居民评估工具最低数据集中口腔/牙科项目的评定者间信度和同时效度 2.0。

Interrater reliability and concurrent validity of oral/dental items in the resident assessment instrument minimum data set 2.0.

机构信息

Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.

Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

出版信息

Gerodontology. 2021 Mar;38(1):66-81. doi: 10.1111/ger.12493. Epub 2020 Oct 20.

DOI:10.1111/ger.12493

PMID:33084126

Abstract

OBJECTIVE

To examine interrater reliability and concurrent validity of oral/dental items in the Resident Assessment Instrument Minimum Data Set (RAI-MDS) 2.0.

BACKGROUND

RAI-MDS is a standardised instrument used in nursing to determine health status and nursing needs. The extent to which oral/dental items in the RAI-MDS describe dental treatment needs concerning oral health has been questioned.

MATERIALS AND METHODS

This study evaluated the interrater reliability (dentist vs. nurse) and validity of oral/dental items in the Swiss version of RAI-MDS 2.0 (areas: K-nutritional status, L-oral/dental status) using professional oral examinations as a benchmark. Data of 168 residents of five long-term care facilities in the canton of Zurich, Switzerland, were collected within 1 year between October 2017 and December 2018. The statistical evaluation used descriptive statistics and Cohen's kappa (95% CI).

RESULTS

RAI-MDS items K1a, chewing (κ 0.098, 95% CI: 0.004-0.19); K1c, pain (κ 0.039, 95% CI: -0.03 to 0.11); L1a, debris (κ 0.117, 95% CI: 0.02-0.21); L1c, dental status (κ 0.229, 95% CI: 0.12-0.34); L1d, dental disease (κ 0.129, 95% CI: 0.02-0.24); L1e, periodontal diseases (κ -0.005, 95% CI: -0.07 to -0.03); and L1f, daily cleaning (κ -0.031, 95% CI: -0.05 to -0.01) showed weak or no agreement, whereas L1b, denture status (κ 0.634, 95% CI: 0.52-0.75), showed substantial agreement.

CONCLUSION

Oral/dental items in RAI-MDS lack reliability and validity. Recognition of oral health situation/treatment needs by nursing staff does not seem to be possible with the current version of this tool.

摘要

目的

检验 Resident Assessment Instrument Minimum Data Set（RAI-MDS）2.0 中口腔/牙科项目的评分者间信度和同时效度。

背景

RAI-MDS 是一种用于护理的标准化工具，用于确定健康状况和护理需求。RAI-MDS 中的口腔/牙科项目在多大程度上描述了与口腔健康相关的牙科治疗需求一直存在争议。

材料与方法

本研究使用专业口腔检查作为基准，评估了瑞士版 RAI-MDS 2.0（领域：K-营养状况、L-口腔/牙科状况）中口腔/牙科项目的评分者间信度（牙医与护士）和效度。2017 年 10 月至 2018 年 12 月，在瑞士苏黎世州的 5 家长期护理机构中，对 168 名居民进行了为期 1 年的数据收集。统计评估使用描述性统计和 Cohen's kappa（95%CI）。

结果

RAI-MDS 项目 K1a，咀嚼（κ 0.098，95%CI：0.004-0.19）；K1c，疼痛（κ 0.039，95%CI：-0.03 至 0.11）；L1a，残渣（κ 0.117，95%CI：0.02-0.21）；L1c，牙齿状况（κ 0.229，95%CI：0.12-0.34）；L1d，牙齿疾病（κ 0.129，95%CI：0.02-0.24）；L1e，牙周疾病（κ -0.005，95%CI：-0.07 至 -0.03）；L1f，日常清洁（κ -0.031，95%CI：-0.05 至 -0.01）显示出较弱或没有一致性，而 L1b，义齿状况（κ 0.634，95%CI：0.52-0.75）显示出实质性一致性。