RELIABILITY OF NURSING ASSISTANTS OBSERVATIONS OF FUNCTIONING AND CLINICAL SYMPTOMS AND SIGNS

Simple methods for the early detection of function loss and disease in the elderly were evaluated. Such methods might be used by non-profess ional personnel as case-finding tools for early intervention. The aim of this study was to assess the reliability of functional and clinical data collected by non-professional nursing assistants. The study grou p consisted of sixty elderly short-stay patients in a stable clinical situation, admitted for rehabilitation and aid in a nursing home. Bart hel ADL index items and clinical symptoms and signs were scored by nur sing assistants and nurses (the reference method). Agreement between s cores was assessed by Cohen's kappa statistics and test of marginal ho mogeneity. All the Barthel items and the clinical symptoms and signs h ad fair or better agreement (weighted kappa >0.40). For dressing, chai r-to-bed transfer, ambulation, bathing, paresis and edema, the agreeme nt was strong (weighted kappa >0.75). The reliability of the Barthel s umscores was also acceptable. We concluded that observation of functio ning and clinical symptoms and signs by non-professional nursing assis tants is reliable.