scholarly journals Development of a new tool for the assessment of patient-defined benefit in hospitalised older patients: the Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP)

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038203
Author(s):  
Maria Johanna van der Kluit ◽  
Geke J Dijkstra ◽  
Barbara C van Munster ◽  
Sophia De Rooij
Keyword(s):  
Field Test ◽  
Teaching Hospital ◽  
Older Patients ◽  
Community Dwelling ◽  
Assessment Scale ◽  
Benefit Assessment ◽  
Step Test ◽  
Patient Benefit ◽  
Evaluation Questionnaire ◽  
Baseline Questionnaire

ObjectivesTo support the shift from disease-oriented towards goal-oriented care, we aimed to develop a tool which is capable both to identify priorities of an individual older hospitalised patient and to measure the outcomes relevant to him.DesignMixed-methods design with open interviews, three step test interviews (TSTIs) and a quantitative field test.SettingUniversity teaching hospital and a regional teaching hospital.ParticipantsHospitalised patients ages 70 years and older.ResultsThe Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) consists of a baseline questionnaire and an evaluation questionnaire. Items were based on 15 qualitative interviews with hospitalised older patients. Feedback from a panel of four community-dwelling older persons resulted in some adaptations to wording and one additional item. Twenty-six hospitalised older patients participated in TSTIs with Version 1 of the baseline questionnaire, revealing indications for a good content validity and barriers in completion behaviour, global understanding and understanding of individual items, which were solved with several adaptations. Four additions were made by participants. After TSTIs with ten patients with the evaluation questionnaire, one adaptation was made. A field test with 91 hospitalised older patients revealed a small number of missing values.To enhance the feasibility, the number of items was reduced from 32 to 22, based on correlations and mean impact score. The field test was repeated with 104 other patients in a regional teaching hospital. To enhance the understanding, the tool was split into two phases. This version was tested with TSTIs with eight patients and appeared to be understandable. The final version was an interview-based tool and took about 11 min to complete.ConclusionsThe P-BAS HOP is a potentially suitable tool to identify priorities and relevant outcomes of the individual patient. Further research is needed to investigate its validity, reliability and responsiveness.

scholarly journals Adaptation of the Patient Benefit Assessment Scale for Hospitalised Older Patients: development, reliability and validity of the P-BAS picture version

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Maria Johanna van der Kluit ◽  
Geke J. Dijkstra ◽  
Sophia E. de Rooij
Keyword(s):  
Construct Validity ◽  
Older Patients ◽  
Assessment Scale ◽  
Benefit Assessment ◽  
Step Test ◽  
Minimal Important Change ◽  
Patient Benefit ◽  
Smallest Detectable Change ◽  
The Individual

Abstract Background The Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) is a tool developed to both identify the priorities of the individual patient and to measure the outcomes relevant to him/her, resulting in a Patient Benefit Index (PBI), indicating how much benefit the patient had experienced from the hospitalisation. The reliability and the validity of the P-BAS HOP appeared to be not yet satisfactory and therefore the aims of this study were to adapt the P-BAS HOP and transform it into a picture version, resulting in the P-BAS-P, and to evaluate its feasibility, reliability, validity, responsiveness and interpretability. Methods Process of instrument development and evaluation performed among hospitalised older patients including pilot tests using Three-Step Test-Interviews (TSTI), test-retest reliability on baseline and follow-up, comparing the PBI with Intraclass Correlation Coefficient (ICC), and hypothesis testing to evaluate the construct validity. Responsiveness of individual P-BAS-P scores and the PBI with two different weighing schemes were evaluated using anchor questions. Interpretability of the PBI was evaluated with the visual anchor-based minimal important change (MIC) distribution method and computation of smallest detectable change (SDC) based on ICC. Results Fourteen hospitalised older patients participated in TSTIs at baseline and 13 at follow-up after discharge. After several adaptations, the P-BAS-P appeared feasible with good interviewer’s instructions. The pictures were considered relevant and helpful by the participants. Reliability was tested with 41 participants at baseline and 50 at follow-up. ICC between PBI1 and PBI2 of baseline test and retest was 0.76, respectively 0.73. At follow-up 0.86, respectively 0.85. For the construct validity, tested in 169 participants, hypotheses regarding importance of goals were confirmed. Regarding status of goals, only the follow-up status was confirmed, baseline and change were not. The responsiveness of the individual scores and PBI were weak, resulting in poor interpretability with many misclassifications. The SDC was larger than the MIC. Conclusions The P-BAS-P appeared to be a feasible instrument, but there were methodological barriers for the evaluation of the reliability, validity, and responsiveness. We therefore recommend further research into the P-BAS-P.

