Patient-Staff Agreement on Barthel Index Scores at Admission and Discharge in a Sample of Elderly Stroke Patients

Objective: To investigate the congruence and influence of lesion side on staff and patient ratings of activity limitations. Study Design: Retrospective study of activity limitations at admission and discharge using the Rasch model and rating scale analysis. Participants: One-hundred twenty elderly stroke patients. Setting: Outpatient geriatric rehabilitation center. Main Outcome Measure: Barthel Index (BI). Results: High patient-staff agreement was found with the lowest agreement on the bathing item of the BI. Although staff rated the degree of activity limitations significantly higher than patients, the effect size was low at admission and discharge. The discrepancy between patient and staff reports did not change during rehabilitation and was equivalent between patients with right and patients with left hemisphere lesions. Conclusion: Patients with a stroke slightly overestimated their competency compared with rehabilitation staff and remained consistent during rehabilitation.