This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Chen, M.-H. Articles by Huang, S.-L. Search for Related Content PubMed PubMed Citation Articles by Chen, M.-H. Articles by Huang, S.-L. Pubmed/NCBI databases Medline Plus Health Information Caregivers Stroke Social Bookmarking                   What's this?

Differences between patient and proxy reports in the assessment of disability after stroke

School of Occupational Therapy, College of Medicine, National Taiwan University, 4F., No.17, XuZhou Rd. Taipei 100, Taiwan, ROC

Ching-Lin Hsieh

School of Occupational Therapy, College of Medicine, National Taiwan University, 4F., No.17, XuZhou Rd. Taipei 100, Taiwan, ROC

Hui-Fen Mao

School of Occupational Therapy, College of Medicine, National Taiwan University, 4F., No.17, XuZhou Rd. Taipei 100, Taiwan, ROC

Sheau-Ling Huang

School of Occupational Therapy, College of Medicine, National Taiwan University, 4F., No.17, XuZhou Rd. Taipei 100, Taiwan, ROC,cathy{at}ntu.edu.tw

Objective : To determine whether the assessment of disability level including basic activities of daily living (ADL) and instrumental ADL varies between patients' and proxy respondents' reports, and to explore the factors influencing proxy agreement.

Design : Patient—proxy agreement study.

Setting : Hospital settings.

Subjects : Fifty-two stroke patients with mild or without cognitive impairments and their primary caregivers voluntarily participated in this study.

Main measures : The self-administered versions of the Barthel Index and Frenchay Activities Index were completed by the patients and their proxy respondents concurrently, yet separately, to assess the level of disability.

Results : The proxy agreement on total scores of the self-administered Barthel Index and self-administered Frenchay Activities Index demonstrated moderate to good agreement (self-administered Barthel Index: intraclass correlation coefficient (ICC) = 0.71; self-administered Frenchay Activities Index: ICC = 0.6). There were no significant differences between patient and proxy reports on self-administered Barthel Index and self-administered Frenchay Activities Index scores (paired

t = —0.22, P = 0.83; paired t = 0.88, P = 0.39, respectively). However, limits of agreement of patient and proxy reports on the self-administered Barthel Index and self-administered Frenchay Activities Index were notable. Stepwise regression analysis found no significant variables associated with proxy agreement.

Conclusions : These results indicate that it is appropriate for research purposes, but not appropriate for clinical usage, to use proxy reports to measure disability levels in patients with stroke. Furthermore, the two methods should not be used interchangeably to monitor patients because of the wide limits of agreement between patient and proxy reports on the self-administered Barthel Index and self-administered Frenchay Activities Index.

Clinical Rehabilitation, Vol. 21, No. 4, 351-356 (2007)
DOI: 10.1177/0269215507072544


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?