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Table 2 Evaluation of selected outcome measures for CGA

From: Using comprehensive geriatric assessment for older adults undertaking a facility-based transition care program to evaluate functional outcomes: a feasibility study

Domain

Outcome (n = 10 participants)

Number of participants assessed at admission/discharge (%)

Duration taken to complete measure (mins) (mean ± SD)

Evaluation comments from staff

Physical

10m Walk Test

9 (90%) / 9 (90%)

2.4 ± 0.53

- Minimal equipment required

- Useful for quickly identifying gait impairments for further assessment and care planning

- Walking speed score helpful for comparing with normative values for other functional correlates

- Test condition of self-paced walking speed can be conducted relatively easily in patients with moderate to severe cognitive impairment as minimal instruction is required

- One participant unable to perform 10MWT due to being non-ambulant (at least 3 years) prior to hospital admission

Modified Barthel Index

100 (100%) / 100 (100%)

10.5 ± 1.54

- Completed by TC nurses at both admission and discharge

- Provides useful information regarding personal ADL performance to assist with care planning

de Morton Mobility Index

100 (100%) / 100 (100%)

14.3 ± 5.35

- Useful as part of initial and discharge assessment as it comprises of balance, bed mobility and ambulation measures

- Useful as provides a comprehensive patient functional mobility profile for nursing and therapy staff management in a short amount of time

- Hierarchy of tasks are useful in assisting to set smaller interim goals

- Used across health and home care settings thus scores can be compared in longer term evaluation of patient functional mobility

- Use will depend on baseline function pre-hospitalisation

Timed Up and Go

9 (90%) / 9 (90%)

2.53 ± 0.96

- Easily completed at patient’s bedside

- Provides very quick review of gait (walking), balance (turning) and leg strength (sit to stand)

- Requires a patient to understand a 5-stage command hence low suitability for moderate cognitive impairment

- One participant was unable to perform TUG due to being non-ambulant (at least 3 years) prior to hospital admission

Social

Lawton scale

100 (100%) / 100 (100%)

5.8 ± 2.17

- Provides useful information regarding older adults’ IADL performance to assist with planning for community discharge

EQ-5D-5L

100 (100%) / 100 (100%)

3.6 ± 1.12

- Provides useful information regarding older adults’ self-perceived general health and wellbeing for program engagement

Cognitive

Mini Mental State Examination

100 (100%) / 100 (100%)

7.9 ± 2.88

- Easier to administer as it takes less time

- Provide useful information on executive function, memory, orientation, language to facilitate communication

- Has ceiling effect

- Inclusion in assessment depends on type of client

- Useful for older adults who are rarely assessed with MMSE

Montreal Cognitive Assessment

100 (100%) / 100 (100%)

30–60

- Completed by TC occupational therapist

- More sensitive in detecting mild cognitive impairment

- Requires more time to assess

Emotional

Geriatric Depression Scale

100 (100%) / 100 (100%)

5.8 ± 3.14

- Can help screen patients for potential depressive symptoms at discharge that may require referral for services post-TCP discharge

- Can make some patients feel slightly uncomfortable on specific questions

- Questionnaire a bit long for administration

- Less relevant for TCP clients; will not use as part of usual assessment unless indicated

Patient Health Questionnaire-9

100 (100%) / 100 (100%)

6.4 ± 2.50

- Provides useful information for patients with potential depressive symptoms

- While this measure focused on diagnostic criteria for DSM-IV depressive disorders, it is less repetitive and provoking

- Assists clinicians to tailor activities for symptoms such as poor sleep, change in appetite and loneliness

- Less relevant for these clients

- Some questions appeared to make clients feel uncomfortable

Less provoking and more general compared to GDS