Catherine McAuley School of Nursing and Midwifery, Brookfield Health Science Complex, University College Cork, Ireland.
Appl Nurs Res. 2011 Feb;24(1):e1-7. doi: 10.1016/j.apnr.2009.11.002. Epub 2010 Jan 15.
To ensure accuracy in recording the Barthel Index (BI) in older people, it is essential to determine who is best placed to administer the index. The aim of this study was to compare doctors' and nurses' reliability in scoring the BI.
Sixty-five consecutive patients admitted to an older adult rehabilitation unit were assessed using the BI. Four raters recorded the BI on all patients. BI scores were compared for equivalence on the level of agreement between raters.
Near-perfect correlation in the total scores between raters indicated that the final score is reliable. There was a statistically significant bias by doctors who gave a higher BI score than nurses with a mean difference of 1.2 (95% confidence interval). Nurses demonstrated good and very good agreement on all 10 items, whereas doctors demonstrated good agreement on only 5 items.
The BI is highly reliable when recorded by nurses with low interrater variation, whereas between doctors, there is greater variation. When assessing older adult's activities of daily living, there is greater interrater reliability in the BI score when the patient is observed performing the activities of daily living compared to the self-report method.
为了确保老年人巴氏指数（BI）记录的准确性，确定谁最适合进行指数评估至关重要。本研究旨在比较医生和护士在评分 BI 方面的可靠性。
对 65 名连续入住老年康复病房的患者使用 BI 进行评估。4 名评估者对所有患者记录 BI。比较评估者之间的评分一致性，以确定是否存在等效性。
评分者之间的总分非常接近完全相关，表明最终得分是可靠的。与护士相比，医生的 BI 评分明显偏高，平均差异为 1.2（95%置信区间），存在统计学意义上的偏差。护士在所有 10 个项目上均表现出良好和非常好的一致性，而医生仅在 5 个项目上表现出良好的一致性。
当由护士记录时，BI 具有高度可靠性，评分者之间的差异较小，而医生之间的差异较大。在评估老年人的日常生活活动能力时，与自我报告方法相比，当患者实际进行日常生活活动时，BI 评分的评估者之间的可靠性更高。
