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LETTER TO THE EDITOR
Year : 2014  |  Volume : 58  |  Issue : 4  |  Page : 284  

Using Barthel index for assessment of disability: A comment on functional disability among elderly persons in a rural area of Haryana


Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India

Date of Web Publication5-Dec-2014

Correspondence Address:
Kanica Kaushal
Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-557X.146300

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How to cite this article:
Kaushal K. Using Barthel index for assessment of disability: A comment on functional disability among elderly persons in a rural area of Haryana. Indian J Public Health 2014;58:284

How to cite this URL:
Kaushal K. Using Barthel index for assessment of disability: A comment on functional disability among elderly persons in a rural area of Haryana. Indian J Public Health [serial online] 2014 [cited 2020 Sep 27];58:284. Available from: http://www.ijph.in/text.asp?2014/58/4/284/146300

Sir,

This is in reference to the article, "Functional Disability Among Elderly Persons in a Rural Area of Haryana" published in Indian Journal of Public Health 2014;58:11-6. [1]

The authors have done a commendable job to estimate the prevalence of functional disability among elderly persons in a rural area of Haryana.

This study was conducted among persons aged 60 years, and above and Functional disability was defined with disability in activities of daily living (ADL) as one of the components. ADL was assessed by using Barthel "ADL" questionnaire. The participant was considered as having ADL disability, if she\he had at least one of ten ADL disabilities.

There are a few concerns regarding this study.

The problem with Barthel index is that the items on the index are too clear-cut to allow for variations in functional abilities of individuals over time; e.g., the toileting items on bowels and bladder only look at the functioning over the preceding week. The functional abilities of some disabled people may vary over a greater time span than 1 week and may be influenced by the environment and equipment available. [2]

Further observers, who aren't acquainted with the patients they are assessing, may score inaccurately as they may not be aware of the usual functional abilities or the total range of ability of those being observed. Moreover, people not aware of the implications of being scored, or who don't fully cooperate, or are at their usual level of functioning and not to their maximum level may be inaccurately scored too. .

The alternative is to score people, when they are unaware of it, but this raises ethical questions.

Everyday abilities scale for India consisting of 12 questions has been widely used to test the functional abilities of daily living relevant to Indian subjects. A 2-point scale was used. Respondents were asked whether the subject could (coded as 0) or could not (coded as 1) generally perform the activity thus reducing the observer bias. A higher total score reflects greater overall disability. [3] Moreover, the questions leave space for variations in functional abilities of individuals.

 
   References Top

1.
Gupta P, Mani K, Rai SK, Nongkynrih B, Gupta SK. Functional disability among elderly persons in a rural area of Haryana. Indian J Public Health 2014;58:11-6.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
A Critique of Barthel Index. Jan Dewing. Available from: http://www.barthelindex.wikispaces.com.pdf. [Last accessed on 2014 Mar 24].  Back to cited text no. 2
    
3.
Everyday Abilities Scale for India. Available from: http://www.wpic.pitt.edu/research/dementia_epidemiology/IndoUS/Instruments/EASI_eng.htm. [Last accessed on 2014 Mar 24].  Back to cited text no. 3
    



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