Index (BI) was high overall but low in specific activities like eating and transfers between gerontology nurses and family medicine residents. Targeted training is needed to improve functional capacity evaluation.
Area of Science:
- Gerontology
- Family Medicine
- Rehabilitation Medicine
Background:
- The Barthel Index (BI) is a common tool for assessing functional capacity.
- Interobserver agreement is crucial for reliable assessment.
- Gerontology nurses and family medicine residents are key healthcare professionals involved in patient assessment.
Purpose of the Study:
- To evaluate the interobserver agreement of the Barthel Index (BI) between clinical nurses in gerontology and residents in family medicine.
- To identify specific areas within the BI where agreement is low or medium.
Main Methods:
- One hundred patients were assessed using the Barthel Index (BI).
- Scores were based on patient or carer interviews conducted two weeks prior to admission.
- Eighteen patients were excluded due to incomplete interviews, leaving 82 patients for analysis.
Main Results:
- The mean BI score was 87.3 for nurses and 88.2 for residents.
- Overall BI score agreement was high (r=0.793).
- Interobserver agreement was low (kappa<0.4) for eating, dressing, and transfers, and medium (kappa 0.40-0.75) for other items.
Conclusions:
- There is a need for specific training for gerontology nurses and family medicine residents on functional capacity evaluation using the BI.
- Improving interobserver agreement in specific BI domains can enhance the reliability of functional assessments.
- Standardized training can lead to more consistent and accurate use of the Barthel Index.