Measuring disability--do self-ratings and service provider ratings compare?

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Health Services Research

Background:

• Disability assessment in open care settings frequently relies on questionnaire-based ratings.
• Understanding the concordance between patient-reported outcomes and healthcare provider assessments is crucial for accurate disability evaluation.
• Discrepancies can impact care planning and resource allocation.

Purpose of the Study:

• To compare disability ratings for activities of daily living (ADLs) obtained from questionnaires with those provided by healthcare personnel in an open care context.
• To identify specific ADLs where agreement is high or low between patient and provider assessments.

Main Methods:

• Utilized dichotomous and quadritomous scales to measure agreement on various ADLs.
• Compared questionnaire-based disability ratings with ratings from healthcare providers for activities including housework, dressing, eating, washing, bathing, and sauna.
• Calculated percentage of agreement for each activity.

Main Results:

• Agreement was notably low for housework activities: 77% for cooking and 64% for cleaning using dichotomous scales.
• High agreement (94-97%) was observed for basic self-care activities like dressing, eating, and daily washing using quadritomous scales.
• More complex self-care activities, such as bathing and sauna, showed lower agreement (84%) compared to basic ADLs.

Conclusions:

• Questionnaire-based disability assessments show variable agreement with healthcare provider ratings, particularly for complex tasks and housework.
• Basic self-care activities demonstrate high concordance, suggesting reliability in these domains.
• Healthcare professionals and researchers must consider potential discrepancies when interpreting disability data from different sources in open care.