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The Barthel Index in Clinical Practice: Use on a Rehabilitation Ward for Elderly People

Primary activities of daily living (ADL) were monitored weekly in 102 patients admitted to a rehabilitation ward for elderly people using the Barthel index. The three commonest diagnoses were 'stroke', 'fractured neck of femur' and 'dementia recovering from acute illness...

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Autores principales: Stone, S P, Ali, B, Auberleek, I, Thompsell, A, Young, A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Royal College of Physicians of London 1994
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5401036/
https://www.ncbi.nlm.nih.gov/pubmed/7807430
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author Stone, S P
Ali, B
Auberleek, I
Thompsell, A
Young, A
author_facet Stone, S P
Ali, B
Auberleek, I
Thompsell, A
Young, A
author_sort Stone, S P
collection PubMed
description Primary activities of daily living (ADL) were monitored weekly in 102 patients admitted to a rehabilitation ward for elderly people using the Barthel index. The three commonest diagnoses were 'stroke', 'fractured neck of femur' and 'dementia recovering from acute illness'. Multiple disabling diagnoses were common: 60% of patients had dementia and 23% had a live-in carer; mean (median) length of stay in the rehabilitation ward was 98 (62 days). Over 18 months, the weekly assessment of patients in the ward was omitted once. No extra resources were needed. There was a significant rise in Barthel scores between admission to the rehabilitation ward (median Barthel 6) and discharge (median 13) for the group as a whole (median change 6, 95% CI 5–7; p < 0.001) and for each of the three main diagnostic groups. Barthel scores on discharge were significantly lower than in patients discharged from an acute ward for elderly people. Barthel scores and mental test scores (MTS) at discharge were significantly related to destination on discharge, with a characteristic pattern for patients unable to return home and having to be placed in nursing homes (Barthel < 10, MTS < 7). Our experience confirms that routine clinical use of the Barthel in this setting is feasible and responds to clinically important change, at least in group evaluation. It suggests that the Barthel may be useful in outcome measurement, case-mix adjustment and audit of discharge practices.
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spelling pubmed-54010362019-01-22 The Barthel Index in Clinical Practice: Use on a Rehabilitation Ward for Elderly People Stone, S P Ali, B Auberleek, I Thompsell, A Young, A J R Coll Physicians Lond Original Papers Primary activities of daily living (ADL) were monitored weekly in 102 patients admitted to a rehabilitation ward for elderly people using the Barthel index. The three commonest diagnoses were 'stroke', 'fractured neck of femur' and 'dementia recovering from acute illness'. Multiple disabling diagnoses were common: 60% of patients had dementia and 23% had a live-in carer; mean (median) length of stay in the rehabilitation ward was 98 (62 days). Over 18 months, the weekly assessment of patients in the ward was omitted once. No extra resources were needed. There was a significant rise in Barthel scores between admission to the rehabilitation ward (median Barthel 6) and discharge (median 13) for the group as a whole (median change 6, 95% CI 5–7; p < 0.001) and for each of the three main diagnostic groups. Barthel scores on discharge were significantly lower than in patients discharged from an acute ward for elderly people. Barthel scores and mental test scores (MTS) at discharge were significantly related to destination on discharge, with a characteristic pattern for patients unable to return home and having to be placed in nursing homes (Barthel < 10, MTS < 7). Our experience confirms that routine clinical use of the Barthel in this setting is feasible and responds to clinically important change, at least in group evaluation. It suggests that the Barthel may be useful in outcome measurement, case-mix adjustment and audit of discharge practices. Royal College of Physicians of London 1994 /pmc/articles/PMC5401036/ /pubmed/7807430 Text en © Journal of the Royal College of Physicians of London 1994 http://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) , which permits non-commercial use and redistribution provided that the original author and source are credited.
spellingShingle Original Papers
Stone, S P
Ali, B
Auberleek, I
Thompsell, A
Young, A
The Barthel Index in Clinical Practice: Use on a Rehabilitation Ward for Elderly People
title The Barthel Index in Clinical Practice: Use on a Rehabilitation Ward for Elderly People
title_full The Barthel Index in Clinical Practice: Use on a Rehabilitation Ward for Elderly People
title_fullStr The Barthel Index in Clinical Practice: Use on a Rehabilitation Ward for Elderly People
title_full_unstemmed The Barthel Index in Clinical Practice: Use on a Rehabilitation Ward for Elderly People
title_short The Barthel Index in Clinical Practice: Use on a Rehabilitation Ward for Elderly People
title_sort barthel index in clinical practice: use on a rehabilitation ward for elderly people
topic Original Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5401036/
https://www.ncbi.nlm.nih.gov/pubmed/7807430
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