Validity and Responsiveness of the Minimum Data Set

Snowden, Mark; McCormick, Wayne C.; Russo, Joan; Srebnik, Debra; Comtois, Kate; Bowen, James; Teri, Linda; Larson, Eric B.

doi:10.1111/j.1532-5415.1999.tb01297.x

Cited by 147 publications

(87 citation statements)

References 22 publications

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“…After admission, the Minimum Data Set (MDS) is assessed quarterly for patients in the nursing home or assisted living tiers. The MDS assesses the patient in multiple spheres of functioning, including cognitive function (Snowden et al, 1999). If the MDS cognitive questions indicate impairment, further assessment and workup are initiated.…”

Section: Methodsmentioning

confidence: 99%

Identifying undiagnosed dementia in residential care veterans: comparing telemedicine to in‐person clinical examination

Shores

Ryan-Dykes

Williams

et al. 2004

Int J Geriat Psychiatry

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We found that telemedicine was as accurate as an in-person clinical examination in establishing the diagnosis of dementia. In addition, subjects reported a high degree of satisfaction with telemedicine and a willingness to participate in telemedicine clinical care in the future. Given the large increase in the aging population and the shortage of geriatric psychiatrists nationally, it appears that telemedicine may be a promising means to expand the availability of geriatric psychiatric consultation to remote areas.

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Section: Methodsmentioning

confidence: 99%

Identifying undiagnosed dementia in residential care veterans: comparing telemedicine to in‐person clinical examination

Shores

Ryan-Dykes

Williams

et al. 2004

Int J Geriat Psychiatry

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“…This ADL score measures functional disability based on four factors: locomotion, toilet use, eating and personal hygiene. The score ranges from zero to six, where zero represents being totally independent and six totally dependent (Morris et al, 1999;Snowden et al, 1999). This variable was dichotomized (0-3 ¼ not totally dependent, 4-6 ¼ dependent).…”

Section: Methodsmentioning

confidence: 99%

Malnutrition and associated factors among aged residents in all nursing homes in Helsinki

Muurinen²,

et al. 2005

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Objective: To acquire information about nutritional problems and factors associated with them in all nursing homes in Helsinki, Finland. Design: Descriptive, cross-sectional study. The residents were assessed by the Mini Nutritional Assessment test (MNA) and information was gathered about residents' backgrounds, functional status, diseases and about daily routines in institutions providing nutritional care. Setting: All nursing homes in Helsinki community, the capital of Finland. Subjects: Of 2424 eligible subjects, 2114 (87%) aged residents, mean age 82 y, were examined. Results: One-third (29%) of the studied residents suffered from malnutrition (MNAo17), and 60% were at risk (MNA 17-23.5). Malnutrition was associated with the female gender, a longer stay in the nursing home, functional impairment, dementia, stroke, constipation and difficulties in swallowing. In addition, eating less than half of the offered food portion, not eating snacks and resident's weight control at long intervals were associated with malnutrition. In logistic regression analysis mainly patientrelated factors predicted malnutrition: impaired functioning (OR 3.71, 95% CI 2.76-4.99), swallowing difficulties (OR 3.03, 95% CI 2.10-4.37), dementia (OR 2.06, 95% CI 1.45-2.93), constipation (OR 1.84, 95% CI 1.38-2.47), but also eating less than half of the offered food portion (OR 3.03, 95% CI 2.21-4.15). Conclusions: Although internal factors explain most about the poor nutritional status of aged residents in nursing homes, the factors related to nutritional care need further investigation to clarify their role in maintaining the nutritional status of aged residents.

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“…8 The validity of MDS Section E items specifically has been examined in at least 4 reports by comparing the MDS data with those collected via previously validated instruments in samples with varying levels of cognitive impairment. [9][10][11][12] Investigators have reported correlation coefficients of r = 0.24 (day shift) to 0.37 (evening shift) with the total scores on the Cohen-Mansfield Agitation Inventory (CMAI), r = 0.54 with the Psychogeriatric Dependency Rating Scale (PGDRS), and r = 0.50 with the Alzheimer's Disease Patient Registry Behavior Checklist as the comparative instruments. An additional report has documented significantly lower prevalence of behaviors as measured by the MDS compared with certified nursing assistants' ratings on the Revised Memory and Behavior Problem Checklist (RMBPC).…”

mentioning

confidence: 99%

Prevalence of Behavioral Symptoms: Comparison of the Minimum Data Set Assessments with Research Instruments

Bharucha

Vasilescu

Dew

et al. 2008

Journal of the American Medical Directors Association

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Objective-To examine the total and domain-specific prevalence of verbally and physically abusive, socially inappropriate, and care-resistive behaviors according to the Minimum Data Set (MDS) compared with research instruments in nursing home residents with severe dementia.Design, Setting, and Methods-As part of a longitudinal observational study, MDS behavioral symptoms data were compared with corresponding items from the Ryden Aggression Scale and the Cohen-Mansfield Agitation Inventory for 15 nursing home residents with severe dementia. McNemar's test was used to compare the difference in the proportion of subjects who experienced any symptoms, as well as specific symptoms in several domains, according to the MDS and the research instruments. Additionally, temporal fluctuations in behavioral symptoms were descriptively and graphically summarized.Results-The MDS significantly underestimated both the total proportion of subjects experiencing any behavioral symptoms (P = .016), as well as the proportion of subjects experiencing verbally abusive symptoms (P < .002), physically abusive symptoms (P = .008), or socially inappropriate behaviors (P = .016) compared with corresponding items from the research instruments. Moreover, these behaviors exhibited considerable temporal instability, suggesting that the systematic daily collection of measures of behavioral disturbances is imperative during the week in which the MDS assessment is to be completed.Discussion-Albeit from a small study sample, our findings call into question the validity of the MDS behavioral symptom items as they are currently recorded, and suggest that a simple intervention of twice daily completion of a behavioral symptoms checklist containing the MDS items during the week of the assessment may significantly improve the accuracy of the recorded data. KeywordsNursing home aggression; MDS validity; behavioral outcome measurement Copyright © 2008 6 Assessments are required on admission, quarterly, annually, at discharge, and whenever there is a significant change in the resident's status. Since its implementation in nursing homes in 1991, the role of the MDS has expanded beyond scheduled assessments to identify care problems and tailor individualized care plans. It now also functions as a case-mix-based prospective reimbursement mechanism for Medicare and Medicaid, and as an indicator of the quality of care provided by LTC institutions. 7 Thus, the reliability and validity of the MDS as an assessment instrument are of paramount importance.Section E4 ("Behavioral Symptoms") of the MDS describes as its intent: "the assessment of the frequency, and alterability of behavioral symptoms in the last seven days that cause distress to the resident, or are distressing or disruptive to facility residents or staff members, even if staff and other residents appear to have adjusted to them." 6 The coding for the 5 specific items comprising Section E4 focuses on the resident's actions rather than his or her intent. Sources of information may include a rev...

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Validity and Responsiveness of the Minimum Data Set

Cited by 147 publications

References 22 publications

Identifying undiagnosed dementia in residential care veterans: comparing telemedicine to in‐person clinical examination

Identifying undiagnosed dementia in residential care veterans: comparing telemedicine to in‐person clinical examination

Malnutrition and associated factors among aged residents in all nursing homes in Helsinki

Prevalence of Behavioral Symptoms: Comparison of the Minimum Data Set Assessments with Research Instruments

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