Travis S S, McAuley W J
Family and Child Development, Virginia Polytechnic Institute and State University, Blacksburg 24061.
Health Serv Res. 1990 Jun;25(2):349-60.
General acceptance of a patterned progression of dependency in activities of daily living has led to the widespread practice of simply counting the individual's basic ADL dependencies to reflect his or her self-care needs and level of impairment. This method is convenient, and it is practical to the extent that individuals do fit a scaled pattern of dependency that allows some meaningful comparison among individuals and between groups to be made. This research, based on 3,611 Medicaid cases in Virginia, reports that 36 percent of those individuals screened for nursing home admission do not match a commonly accepted pattern of dependency. The analyses include a logistic regression procedure to explain the characteristics of the "ADL divergent" cases and a Guttman scaling procedure on the ADL data for the sample. Results of the analyses indicate that a Guttman scaling procedure does as well as, but not better than, the original Katz ADL scale, with both scales describing approximately two-thirds of the cases in the sample.
日常生活活动中依赖模式的逐步发展得到普遍认可，这导致了一种广泛的做法，即简单地计算个体在基本日常生活活动中的依赖程度，以反映其自我护理需求和受损程度。这种方法很方便，而且在个体确实符合某种依赖程度的分级模式，从而能够在个体之间以及群体之间进行有意义的比较时，它是切实可行的。这项基于弗吉尼亚州3611例医疗补助案例的研究报告称，在筛选进入养老院的个体中，有36%不符合普遍认可的依赖模式。分析包括一个逻辑回归程序，以解释“日常生活活动差异”案例的特征，以及对样本的日常生活活动数据进行古特曼量表分析。分析结果表明，古特曼量表分析的效果与原始的卡茨日常生活活动量表相当，但并不比其更好，两种量表都描述了样本中约三分之二的案例。
