Comparison between subjective and objective evaluations of self-care performance in elderly inpatients

ABSTRACT Objetive To identify the functional status in self-care performance of elderly inpatients, through subjective and objective evaluations. Methods Fifty-five pairs of elderly and their respective caregivers of both sexes were submitted to subjective (self-rating and rating by caregivers) and objective assessment. The Performance Test of Activities of Daily Living and items in the Instrumental Activities of Daily Living scale were used. Functional status was rated 1 (unable to perform task), 2 (able to perform task with assistance) or 3 (able to perform task unassisted). The agreement rate among different self-rating and rating by caregivers, and objective assessment was calculated by dividing the number of identical responses by the total. Results Most elderly patients and caregivers were women (58.2% and 83.6%, respectively). The mean age was 80 years for elderly patients and 58.7 years for caregivers. Low schooling levels (1 to 4 years) prevailed among elderly patients (65.4%), while caregivers often had complete high education (32.7%). Functional status (FN=1, 2 and 3) varied between tasks, and the agreement rate between assessment methods ranged from 58 to 98.1%, particularly in comparisons involving objective assessment. Conclusion Self-reported data and data contributed by caregivers must be compared with performance data collected via objective assessment for a reliable appreciation of the true functional status of older adults.摘要 研究目的：通过主观与客观评估，明确老年住院患者的自我照护功能状态。 方法：招募55对不同性别的老年住院患者及其各自照护者，分别采用主观评估（包括患者自评与照护者他评）与客观评估方式。本研究采用日常生活活动能力评定量表（Performance Test of Activities of Daily Living）及工具性日常生活活动能力量表（Instrumental Activities of Daily Living）的相关条目进行测评。功能状态评分标准为：1分（无法完成任务）、2分（需协助方可完成任务）、3分（可独立完成任务）。以一致应答数占总应答数的比例，计算不同自评、他评及客观评估方式之间的一致性率。 结果：多数老年患者及照护者为女性（占比分别为58.2%与83.6%）。老年患者的平均年龄为80岁，照护者的平均年龄为58.7岁。65.4%的老年患者受教育年限为1~4年，属于低学历群体，而32.7%的照护者完成了高等教育。不同任务的功能状态评分存在差异，不同评估方式间的一致性率介于58.0%~98.1%之间，尤其在与客观评估的对比中一致性表现更佳。 结论：若要准确评估老年群体真实的功能状态，需将患者自评数据、照护者提供的他评数据与通过客观评估获取的行为表现数据进行对比分析。