Barthel指数评估老年髋部骨折患者生活自理能力

Barthel index in assessment of daily Living ability of elderly patients with hip fracture

目的检验Barthel指数在老年髋部骨折患者术后生活自理能力评估中的可靠性。方法纳入2019-08至2020-05在武警特色医学中心骨科住院的老年髋部骨折患者52例,参与Barthel指数评估的护理人员分为ABC三组,每组均含接受过培训与未接受培训的护理人员各1名。术后1周随机抽取1个护理小组对患者进行评估,组内护士需在4 h内分别完成患者的Barthel指数评估。使用组内相关系数对Barthel指数的观察者间信度(Inter-observer reliability)进行评价。结果老年髋部骨折患者术后1周的Barthel指数评分总体均值为42.72±5.13,各组内比较差异无统计学意义(P>0.05);所有患者在术后1周时均未达到轻度依赖及以上水平(>60分),各组内重度依赖及中度依赖的构成比差异无统计学意义(P>0.05);“上下楼梯”“洗澡”“进食”为所有入组患者的一致性判断条目,可能与髋部骨折的病种特点有关;三组组内相关系数均大于0.90(ICC_(A组)=0.903,ICC_(B组)=0.957,ICC_(C组)=0.905),表明各评估者间的评分一致性良好。结论使用Barthel指数评估老年髋部骨折患者生活自理能力具有较高的可靠性并较少受到个体差异影响。

Objective To assess the reliability of Barthel index(BI)in the assessment of daily living ability of elderly patients with hip fracture.Methods A total of 52 elderly patients with hip fracture from August 2019 to May 2020 were included.The nurses were divided into ABC groups,each group containing one trained and one untrained nursing staff.At 1 week postoperatively,one nursing team was randomly selected to evaluate the patients,and the nurses in the group were required to complete the Barthel index assessment within 4 hours for each patient.The intraclass correlation coefficient(ICC)was used to evaluate the inter observer reliability of the Barthel index.Results The overall mean of the BI at 1 week after surgery was 42.72±5.13,and there was no statistical difference within each group(P>0.05).All patients did not reach the level of mild dependence and above(>60 points)at 1 week after surgery,and there was no statistical difference in the proportions of the level of heavy/moderate dependence within each group(P>0.05)."Stairs","Bathing",and"Feeding"were the consistent judgment items for all the enrolled patients,which might be related with the characteristics of hip fractures.The intraclass correlation coefficients of the 3 groups were all greater than 0.90(ICC_(Group1)=0.903,ICC_(Group2)=0.957,ICC_(Group3)=0.905).The results showed that the inter-rater reliability of BI was sufficient.Conclusions The Barthel index is reliable in measuring the daily living ability of elderly patients with hip fractures.