Specific item patterns in comparison to generalized sum score-the Care Dependency Scale (CDS) as a screening tool for...

Area of Science:

• Gerontology
• Nursing Science
• Health Services Research

Background:

• Pressure ulcers, falls, and malnutrition are significant care problems in long-term care facilities.
• The Care Dependency Scale (CDS) is a tool used to assess care needs.
• Identifying specific CDS items predictive of these problems can improve patient outcomes.

Purpose of the Study:

• To identify specific items within the Care Dependency Scale (CDS) that are most predictive of pressure ulcers, falls, and malnutrition.
• To evaluate the effectiveness of these identified CDS items in screening for these care problems.

Main Methods:

• Secondary data analysis of 19,787 individuals from 262 German long-term care facilities (2008-2012).
• Classification and Regression Trees (CART) were used to identify predictive CDS items.
• Area Under the Receiver Operating Characteristic Curve (AUC) statistics validated the identified items.

Main Results:

• Mobility was the most significant predictor for pressure ulcer prevalence (9.0% in completely dependent individuals).
• Complete dependency in 'eat and drink' was the strongest predictor for malnutrition (25.2% prevalence).
• Mobility and body posture showed higher AUC for pressure ulcers than the total CDS score; 'eat and drink' showed higher AUC for malnutrition.

Conclusions:

• Specific CDS items, particularly mobility and 'eat and drink' dependency, are valuable for screening pressure ulcers and malnutrition risks.
• The CDS can serve as an effective screening tool for various nursing care problems in long-term care settings.