Abstract
Purpose:
Although assessment of daily functioning is crucial in geriatrics, frequently used tools for assessing activities of daily living (ADL) such as the Katz (basic ADL) and Lawton scale (instrumental ADL) have clear clinical and scientific shortcomings. This study aimed to translate both scales to the language of the International Classification of Functioning, Disability and Health (ICF), the current reference in health care for assessing human functioning.
Methodology:
A qualitative design, based on in depth-interviews with geriatric patients (n=50), was used to gain insight in individual experiences and slopes of decline in performing basic and instrumental ADL. Narratives were analysed by "constant comparison" and results were linked to terminology of the ICF. To enhance reliability peer-debriefing by a multidisciplinairy team of experts was used.
Results:
Each activity of the Katz and Lawton scale could be linked to an ICF-category. Furthermore, analysis of the reported diminished performance skills resulted in a clear description of the ICF-scoring system ranging from autonomy (score 0) towards complete dependency (score 4). Reported reasons for limitations could all be related to body functions and structure or personal and environmental elements of the ICF-framework.
Conclusion:
This study resulted in a uniform scoring guideline and flow-chart for the Katz and Lawton scale. This new and improved scoring system takes each subject as his own reference and could provide clarity in assessing basis and instrumental ADL. Further research is carried out to explore the psychometric properties and evaluates the value of its contribution to assessment of daily functioning in geriatric patients.
Although assessment of daily functioning is crucial in geriatrics, frequently used tools for assessing activities of daily living (ADL) such as the Katz (basic ADL) and Lawton scale (instrumental ADL) have clear clinical and scientific shortcomings. This study aimed to translate both scales to the language of the International Classification of Functioning, Disability and Health (ICF), the current reference in health care for assessing human functioning.
Methodology:
A qualitative design, based on in depth-interviews with geriatric patients (n=50), was used to gain insight in individual experiences and slopes of decline in performing basic and instrumental ADL. Narratives were analysed by "constant comparison" and results were linked to terminology of the ICF. To enhance reliability peer-debriefing by a multidisciplinairy team of experts was used.
Results:
Each activity of the Katz and Lawton scale could be linked to an ICF-category. Furthermore, analysis of the reported diminished performance skills resulted in a clear description of the ICF-scoring system ranging from autonomy (score 0) towards complete dependency (score 4). Reported reasons for limitations could all be related to body functions and structure or personal and environmental elements of the ICF-framework.
Conclusion:
This study resulted in a uniform scoring guideline and flow-chart for the Katz and Lawton scale. This new and improved scoring system takes each subject as his own reference and could provide clarity in assessing basis and instrumental ADL. Further research is carried out to explore the psychometric properties and evaluates the value of its contribution to assessment of daily functioning in geriatric patients.
| Original language | English |
|---|---|
| Pages (from-to) | 34–65 |
| Number of pages | 31 |
| Journal | Tijdschrift voor Gerontologie en Geriatrie |
| Volume | 45 |
| Issue number | 1 |
| Publication status | Published - Feb 2014 |
| Event | 37e Wintermeeting van de Belgische Vereniging voor Gerontologie en Geriatrie - Oostende, Belgium Duration: 21 Feb 2014 → 22 Feb 2014 |
Keywords
- Activities of daily living
- Assessment of daily functioning
- International Classification of Functioning