Gattinger Heidrun, Ott Stefan, Saxer Susi
Institut für Angewandte Pflegewissenschaft, FHS St. Gallen Hochschule für Angewandte Wissenschaften, St. Gallen.
Dozent für Wirtschaftsmathematik und Statistik, FHS St. Gallen Hochschule für Angewandte Wissenschaften, St. Gallen.
Pflege. 2014 Feb;27(1):19-29. doi: 10.1024/1012-5302/a000336.
Numerous studies have been performed to assess the validity and reliability of the Minimum Data Set (MDS) of the Resident Assessment Instrument (RAI), which was developed and initially implemented in the United States. In general, RAI-MDS 2.0 has been reported to have moderate to high interrater reliability. From the late 1990s onwards the geriatric nursing assessment has been used in nursing homes in Switzerland. The objective of this study was to examine interrater agreement and reliability of the Swiss version of RAI-MDS 2.0 for the first time. For this purpose, 61 nursing home residents were independently assessed by two assessors. The MDS coordinator of the nursing home and an extern expert conducted independent resident assessments by reviewing the chart and asking front line staff about the residents' behaviour. Proportions of exact agreement were calculated and interrater reliability was assessed using kappa and intraclass correlation (ICC) coefficients. For most of the checked items, a high agreement between the two raters was observed. The reliability coefficients for 47 % of the items reached values between 0,81 and 1,0. 29 % of the items achieved values between 0,61 and 0,80. The values of 10 % of the items ranged between 0,41 and 0,60. Two items assessing skin condition obtained a value of 0,25 and 0, respectively. The results of the reliability analysis show that mainly items evaluating pain, mood and behavior, and some items estimating physical function and skin condition are less reliable.
已经开展了大量研究来评估居民评估工具(RAI)的最小数据集(MDS)的有效性和可靠性,该数据集是在美国开发并首次实施的。总体而言,据报道RAI-MDS 2.0具有中等至高的评估者间信度。从20世纪90年代末起,老年护理评估就在瑞士的养老院中使用。本研究的目的是首次检验瑞士版RAI-MDS 2.0的评估者间一致性和信度。为此,由两名评估者对61名养老院居民进行独立评估。养老院的MDS协调员和一名外部专家通过查阅病历并询问一线工作人员关于居民的行为来进行独立的居民评估。计算完全一致的比例,并使用kappa系数和组内相关系数(ICC)评估评估者间信度。对于大多数检查项目,观察到两名评估者之间有高度一致性。47%的项目的信度系数达到0.81至1.0之间的值。29%的项目的值在0.61至0.80之间。10%的项目的值在0.41至0.60之间。两项评估皮肤状况的项目分别获得了0.25和0的值。信度分析结果表明,主要是评估疼痛、情绪和行为的项目,以及一些评估身体功能和皮肤状况的项目信度较低。