Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, 1401, 18e rue, H-610, Québec, G1J 1Z4, QC, Canada.
VITAM - Centre de recherche en santé durable, Québec, QC, Canada.
CJEM. 2021 May;23(3):337-341. doi: 10.1007/s43678-020-00073-9. Epub 2021 Feb 11.
To assess the inter-rater reliability and feasibility of the self-assessed Older Americans Resources and Services scale compared to its administration by a research assistant in older Emergency Department (ED) patients.
This is a planned sub-analysis of a single-center randomized cross-over pilot study. A convenience sample of ED patients aged ≥ 65 was constituted at the CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus) between 2018/05 and 2018/07. Research assistants assessed participants' functional status using the Older Americans Resources and Services scale and patients self-assessed using a modified Older Americans Resources and Services scale. Test administration order was randomized. The main outcome, inter-rater reliability, was measured using intraclass correlation (ICC). Feasibility was measured using self-assessment completion rate.
67 patients were included and 60 completed self-assessment. Mean age was 74.4 ± 7.6 and 34 (56.7%) participants were women. Mean research assistant-assessed Older Americans Resources and Services scale score was 25.1 ± 3.3, while mean self-assessed Older Americans Resources and Services scale score was 26.4 ± 2.5 [ICC: 0.8 (95% CI: 0.7-0.9)]. Mean activities of daily living scores were 12.5 ± 1.8 for research assistant assessment and 13.5 ± 0.9 for self-assessment [ICC: 0.6 (95% CI: 0.4-0.7)]. Mean instrumental activities of daily living scores were 12.6 ± 1.8 and 12.9 ± 1.8 for research assistant assessment and self-assessment, respectively [ICC: 0.9 (95% CI: 0.8-0.9)].
Our results indicate that self-assessment of functional status by older ED patients is feasible, and good-to-moderate inter-rater reliability results were obtained. A self-assessed score may identify patients in need of further geriatric/functional assessment who may otherwise have been left unscreened.
评估老年人资源和服务自我评估量表（OARS）与由研究助理评估相比的在老年急诊科（ED）患者中的评估者间信度和可行性。
这是一项单中心随机交叉试验的计划子分析。2018 年 5 月至 2018 年 7 月，在魁北克大学拉瓦尔分校的魁北克大学健康中心（耶稣儿童医院）组成了一个便利的 ED 患者样本，年龄≥65 岁。研究助理使用老年人资源和服务量表评估参与者的功能状态，患者使用改良的老年人资源和服务量表进行自我评估。测试管理顺序是随机的。主要结局，评估者间信度，使用组内相关系数（ICC）进行测量。可行性使用自我评估完成率进行测量。
纳入 67 例患者，60 例完成自我评估。平均年龄为 74.4±7.6 岁，34 例（56.7%）患者为女性。研究助理评估的老年人资源和服务量表平均得分为 25.1±3.3，而自我评估的老年人资源和服务量表平均得分为 26.4±2.5[ICC：0.8（95%CI：0.7-0.9）]。研究助理评估的日常生活活动得分为 12.5±1.8，自我评估的得分为 13.5±0.9[ICC：0.6（95%CI：0.4-0.7）]。研究助理评估和自我评估的工具性日常生活活动评分分别为 12.6±1.8 和 12.9±1.8[ICC：0.9（95%CI：0.8-0.9）]。
我们的结果表明，老年 ED 患者的自我评估功能状态是可行的，并且获得了良好到中度的评估者间信度结果。自我评估得分可能可以识别出需要进一步进行老年/功能评估的患者，否则这些患者可能会被遗漏。
