THE EVALUATION OF THE DESIGN AND RELIABIL ITY OF A QUESTIONNAIRE FOR THE DETECTION OF ELDERLY INDIVIDUALS WHO NEED SOCIAL AND HEALTH-CARE SERVICES

BACKGROUND: To assess the construction of a short screening questionna ire designed for the detection of elderly people living in the communi ty and in need of social and health care, and to test the reliability of the scores obtained on the scales of Activities of Daily Living (AD L) and mobility through its application. METHODS: A short screening qu estionnaire of 11 items was designed to score elderly community dwelli ngs on the scales of ADL and mobility of the International Classificat ion of impairments, Disabilities and Handicaps of the WHO (ICIDH). A r andom sample of 1,000 people aged 65 and over from the community of a geographical area of Catalonia (Spain) were interviewed in 1989, eithe r by telephone or in-home personal interview, by non-proffesional trai ned interviewers on the basis of the mentioned schedule, and scored on the ICIDH ADL and Mobility scales. The design of the screening questi onnaire was evaluated on the construction, content and wording through a 16 opinion statements questionnaire upon which 12 professionals, fa miliarized with questionnaire construction, expressed agreement or dis agreement. To test reliability, each interviewer re-scored, one month apart, 20 subjects based on the information they had registered on the questionnaires, and following the same procedure, a gold standard obs erver re-scored all 1,000 interviews. In addition, a number of intervi ews were tape recorded, with previous consent of the subjects, and re- scored by 9 different observers. Interobserver and intraobserver relia bility was measured with Cohen's weighted kappa coefficient. RESULTS: The average time of questionnaire administration was aproximately 10 /- 5 min. Although the instrument was said to be a good tool for the i nterviewer to score the subjects on the scales, wording of some items of the questionnaire need to be reviewed. Both intraobserver and inter observer reliability were high: kappa coefficients of 0.79-0.97 and > 0.75 respectively. CONCLUSION: The use of a simple and reliable ADL an d mobility questionnaire is a practical way to obtain information on t he functional status of elderly people living at home, and to select e lderly people for a further comprehensive assesment of their social an d health care needs for planning the appropriate services in the commu nity.