Krupp Sonja, Schöne Feliza, Balck Friedrich, Hofmann Werner, Willkomm Martin, Kasper Jennifer
Forschungsgruppe Geriatrie Lübeck, Krankenhaus Rotes Kreuz Lübeck - Geriatriezentrum, Marlistraße 10, 23566, Lübeck, Deutschland.
Abteilung Psychosoziale Medizin und Entwicklungsneurowissenschaften, Med. Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland.
Z Gerontol Geriatr. 2022 Mar;55(2):99-104. doi: 10.1007/s00391-022-02041-7. Epub 2022 Feb 21.
Independence in activities of daily living depends to a large extent on the upper extremities; however, the instruments widely used in geriatrics to assess self-care abilities do not allow a focus on this body region. In order to map the fluctuating course of hand function-dependent daily living skills with a self-assessment instrument, rheumatologists have developed the Duruöz Hand Index (DHI).
The German translation authorized by Duruöz was tested for its applicability in the assessment of geriatric outpatient and day hospital patients and test quality criteria were determined.
Study participants completed the DHI three times. A postgraduate student blinded to the results performed an anamnesis and examination. The geriatric team made an inter-professional assessment of hand function-related daily living skills twice with at least 2‑week intervals.
Data collection was performed from 16 November 2016 to 27 April 2017 on 101 geriatric day hospital or outpatient patients. Retest reliability was high (0.937), as was internal consistency (Cronbach's α 0.949). Difficulty with activities of daily living correlated more closely with joint mobility (Keitel Index) and fine motor skills (20 cents test) than with hand strength.
The DHI provides a survey of difficulties with activities of daily living that is focused on the upper extremities. Because about one in three patients required assistance (answering follow-up questions, reading aloud) despite the exclusion of patients with more severely impaired cognition and vision, the examiner should remain present.
日常生活活动的独立性在很大程度上取决于上肢;然而,老年医学中广泛用于评估自我护理能力的工具无法聚焦于这一身体部位。为了用一种自我评估工具描绘依赖手部功能的日常生活技能的波动过程,风湿病学家开发了杜罗兹手部指数(DHI)。
对经杜罗兹授权的德语翻译版本在老年门诊患者和日间医院患者评估中的适用性进行测试,并确定测试质量标准。
研究参与者三次完成DHI评估。一名对结果不知情的研究生进行病史采集和检查。老年医学团队对与手部功能相关的日常生活技能进行了两次跨专业评估,间隔至少2周。
2016年11月16日至2017年4月27日,对101名老年日间医院或门诊患者进行了数据收集。重测信度较高(0.937),内部一致性也较高(Cronbach's α 0.949)。日常生活活动困难与关节活动度(凯特尔指数)和精细运动技能(20分测试)的相关性比与手部力量的相关性更密切。
DHI提供了一项聚焦于上肢的日常生活活动困难情况调查。由于尽管排除了认知和视力受损更严重的患者,但仍约有三分之一的患者需要协助(回答后续问题、大声朗读),因此检查人员应始终在场。