scholarly journals Adaptation of the Patient Benefit Assessment Scale for Hospitalised Older Patients: Development, Reliability and Validity of the P-BAS Picture Version

2021 ◽  
Author(s):  
Maria Johanna van der Kluit ◽  
Geke J. Dijkstra ◽  
Sophia E. de Rooij
Keyword(s):  
Construct Validity ◽  
Older Patients ◽  
Assessment Scale ◽  
Benefit Assessment ◽  
Step Test ◽  
Minimal Important Change ◽  
Patient Benefit ◽  
Smallest Detectable Change ◽  
The Individual

Abstract Background: The Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) is a tool developed to both identify the priorities of the individual patient and to measure the outcomes relevant to him/her, resulting in a Patient Benefit Index (PBI), indicating how much benefit the patient had experienced from the hospitalisation. The reliability and the validity of the P-BAS HOP appeared to be not yet satisfactory and therefore the aims of this study were to adapt the P-BAS HOP and transform it into a picture version, resulting in the P-BAS-P, and to evaluate its feasibility, reliability, validity, responsiveness and interpretability.Methods: Process of instrument development and evaluation performed among hospitalised older patients including pilot tests using Three-Step Test-Interviews (TSTI), test-retest reliability on baseline and follow-up, comparing the PBI with Intraclass Correlation Coefficient (ICC), and hypothesis testing to evaluate the construct validity. Responsiveness of individual P-BAS-P scores and the PBI with two different weighing schemes were evaluated using anchor questions. Interpretability of the PBI was evaluated with the visual anchor-based minimal important change (MIC) distribution method and computation of smallest detectable change (SDC) based on ICC.Results: Fourteen hospitalised older patients participated in TSTIs at baseline and thirteen at follow-up after discharge. After several adaptations, the P-BAS-P appeared feasible with good interviewer’s instructions. The pictures were considered relevant and helpful by the participants. Reliability was tested with 41 participants at baseline and 50 at follow-up. ICC between PBI1 and PBI2 of baseline test and retest was 0.76, respectively 0.73. At follow-up 0.86, respectively 0.85.For the construct validity, tested in 169 participants, hypotheses regarding importance of goals were confirmed. Regarding status of goals, only the follow-up status was confirmed, baseline and change were not. The responsiveness of the individual scores and PBI were weak, resulting in poor interpretability with many misclassifications. The SDC was larger than the MIC.Conclusions: The P-BAS-P appeared to be a feasible instrument, but there were methodological barriers for the evaluation of the reliability, validity, and responsiveness. We therefore recommend further research into the P-BAS-P.

scholarly journals Reliability and validity of the Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maria Johanna van der Kluit ◽  
Geke J. Dijkstra ◽  
Sophia E. de Rooij
Keyword(s):  
Construct Validity ◽  
Correlation Coefficient ◽  
Older Patients ◽  
Reliability And Validity ◽  
Weighted Kappa ◽  
Assessment Scale ◽  
Benefit Assessment ◽  
Patient Benefit ◽  
Important Benefit

