Reliability of a geriatric assessment instrument with illustrations

Abstract

Background: The Typology of the Aged with Illustrations is a four‐scale geriatric assessment measure of elderly function and activity of daily living. Illustrations are incorporated to facilitate the understanding of elderly function and activity status. The purpose of the study was to test the reliability and validity of the instrument and the effectiveness of the illustrations in improving performance.Methods: Reliability of the typology was investigated using the test–retest procedure, with a sample of 240 elderly persons. The effectiveness of the illustrations was measured, using the instrument with and without the illustrations, by kappa statistics and the χ2 test. The results were stratified to assess differences in reliability between experienced and nonexperienced evaluators, and for elderly persons in residential institutions compared with day care facilities. Both constructive and concurrent validities were also evaluated.Results: The intra‐rater reliability (re‐assessment by the same evaluator 1 week later) of the instrument was increased significantly on all four scales (average kappa statistics: 0.82 with illustrations, 0.65 without illustrations) with the inclusion of illustrations vs no illustrations, and the inter‐rater reliability (re‐assessment by a second evaluator within 24 hours) was significantly increased for the mobility and eating scales. There was no difference in reliability for experienced and inexperienced evaluators, or for different care situations.Conclusion: The inclusion of illustrations in the instrument facilitated the understanding of elderly persons’ activity of daily living and increased its reliability. This instrument has wide applicability and can be used for communication between health care professionals and for on‐the‐job training in geriatric functional assessment.