ArticleFrontiers in psychology2024
Validation of the Barthel Index in Chinese nursing home residents: an item response theory analysis.
Article in Frontiers in psychology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed.
- Evaluation of the impact of continuous nursing and cluster nursing on carpal tunnel syndrome release surgery.Journal of orthopaedic surgery and research · 2025Trial
- A double-blind randomized control trial of transcranial direct current stimulation in post-stroke fatigue.Frontiers in neurologyTrial
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- Development and validation of a nomogram for predicting frailty among older adults with multimorbidity in the emergency department.Frontiers in medicine · 2026Article
- Chewing ability and its associated factors in maintenance hemodialysis patients: a cross-sectional study.BMC oral health · 2025Article
- Factors associated with oral frailty among community-dwelling older adults in Chengdu, China: a cross-sectional study.BMC geriatrics · 2025Article
- Assessing Functional Independence and Associated Factors in Older Populations of Kazakhstan: Implications for Long-Term Care.Healthcare (Basel, Switzerland) · 2025Article
- Observational
- Analysis of depression prevalence and associated influencing factors in maintenance hemodialysis patients.Frontiers in psychiatry · 2025Article
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Authors and funding
7 authors.
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Abstract
Background: The Barthel Index (BI) is used to standardize the grading of assessments for clinical needs, insurance support, and long-term care resource allocation in China. However, its psychometric properties among nursing home residents remain unclear. Therefore, this study aims to assess and modify the psychometric properties of BI in nursing home residents. Methods: A total of 1,402 individuals undergoing evaluation in a nursing home facility in China were included in this study from November 2021 to November 2022. Correlations between items were examined to identify the potential multicollinearity concerns. The unidimensional item response theory (IRT) was used to validate and modify the single structure of BI. Furthermore, the logistic regression/IRT hybrid DIF detection method was conducted to assess differential item functioning (DIF) between the dementia group and the normal group. Results: The pairing of items 5 ("bowl control") and 6 ("bladder control") revealed a local dependence issue, leading to their consolidation. Items 56 (bowel and bladder control) and 9 (mobility) both displayed poor fit indices and underwent category collapsing. Through the application of the generalized partial credit model, the adjusted scale displayed better fit indices, demonstrating a robust discriminative power (DC >1.5) and orderly thresholds. Furthermore, non-uniform DIF was identified in item 2 (bathing) between the dementia group and the normal group. Conclusion: The modified BI demonstrated favorable psychometric properties and proved to be suitable for evaluating nursing home residents experiencing moderate functional impairment, which may provide a precise evaluation for long-term care resource allocation. Future studies could explore integrating supplementary measurements, such as objective indices, to assess a broader spectrum of functional statuses to potentially enhance the limited precision width observed in BI.
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