Abstract Background The Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) is a tool which is capable of both identifying the priorities of the individual patient and measuring the outcomes relevant to him/her, resulting in a Patient Benefit Index (PBI) with range 0–3, indicating how much benefit the patient had experienced from the admission. The aim of this study was to evaluate the reliability, validity, responsiveness and interpretability of the P-BAS HOP. Methods A longitudinal study among hospitalised older patients with a baseline interview during hospitalisation and a follow-up by telephone 3 months after discharge. Test-retest reliability of the baseline and follow-up questionnaire were tested. Percentage of agreement, Cohen’s kappa with quadratic weighting and maximum attainable kappa were calculated per item. The PBI was calculated for both test and retest of baseline and follow-up and compared with Intraclass Correlation Coefficient (ICC). Construct validity was tested by evaluating pre-defined hypotheses comparing the priority of goals with experienced symptoms or limitations at admission and the achievement of goals with progression or deterioration of other constructs. Responsiveness was evaluated by correlating the PBI with the anchor question ‘How much did you benefit from the admission?’. This question was also used to evaluate the interpretability of the PBI with the visual anchor-based minimal important change distribution method. Results Reliability was tested with 53 participants at baseline and 72 at follow-up. Mean weighted kappa of the baseline items was 0.38. ICC between PBI of the test and retest was 0.77. Mean weighted kappa of the follow-up items was 0.51. ICC between PBI of the test and retest was 0.62. For the construct validity, tested in 451 participants, all baseline hypotheses were confirmed. From the follow-up hypotheses, tested in 344 participants, five of seven were confirmed. The Spearman’s correlation coefficient between the PBI and the anchor question was 0.51. The optimal cut-off point was 0.7 for ‘no important benefit’ and 1.4 points for ‘important benefit’ on the PBI. Conclusions Although the concept seems promising, the reliability and validity of the P-BAS HOP appeared to be not yet satisfactory. We therefore recommend adapting the P-BAS HOP.

scholarly journals Reliability and validity of the Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP)

2020 ◽  
Author(s):  
Maria van der Kluit ◽  
Geke Dijkstra ◽  
Sophia de Rooij
Keyword(s):  
Construct Validity ◽  
Correlation Coefficient ◽  
Older Patients ◽  
Reliability And Validity ◽  
Weighted Kappa ◽  
Assessment Scale ◽  
Benefit Assessment ◽  
Patient Benefit ◽  
Important Benefit

Abstract Background: The Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) is a tool which is capable of both identifying the priorities of the individual patient and measuring the outcomes relevant to him, resulting in a Patient Benefit Index (PBI) with range 0-3, indicating how much benefit the patient had experienced from the admission. The aim of this study was to evaluate the reliability, validity, responsiveness and interpretability of the P-BAS HOP.Methods: A longitudinal study among hospitalised older patients with a baseline interview during hospitalisation and a follow-up by telephone three months after discharge. Test-retest reliability of the baseline and follow-up questionnaire were tested. Percentage of agreement, Cohen’s kappa with quadratic weighting and maximum attainable kappa were calculated per item. The PBI was calculated for both test and retest of baseline and follow-up and compared with Intraclass Correlation Coefficient (ICC). Construct validity was tested by evaluating pre-defined hypotheses comparing the priority of goals with experienced symptoms or limitations at admission and the achievement of goals with progression or deterioration of other constructs. Responsiveness was evaluated by correlating the PBI with the anchor question ‘How much did you benefit from the admission?’. This question was also used to evaluate the interpretability of the PBI with the visual anchor-based minimal important change distribution method.Results: Reliability was tested with 53 participants at baseline and 72 at follow-up. Mean weighted kappa of the baseline items was 0.38. ICC between PBI of the test and retest was 0.77.Mean weighted kappa of the follow-up items was 0.51. ICC between PBI of the test and retest was 0.62.For the construct validity, tested in 451 participants, all baseline hypotheses were confirmed. From the follow-up hypotheses, tested in 344 participants, five of seven were confirmed. The Spearman’s correlation coefficient between the PBI and the anchor question was .51.The optimal cut-off point was 0.7 for ‘no important benefit’ and 1.4 points for ‘important benefit’ on the PBI. Conclusions: Although the concept seems promising, the reliability and validity of the P-BAS HOP appeared to be not yet satisfactory. We therefore recommend adapting the P-BAS HOP.

Frailty and Health Care Utilization among Community-Dwelling Older Patients with Diabetes Mellitus

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1468-P
Author(s):  
SHIVANI PRIYADARSHNI ◽  
SRUTHI NELLURI ◽  
ZUBAIR RAHAMAN ◽  
MICHAEL J. MINTZER ◽  
STUTI DANG ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Health Care Utilization ◽  
Older Patients ◽  
Community Dwelling ◽  
Care Utilization ◽  
Patients With Diabetes

The Rowland Universal Dementia Assessment Scale (RUDAS): a multicultural cognitive assessment scale

2004 ◽  
Vol 16 (1) ◽  
pp. 13-31 ◽  
Author(s):  
Joella E. Storey ◽  
Jeffrey T. J. Rowland ◽  
David A. Conforti ◽  
Hugh G. Dickson
Keyword(s):  
Roc Curve ◽  
Predictive Accuracy ◽  
Geriatric Medicine ◽  
Community Dwelling ◽  
Assessment Scale ◽  
Elderly Persons ◽  
Roc Curve Analysis ◽  
Simple Method ◽  
Cognitive Domains ◽  
Cut Point

