Interrater-Reliabilität und Übereinstimmung der Schweizer RAI-MDS Version 2.0

Abstract

Numerous studies have been performed to assess the validity and reliability of the Minimum Data Set (MDS) of the Resident Assessment Instrument (RAI), which was developed and initially implemented in the United States. In general, RAI-MDS 2.0 has been reported to have moderate to high interrater reliability. From the late 1990s onwards the geriatric nursing assessment has been used in nursing homes in Switzerland. The objective of this study was to examine interrater agreement and reliability of the Swiss version of RAI-MDS 2.0 for the first time. For this purpose, 61 nursing home residents were independently assessed by two assessors. The MDS coordinator of the nursing home and an extern expert conducted independent resident assessments by reviewing the chart and asking front line staff about the residents' behaviour. Proportions of exact agreement were calculated and interrater reliability was assessed using kappa and intraclass correlation (ICC) coefficients. For most of the checked items, a high agreement between the two raters was observed. The reliability coefficients for 47 % of the items reached values between 0,81 and 1,0. 29 % of the items achieved values between 0,61 and 0,80. The values of 10 % of the items ranged between 0,41 and 0,60. Two items assessing skin condition obtained a value of 0,25 and 0, respectively. The results of the reliability analysis show that mainly items evaluating pain, mood and behavior, and some items estimating physical function and skin condition are less reliable.