This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Melin, A.-L. Articles by Bygren, L. O. Search for Related Content PubMed Articles by Melin, A.-L. Articles by Bygren, L. O. Social Bookmarking                         What's this?

Perceived functional health of frail elderly in a primary home care programme and correlation of self-perception with objective measurements

Anna-Lisa Melin, Department of Social Medicine, University of Umeå, and Serafen Primary Health Care Centre, Stockholm, Sweden, Address for correspondence and reprint Anna-Lisa Melin Serafen Primary Health Care Centre Hantverkargatan 2 S-112 83 Stockholm Sweden

Lars Olov Bygren

Lars Olov Bygren, Department of Social Medicine, University of Umeå, Sweden

This study examined the effects of a primary home care intervention programme on self-assessed functional health, and the correlation of self-perception with objective measures in frail elderly subjects.

Elderly patients about to be discharged from an acute hospital, at risk for institutionalization, were randomly assigned to physician-led primary home care or to standard care. After early post-hospital in-home intervention and assessment, ongoing medical care and treatment were monitored by a multidisciplinary team. Functional data were collected at baseline and after six months. Self-rated and objectively rated functional variables included medical factors, personal and instrumental activities of daily living, ambulation, and social activities and contacts.

From study entry to follow-up, the scores for personal activities of daily living were significantly increased in team and control subjects as were social contacts in the team subjects (P = 0.03). No differences between team and control groups were found for self-rated functions from study entry to follow-up, except for a tentatively statistical significance in self-rated physical health in favour of the team subjects.

Positive correlations were recorded between all self-rated and objectively rated functions, but they were stronger at follow-up. Physical health and social contacts were overrated, whereas indoor ambulation and social activities were underratcd compared to objective measures at follow-up. Personal activities of daily living, were overrated at study entry, but showed substantial agreement at follow-up (0.62).

Within demographic subgroups patients over 80 showed a stronger correlation between self-ratcd and objectively measured social functions after six months than younger patients. Men and women underrated ambulation compared to objective measures at follmv-up. Women underestimated their social activities compared to objective scoring at follow-up, whereas men showed a fair correlation. Personal activities of daily living at follow-up remained unchanged within demographic subgroups.

The correlations between self-rated and objectively measured functions were not as definite as expected. Overrated physical health and social contacts, and underrated indoor ambulation and social activities probably provided a more realistic description of the patients' functions than the objective measurements could reveal.

The outcomes indicate that self-rating of functions provides a valid measure of functional health in medically stable elderly patients.

Key Words: Self-assessment • functional status • chronical illness • frail elderly • primary home care

Scandinavian Journal of Public Health, Vol. 21, No. 4, 256-263 (1993)
DOI: 10.1177/140349489302100405


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?