Abstract
Background: We examined the agreement over time of the physical functioning domains of the Resident Assessment Instrument: Minimum Data Set Version 2.0 (RAI-MDS) and the Functional Independence Measure (FIM) in nursing home residents with dementia. Methods: We completed a secondary analysis of data from a longitudinal quasi-experimental study of residents who could transfer independently or with the assistance of one person. FIM assessments were completed at up to three time points by researchers using interviews. RAI-MDS assessments, completed by nursing home staff, were matched to the FIM assessment by nearest time. FIM and RAI-MDS assessments were correlated based on time between assessments using Pearson’s correlation. Items for activities of daily living (ADL) from the RAI-MDS were rescaled using two previously published crosswalks. Motor and ADL subscales were also used, containing eight and six items, respectively. Results: A total of 362 paired interviews and assessments were collected from 130 residents. The mean scores and standard deviations were as follows: FIM: 19.64 (7.60); William’s RAI-MDS crosswalk: 18.04 (5.25); and Velozo’s RAI-MDS crosswalk: 18.09 (6.50). Using both crosswalks, most items showed medium (r > 0.3) or large (r > 0.5) correlations, even at greater than 41 days between assessments. Subscales showed large correlations for all time intervals for both crosswalks. Conclusions: The RAI-MDS remains stable when data are collected greater than 41 days from the FIM assessment. These findings should add confidence in the RAI-MDS data and its clinical utility.
Highlights
Clinicians and administrators in nursing homes often rely on data collected on the functional status of residents to inform decisions to improve the quality of life of residents and to facilitate quality improvement initiatives
Because dependency in activities of daily living (ADL) is proportional to the amount of support required, it is important for administrators to have accurate data on the ADL of nursing home residents with dementia
Using secondary data gathered from the CIHR-funded MOVE study, described below [8], this study examined the correlation of individual RAI-MDS 2.0 and Functional Independence Measure (FIM) data elements as well as Motor and ADL subscales created by Williams [7] at three time points, and compared these correlations by time between assessments
Summary
Clinicians and administrators in nursing homes often rely on data collected on the functional status of residents to inform decisions to improve the quality of life of residents and to facilitate quality improvement initiatives. The Resident Assessment Instrument: Minimum Data Set Version 2.0. (RAI-MDS 2.0) is a standardized instrument for data collection used internationally in nursing homes for care planning, reimbursement and quality monitoring [1] and contains over 300 items related to function, cognition and behaviour. Data collected from residents in a nursing home can be aggregated to provide quality indicators about the care provided at the individual and facility levels and some researchers have used the RAI-MDS 2.0 to derive such indicators [2,3]. We examined the agreement over time of the physical functioning domains of the Resident Assessment Instrument: Minimum Data Set Version 2.0 (RAI-MDS).
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