Measurement Characteristics of Disability-Related Constructs in ChronicallyInstitutionalized Nursing Home Residents

2.50
Hdl Handle:
http://hdl.handle.net/10755/166205
Category:
Abstract
Type:
Presentation
Title:
Measurement Characteristics of Disability-Related Constructs in ChronicallyInstitutionalized Nursing Home Residents
Author(s):
McConnell, Eleanor
Author Details:
Eleanor McConnell, PhD, Duke University School of Nursing School of Nursing, Durham, North Carolina, USA, email: eleanor.mcconnell@duke.edu
Abstract:
Nursing home residents suffer from high levels of dependency in self-care, yet little is known about factors that may be precursors to worsening dependency. Disablement models suggest the present of potentially manipulable variables intervening between disease and disability that may be fruitful points for intervention. Before these models can be fully utilized, adequacy of measurement of disability and related factors in the population of interest must be established. The purpose of this study was to assess the test characteristics of measures of disability and related constructs proposed in the based measures originally developed and tested in populations other than nursing home residents were examined. Research questions were: (1) What is the inter-rater, test-retest, and internal consistency reliability of standardized measures of cognitive performance, strength, range of motion, functional limitation, and disability? and (2) Does each measure perform in nursing home residents in a manner consistent with that reported in other populations? Inclusion criteria were: (1) Over age 60, (2) stands with assistance, (3) follows simple commands, (4) permanent resident of nursing home, (5) not terminally ill or medically unstable, (6) resident or proxy informed consent obtained. Sixteen permanent residents over age 60 from one nursing home participated in the reliability testing. Data from an additional 49 subjects representing two nursing home sites were used to assess the factor structure of each measure. Reliability was assessed using intra-class correlation coefficients (ICCs). Coefficient alpha was calculated as a measure of internal consistency. Exploratory factor analysis using a principal axis factoring technique was used to explore the dimensionality of each measure. Measures obtained included hand-held dynamometry, goniometry, the Neurobehavioral Cognitive Screening Examination (NCSE), the 7-item Physical Performance Test (PPT), and the Functional Independence Measure (FIM). Subjects' functional and cognitive status were similar to nursing home patients nationally, but were more likely to be male (67%), were slightly younger (mean age 76.7, SD=9.13). Findings: All measures had excellent test-retest and inter-rater relability, except two items on the NCSE. Test-retest concordance at one week varied by measure and ranged from ICC=.83 to .91 for range of motion and strength measures, ICC=.32 to .91 for the NCSE, ICC=.80 for teh PPT, and ICC=.71 to .89 for teh FIM. Inter-rater reliabilities for all measures ranged from ICC=.80 to .99. Internal consistency of teh NCSE, PPT and FIM was high. Factor structures for each measure were consistent with other measurement work reported on these instruments, except for the NCSE, literature was observed. Implications: Many existing measures of disability and related constructs can be sued reliably in selected nursing home residents. Unresolved issues in using these measures in nursing hom residents include establishing their relationship to self-reported and proxy-reported function, and structuring measurement protocols to minimize respondent burden and missing data.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
Feb 29 - Mar 2, 1996
Conference Host:
Southern Nursing Research Society
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleMeasurement Characteristics of Disability-Related Constructs in ChronicallyInstitutionalized Nursing Home Residentsen_GB
dc.contributor.authorMcConnell, Eleanoren_US
dc.author.detailsEleanor McConnell, PhD, Duke University School of Nursing School of Nursing, Durham, North Carolina, USA, email: eleanor.mcconnell@duke.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/166205-
dc.description.abstractNursing home residents suffer from high levels of dependency in self-care, yet little is known about factors that may be precursors to worsening dependency. Disablement models suggest the present of potentially manipulable variables intervening between disease and disability that may be fruitful points for intervention. Before these models can be fully utilized, adequacy of measurement of disability and related factors in the population of interest must be established. The purpose of this study was to assess the test characteristics of measures of disability and related constructs proposed in the based measures originally developed and tested in populations other than nursing home residents were examined. Research questions were: (1) What is the inter-rater, test-retest, and internal consistency reliability of standardized measures of cognitive performance, strength, range of motion, functional limitation, and disability? and (2) Does each measure perform in nursing home residents in a manner consistent with that reported in other populations? Inclusion criteria were: (1) Over age 60, (2) stands with assistance, (3) follows simple commands, (4) permanent resident of nursing home, (5) not terminally ill or medically unstable, (6) resident or proxy informed consent obtained. Sixteen permanent residents over age 60 from one nursing home participated in the reliability testing. Data from an additional 49 subjects representing two nursing home sites were used to assess the factor structure of each measure. Reliability was assessed using intra-class correlation coefficients (ICCs). Coefficient alpha was calculated as a measure of internal consistency. Exploratory factor analysis using a principal axis factoring technique was used to explore the dimensionality of each measure. Measures obtained included hand-held dynamometry, goniometry, the Neurobehavioral Cognitive Screening Examination (NCSE), the 7-item Physical Performance Test (PPT), and the Functional Independence Measure (FIM). Subjects' functional and cognitive status were similar to nursing home patients nationally, but were more likely to be male (67%), were slightly younger (mean age 76.7, SD=9.13). Findings: All measures had excellent test-retest and inter-rater relability, except two items on the NCSE. Test-retest concordance at one week varied by measure and ranged from ICC=.83 to .91 for range of motion and strength measures, ICC=.32 to .91 for the NCSE, ICC=.80 for teh PPT, and ICC=.71 to .89 for teh FIM. Inter-rater reliabilities for all measures ranged from ICC=.80 to .99. Internal consistency of teh NCSE, PPT and FIM was high. Factor structures for each measure were consistent with other measurement work reported on these instruments, except for the NCSE, literature was observed. Implications: Many existing measures of disability and related constructs can be sued reliably in selected nursing home residents. Unresolved issues in using these measures in nursing hom residents include establishing their relationship to self-reported and proxy-reported function, and structuring measurement protocols to minimize respondent burden and missing data.en_GB
dc.date.available2011-10-27T14:42:25Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:42:25Z-
dc.conference.dateFeb 29 - Mar 2, 1996en_US
dc.conference.hostSouthern Nursing Research Societyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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