Refine
Year of publication
- 2011 (2)
Document Type
Language
- English (2)
Keywords
- Dependency Scale (2) (remove)
Institute
Objective: The aim of this study is to compare the responsiveness of the Care Dependency Scale for Rehabilitation (CDS-R) and the Barthel Index in rehabilitation. Design: A longitudinal study was performed over six months (2007–8) where patients were assessed using the scales after admission and before discharge. Setting and subjects: A convenience sample of 1,542 patients was recruited in an Austrian rehabilitation centre. Measures: The CDS-R and the Barthel Index.
Data analysis: Responsiveness was determined by descriptive analysis, significance tests and calculation of effect sizes.
Results: For the 1,542 patients, the calculation according to Kazis yielded values of 0.10 for both instruments. For the group of patients who showed clinically relevant changes, values of 0.50 were obtained for the CDS-R and 1.06 for the Barthel Index. For the group 1,542 patients, the calculation according to Liang yielded values of 0.42 for the CDS-R and 0.34 for the Barthel Index. For the group of patients who showed clinically relevant changes, values of 1.47 were obtained for the CDS-R and 1.92 for the Barthel Index.
Conclusion: The Barthel Index seems to be slightly more responsive than the CDS-R, and both instruments seem to be appropriate for the assessment of patients’ changes over time. Nevertheless, the exact level of responsiveness could not be clearly identified for both instruments. To confirm the level of responsiveness, further research is recommended.
Around 10% of Western Europe’s population suffer from a disability which can entail a decrease of independency and quality of life. However, the lives of these people can be improved by rehabilitative treatment and care. Changing the degree of dependency from dependent to independent is essential in rehabilitation, as is the assessment of these changes. To perform such kind of measurements, assessment instruments have to be responsive. In spite of this concern, responsiveness of assessment instruments is studied to a small extent only. This also applies to the Care Dependency Scale for Rehabilitation (CDS-R), a short assessment instrument measuring the care dependency of patients regarding physical and psychosocial aspects. In this longitudinal-study, the responsiveness of the CDS-R, in general and related to different disease-groups, should be determined. Therefore, a convenience sample of 1564 patients was assessed in an Austrian rehabilitation centre with the scale after admission and before discharge. Responsiveness was determined by descriptive analysis, calculation of effect-sizes and significance tests. Differences between admission and discharge occurred on a statistically significant level for patients who changed. Kazis’ effect-sizes can be considered as of small/medium effect for patients who changed (0.24/0.49), and as of large effect according to Liang (0.86/1.46). Eta squared was 0.10/0.19 which can be interpreted as of moderate/large effect for patients who changed. Responsiveness-analyses related to different disease-groups showed constantly large effect-sizes for patients with musculoskeletal-disorders. These results indicate that the CDS-R can detect patient-changes over time and discriminate between patients who change under rehabilitation or not. These aspects argue for the responsiveness of the scale, wherefore the CDS-R seems to be appropriate for the assessment of treatment/health-care effectiveness and the evaluation of individual patient-changes. Nevertheless further research is recommended to confirm the level of responsiveness of the scale in general and for different disease-groups.