Objective: To develop and validate a simple method for detecting dementia that is valid across cultures, portable and easily administered by primary health care clinicians.Design: Culture and Health Advisory Groups were used in Stage 1 to develop culturally fair cognitive items. In Stage 2, clinical testing of 42 items was conducted in a multicultural sample of consecutive new referrals to the geriatric medicine outpatient clinic at Liverpool Hospital, Sydney, Australia (n=166). In Stage 3, the predictive accuracy of items was assessed in a random sample of community-dwelling elderly persons stratified by language background and cognitive diagnosis and matched for sex and age (n=90).Measurements: A research psychologist administered all cognitive items, using interpreters when needed. Each patient was comprehensively assessed by one of three geriatricians, who ordered relevant investigations, and implemented a standardized assessment of cognitive domains. The geriatricians also collected demographic information, and administered other functional and cognitive measures. DSM-IV criteria were used to assign cognitive diagnoses. Item validity and weights were assessed using frequency and logistic regression analyses. Receiver-operating characteristic (ROC) curve analysis was used to determine overall predictive accuracy of the RUDAS and the best cut-point for detecting cognitive impairment.Results: The 6-item RUDAS assesses multiple cognitive domains including memory, praxis, language, judgement, drawing and body orientation. It appears not to be affected by gender, years of education, differential performance factors and preferred language. The area under the ROC curve for the RUDAS was 0.94 (95% CI 0.87–0.98). At a cut-point of 23 (maximum score of 30), sensitivity and specificity were 89% and 98%, respectively. Inter-rater (0.99) and test-retest (0.98) reliabilities were very high.Conclusions: The 6-item RUDAS is portable and tests multiple cognitive domains. It is easily interpreted to other languages, and appears to be culturally fair. However, further validation is needed in other settings, and in longitudinal studies to determine its sensitivity to change in cognitive function over time.

scholarly journals Associations between locomotive and non-locomotive physical activity and physical performance in older community-dwelling females with and without locomotive syndrome: a cross-sectional study

2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Tomohiro Nishimura ◽  
Atsushi Hagio ◽  
Kanako Hamaguchi ◽  
Toshiyuki Kurihara ◽  
Motoyuki Iemitsu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Walking Speed ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Step Test ◽  
Locomotive Syndrome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Slow Walking ◽  
Slow Walking Speed

Abstract Background Locomotive syndrome (LS) is a condition of reduced mobility due to a disorder of the locomotive system. Increasing moderate to vigorous physical activity (MVPA) has been recommended to prevent LS. However, to increase daily MVPA is difficult for older people with LS. The MVPA consists of not only locomotive activities such as walking but also non-locomotive activities such as household activities. The aim of this study was to examine the associations between locomotive/non-locomotive MVPA and physical performance in older females with and without LS. Methods Participants of this cross-sectional study were 143 older community-dwelling Japanese females. The participants were divided into two groups based on the results of the stand-up test: the normal group (NL) (n = 86) and the LS group (n = 57). Both the locomotive and non-locomotive PA seperately measured with its intensity. The intensity of physical activity (PA) was calculated as METs and classified as sedentary behavior (SB 1–1.5 metabolic equivalent tasks (METs)), low-intensity physical activity (LPA 1.6–2.9 METs), and MVPA (≥ 3 METs). For example, locomotive LPA is slow walking speed of 54 m/min, and locomotive MVPA is walking speed of 67 m/min. While non-locomotive LPA is office work and cooking, non-locomotive MVPA is housecleaning. Physical function was evaluated by handgrip strength, walking speed, and 2-step test. Results Walking speed, hand-grip strength, 2-step test, daily step counts, and all PA measurements were not significantly different between two groups. In the LS, locomotive MVPA (r = 0.293, p < 0.05) and total MVPA (r = 0.299, p < 0.05) was significantly correlated with walking speed, but not in the NL. Conclusions Walking speed was positively correlated with locomotive MVPA and total MVPA in the LS group, but not in NL group. This result suggests that slow walking speed in older people with LS occur in connection with lower locomotive MVPA and total MVPA.

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