Development of multi-disciplinary team I-ADL assessment in community health care: an interrater reliability study of the measure of instrumental daily activity

This paper describes a development process concerning the active involvemen t of staff of different professions in developing and implementing methods for assessment of activities of daily living (ADL) in home-based geriatric rehabilitation. Although a variety of established ADL instruments exist, at the time for this study no I-ADL (Instrumental Activities of Daily Living) instrument suitable for communication among staff members of different pro fessions was available. The specific aim was to test a new I-ADL instrument for interrater reliability. The developmental process resulting in the Mea sure of Instrumental Daily Activity (MIDA) is described. The instrument com prises 12 I-ADL items, defined on the basis of practical home rehabilitatio n experience. The study involved 36 clients with impairments, aged 65 + yea rs. Multi-disciplinary interrater reliability was tested by 67 parallel ind ependent assessments during a 3-month period, performed by pairs of raters of different professions. Overall agreement was very good (mean weighted ka ppa = 0.89). The MIDA fulfils the basic requirements necessary for valid I- ADL assessment of elderly clients in community health care. An important qu ality is the active involvement of all staff in the assessment procedure, f acilitating and stimulating the implementation of a general rehabilitative attitude in everyday practice. (C) 1999 Published by Elsevier Science Irela nd Ltd. All rights reserved.