Agreement between observations on the functional capacity of home care elderly patients

Abstract

OBJECTIVE: To assess the agreement between measures of caregiver's perception and health provider's direct observation of performance in daily living activities among home care elderly patients. METHODS: Performance observations were carried out among 40 elderly patients and their respective caregivers were interviewed. During home visits, data on caregiver's perception were collected by an independent observer using the Functional Independence Measure (FIM) instrument. Health providers evaluated elderly patients on their functional capacity in six dimensions: self-care, sphincter control, mobility, walking, communication and social cognitive skills. RESULTS: Intraclass correlation coefficient (ICC) showed an excellent agreement in all dimensions and the highest total FIM score was 0.95. Only the dimensions self-care and mobility showed a bias error between measures (signal test: p<0.001). Bias errors were not found when Bland-Altman graphic was applied. CONCLUSIONS: The agreement between health provider's and caregiver's measures demonstrated a good interaction between program team and caregivers, which is of great importance on evaluating and treating elderly patients. The results also suggest that when a valid and reliable instrument such as FIM is used, there is a high reproducibility of measures, even for different types of evaluations.