Rudman D, McCormack J, Cuisinier M, Mattson D E
Department of Medicine, Medical College of Wisconsin, Milwaukee.
Am J Phys Med Rehabil. 1993 Oct;72(5):276-80. doi: 10.1097/00002060-199310000-00005.
This report describes a simple method to quantify changes in the activities of daily living (ADLs) over a 6-month time period in long-stay VA nursing home populations. In these institutions, each resident receives a score of one to five every 6 months describing the degree of dependence in eating, mobility, transfer and toileting ("patient assessment instrument" or PAI). From these data, quantitative indicators can be calculated for the studied population: the average score for each ADL at the beginning and end of the period, and the average 6-month change in this score; the proportions of all residents whose ADL score improved, remained unchanged or worsened; the proportion of initially independent residents whose ADL score worsened, and the proportion of initially dependent residents whose score improved. The method was applied in two VA nursing homes (A and B). The profiles of ADL outcomes in the two nursing homes differed in several respects. For example, in nursing home A, 80% or more of the population either remained unchanged or improved in ADLs and only 2 to 18% deteriorated. In nursing home B, on the other hand, only 50 to 60% of the population remained unchanged or improved and 36 to 50% deteriorated. For the initially independent residents, the frequency of deterioration of ADLs in nursing home B was several times greater than that in nursing home A. The described method of quantifying ADL outcomes could readily be applied to the PAI data that are available in all VA nursing homes.(ABSTRACT TRUNCATED AT 250 WORDS)
本报告描述了一种简单方法，用于量化长期入住退伍军人事务部（VA）疗养院的人群在6个月时间内日常生活活动（ADL）的变化。在这些机构中，每位居民每6个月会得到一个1至5分的评分，描述其在进食、行动、转移和如厕方面的依赖程度（“患者评估工具”或PAI）。根据这些数据，可以为研究人群计算定量指标：该时间段开始和结束时每项ADL的平均评分，以及该评分的平均6个月变化；ADL评分改善、保持不变或恶化的所有居民的比例；初始独立居民中ADL评分恶化的比例，以及初始依赖居民中评分改善的比例。该方法应用于两家VA疗养院（A和B）。两家疗养院的ADL结果概况在几个方面有所不同。例如，在疗养院A中，80%或更多的居民ADL保持不变或有所改善，只有2%至18%的居民恶化。另一方面，在疗养院B中，只有50%至60%的居民保持不变或有所改善，36%至50%的居民恶化。对于初始独立居民，疗养院B中ADL恶化的频率比疗养院A高几倍。所描述的量化ADL结果的方法可以很容易地应用于所有VA疗养院都有的PAI数据。（摘要截选至250字）
