Measurement of function in older adults transitioning from hospital to home: an integrative review.
Daniel Liebzeit, Barbara King, Lisa Bratzke
PMID 29249631WHAT IT FOUND
Function scales used after hospital discharge were mostly built for observation, but studies often asked patients by telephone.
Patients reported better function than nurses or proxies, so self-report scores may not match observed ability.
Key findings
01The review included 40 eligible publications and identified the Katz ADL, Barthel Index, Lawton and Brody IADL, and ADL Summary Scale as instruments used to measure function in older adults moving from hospital to home.
02The Katz ADL was usually given by self-report or telephone after discharge, but validity testing for the original instrument was only for nurse observation.
03Patients reported better function than their nurses or proxies on the Katz ADL and Lawton and Brody IADL.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The search may have missed studies because function is described with many different terms. It looked only at hospital to home, not to subacute or long-term care, so it may not apply to those transitions. It reviewed research instruments, not clinical use, so it does not tell you how to use them in practice. Many included studies used modified instruments with little or no testing of those modifications. Most evidence was about observation-based scoring, not self-report, and self-report validity was limited.
Declared interests
The publication types list NIH extramural research support. No author conflict-of-interest statement was included in the supplied text.
The easy way to misread this
Do not conclude that these instruments are validated for self-report after discharge. The review found limited self-report validity and little evidence that they can detect real change over time.