Original investigation
Published: 2017-09-15

Use of the Barthel Index, mini mental status examination and discharge status to evaluate a special dementia care unit

Department of Statistics and Standardised Methods in Nursing Science, Vallendar University of Philosophy and Theology (PTHV), Faculty of Nursing Science, Germany
Malteser Hospital, St. Hildegard, Cologne, Germany
Special Dementia Care Unit, Malteser Hospital, St. Hildegard, Cologne, Germany
German Institute of Applied Nursing Research, Cologne, Germany
German Institute of Applied Nursing Research, Cologne, Germany
Special Dementia Care Unit Evaluation Classification of Dementia Patients Measurement, Barthel- Index MMSE

Abstract

Background: when dementia patients are grouped according to their ordinal Barthel Index and Mini Mental
Status Examination sum scores, it is not clear which portions of the data should be used when valid classifications
are developed. Criteria used for classification of patients must be stochastically independent.
Objectives: the relationship between Barthel-Index, Mini-Mental State Examination sum scores and discharge
status was investigated to develop subgroups of dementia patients. The developed classification uses stochastically
independent information and can be used to evaluate special care units.
Methods: we used an unrestricted partial credit model to assess the possible scores on the Barthel-Index. We
investigated the individual effects of items on the Barthel sum score by using non-parametric conditional-inference-
regression trees. The relationships between Barthel score, Mini Mental Status score, and discharge status,
in terms of classifying the dementia patients into subgroups, were investigated using a latent class analysis.
Results: an interval scale Barthel-Index did not yield a significant improvement versus the ordinal Barthel-Index
sum score. Differences in Barthel-Index were meaningful only in the context of three groups using four items.
A classification of dementia patients in latent classes could be developed using three Barthel – and Mini Mental
Status-Groups and the discharge status of patients who were living at home before admission. Three Barthel
– and Mini Mental Status Groups can be combined with the discharge status of those patients who live at
home before admission. A combination of a high Barthel – with a low Mini-Mental-Status-group has the highest
probability to live no longer at home after discharge.
Discussion: the relative frequency of living at home after discharge in different Barthel and Mini Mental Status
subgroups could be compared between different acute hospitals as an indicator of service quality for dementia
patients. A high risk group is identified by a combination of a high Barthel- and a low Mini Mental Status
Examination Group.

Affiliations

A. Brühl

Department of Statistics and Standardised Methods in Nursing Science, Vallendar University of Philosophy and Theology (PTHV), Faculty of Nursing Science, Germany

J. Hoffmann

Malteser Hospital, St. Hildegard, Cologne, Germany

U. Sottong

Special Dementia Care Unit, Malteser Hospital, St. Hildegard, Cologne, Germany

M. Isfort

German Institute of Applied Nursing Research, Cologne, Germany

D. Tucman

German Institute of Applied Nursing Research, Cologne, Germany

Copyright

© Società Italiana di Gerontologia e Geriatria (SIGG) , 2017

How to Cite

[1]
Brühl, A., Hoffmann, J., Sottong, U., Isfort, M. and Tucman, D. 2017. Use of the Barthel Index, mini mental status examination and discharge status to evaluate a special dementia care unit. JOURNAL OF GERONTOLOGY AND GERIATRICS. 65, 3 (Sep. 2017), 144-149.
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