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Change in self-reported functioning in older persons entering a residential care facility
A L Siu1, J G Ouslander, D Osterweil
1UCLA Multicampus Program of Geriatric Medicine and Gerontology 90024.
Journal of Clinical Epidemiology
|October 1, 1993
Summary
Measures of function in long-term care showed significant changes, but physical functioning measures were less responsive, especially for improvement. Clinicians must carefully select tools to monitor patient function accurately.
Area of Science:
- Gerontology
- Rehabilitation Medicine
- Health Services Research
Background:
- Assessing functional status is crucial for long-term care residents.
- Responsiveness of functional measures impacts clinical monitoring and research validity.
Purpose of the Study:
- To evaluate the responsiveness of self-reported functional measures in long-term care admissions.
- To compare the responsiveness of COOP charts and a short-form survey for physical functioning.
Main Methods:
- Longitudinal evaluation of functional measures at baseline and follow-up.
- Comparison of two self-reported function measures (COOP charts, short-form survey).
- Convergent validity assessed using correlation coefficients; discriminative validity assessed using ROC curves.
Main Results:
- Over one-fifth of subjects showed functional worsening or improvement.
- Convergent validity was found for pain, social, and mental health, but not physical function.
- Short-form physical function measure better discriminated worsening compared to COOP charts.
- All physical function measures demonstrated low responsiveness for detecting improvement.
Conclusions:
- Functional status in long-term care is dynamic, with significant changes observed.
- Existing self-reported physical function measures have limitations in responsiveness, particularly for improvement.
- Careful selection of responsive functional measures is essential for clinicians and researchers.