BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet Test: Modified Barthel Index Year: 1981 Domain: Biological Assessment Tool Category: Physical functioning/ADLs Variations/Translations: Original version of the Barthel Index was documented in 1958 by Mahoney & Barthel, but it has been in use since 1955. Two modified variants exist: by Granger, Albrecht & Hamilton in 1979 and by Fortinsky, Granger & Seltzer in 1981. Setting: Institutional Method of Delivery: Completed by a health professional or self-administered Description: The Barthel Index examines functional independence in personal care and mobility. It is used for pre and post treatment performance monitoring in long-term hospital patients with chronic paralytic conditions, and to assess the nursing care required. It has also been used with rehabilitation patients. The patient is rated from his or her medical records or from direct observation. The original Barthel Index (Mahoney & Barthel, 1958) was comprised of 10 items covering personal care and mobility. The patient is rated in terms of whether he or she can perform the tasks independently, with assistance, or is dependent on assistance. Both of the Modified Barthel Index extends the original form to 15-items to include eating and drinking (either as separate items [Granger, Albrecht & Hamilton, 1979] or merged together [Fortinsky, Granger & Seltzer, 1981]). The 1981 version also included an addition item on dressing after using the toilet and uses four point response scales. Scoring/Interpretation: The 1981 form of the Modified Barthel Index scores on a range of 0 to 100. The overall scores suggest the amount of time and assistance a patient requires and is calculated from the summation of scores on each rating. Higher scores indicate greater independence. Time to Administer: 2-5 minutes (by health professional), 10 minutes (self-administered) ( McDowell & Newell, 1996). Availability: Found in Fortinsky, Granger & Seltzer (1981). Software: N/A Website: N/A Quantitative/Qualitative: Quantitative Validity (Quantitative): A correlation of 0.91 between Barthel scores and the performance of 72 tasks has been reported (Fotinsky et. al., 1981). Reliability (Quantitative): ): Test-retest reliability of 0.89 has been reported with an inter-rater agreement exceeding 0.95 (Granger, Albrecht & Hamilton, 1979). A Cronbach’s alpha for internal reliability of 0.98 has also been reported (McDowell & Newell, 1996). References: Chino, N., Andreson,T.P., & Granger, C.V. (1988). Strokerehabilitation outcome studies: comparison of a Japanese facility with 17 U.S. facilities. International Disability Studies,10, 150-154. Collin, C., Wade, D.T., Davies, S., et.al. (1988). The Barthel ADL Index: a reliability study. International Disability Studies, 10, 61-63. Fortinsky, R.H., Granger, C.V., & Seltzer, G.B. (1981). The use of functional assessment in understanding home care needs. Medical Care, 19, 489-497. Granger, C.V. (1985). Outcome of comprehensive medical rehabilitation: an analysis based upon the impairment, disability, and handicap model. International Rehabilitation Medicine, 7, 45-50. Granger, C.V., Albrecht, G.L., & Hamilton, B.B. (1979). Outcome of comprehensive medical rehabilitation: measurement by PULSES Profile and the Barthel Index. Archives of Physical Medical Rehabilitation, 60, 145-154. Mahoney F.I., Wood, O.H., & Barthel, D.W. (1958). Rehabilitation of chronically ill patients: the influence of complications on the final goal. Southern Medical Journal, 51, 605-609. McDowell, I. & Newell, C. (1996). Measuring Health: A Guide to Rating Scales and Questionnaires. (2nd ed.). New York: Oxford University Press. Pp. 56-63. McGinnis,G.E., Seward, M.L., DeJong, G., et. al. (1986). Program evaluation of physical medicine and rehabilitation departments using self-report Barthel. Archives of Physical Medical Rehabilitation, 14, 61-65. Nosek, M.A., Parker, R.M, Larsen, S. (1987). Psychosocial independence and functional abilities: their relationship in adults with severe musculoskeletal impairments. Archives of Physical Medical Rehabilition, 68, 840-845. Shinar, D., Gross, C.R., Bronstein, K.S., et al. (1987). Reliability of the activities of daily living scale and its use in telephone interview. Archives of Physical Medical Rehabilitation, 68, 723-728. Wylie, C.M., & White, B.K. (1964). A measure of diability. Archives of Environmental Health, 8, 834-839. Comments: N/A