Medical Psychology and Medical Sociology, Clinic for Psychiatry and Psychotherapy, Erlangen University Hospital, Germany.
Int Psychogeriatr. 2010 Dec;22(8):1291-300. doi: 10.1017/S1041610210000487. Epub 2010 May 18.
Currently there is no standardized procedure for recording direct care time of dementia patients in a nursing home. Recording the direct care time, however, provides an important component of both cost estimates for time-dependent reimbursement of nursing activities and for recording the degree of dependency as an outcome measure for the efficiency of new treatment methods for dementia patients. The purpose of this study is thus to develop and validate the "RUD-FOCA" (Resource Utilization in Dementia - Formal Care), based on the RUD lite, as a standardized tool to measure the direct care time actually required in the nursing home.
Based on four hypotheses, construct validity was tested within a randomized controlled trial in a sample of 148 residents in six German nursing homes. The RUD-FOCA records the care time in three areas: activities of daily living (ADL), instrumental activities of daily living (IADL) and supervision. For validation, the residents' capabilities were examined using the Barthel Index, the Nurses' Observation Scale on Geriatric Patients (NOSGER), the Alzheimer Disease Assessment Scale (ADAS), the Erlangen Test on Activities of Daily Living (E-ADL) and the Mini-mental State Examination (MMSE). The hypotheses assume relationships between the time required for care in the three areas and the limitations involved in these areas. The retest reliability was also determined.
ADL care accounts for two-thirds of total care time in the homes. The hypotheses which refer to total time, ADL and supervision are supported by differentiated correlation profiles. The IADL hypothesis is not supported owing to even, low correlations. The retest reliability was r = 0.76 for the entire care time.
Overall time and the times for ADL care and supervision can be considered valid estimates. The validity is lowest for recording IADL times. Thus, the RUD-FOCA is suitable as an instrument to determine the direct care time in the nursing home. Recording IADL times should be improved by detailed operationalization.
目前，在养老院中记录痴呆患者直接护理时间尚无标准化程序。然而，记录直接护理时间是护理活动时间依赖性报销费用估算的重要组成部分，也是记录痴呆患者新治疗方法效率的依赖程度的结果测量的重要组成部分。因此，本研究的目的是基于 RUD lite 开发和验证“RUD-FOCA（痴呆患者资源利用 - 正式护理）”，作为一种标准化工具来测量养老院中实际所需的直接护理时间。
在一项包含六个德国养老院的 148 名居民的随机对照试验中，基于四个假设，测试了结构有效性。RUD-FOCA 记录了三个领域的护理时间：日常生活活动（ADL）、工具性日常生活活动（IADL）和监督。为了验证，使用 Barthel 指数、护士观察老年患者量表（NOSGER）、阿尔茨海默病评估量表（ADAS）、埃尔兰根日常生活活动测试（E-ADL）和简易精神状态检查（MMSE）检查了居民的能力。假设假设了三个护理领域所需的时间与这些领域的限制之间的关系。还确定了重测可靠性。
ADL 护理占家庭总护理时间的三分之二。涉及总时间、ADL 和监督的假设得到了差异化相关分析的支持。由于甚至相关性较低，IADL 假设未得到支持。整个护理时间的重测可靠性为 r = 0.76。
总时间以及 ADL 护理和监督时间可以被认为是有效的估计值。记录 IADL 时间的有效性最低。因此，RUD-FOCA 适合作为确定养老院直接护理时间的工具。记录 IADL 时间需要通过详细的操作化来改进。
