Original Article

Aging Clinical and Experimental Research

, Volume 7, Issue 4, pp 228-233

First online:

Classifying change with the Sickness Impact Profile for Nursing Homes (SIP-NH)

  • Rahul DhandaAffiliated withDivision of General Medicine, University of Texas Health Science CenterThe Aging Research and Education Center, University of Texas Health Science Center
  • , C. D. MulrowAffiliated withDivision of General Medicine, University of Texas Health Science CenterDivision of Geriatrics and Gerontology, University of Texas Health Science CenterGeriatric Research, Education and Clinical Center, Audie L. Murphy Memorial Veterans Hospital
  • , M. B. GeretyAffiliated withDivision of General Medicine, University of Texas Health Science CenterDivision of Geriatrics and Gerontology, University of Texas Health Science CenterGeriatric Research, Education and Clinical Center, Audie L. Murphy Memorial Veterans Hospital
  • , S. LeeAffiliated withThe Aging Research and Education Center, University of Texas Health Science Center
  • , J. E. CornellAffiliated withDivision of Geriatrics and Gerontology, University of Texas Health Science CenterGeriatric Research, Education and Clinical Center, Audie L. Murphy Memorial Veterans Hospital

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Abstract

The aim of this cohort study was to evaluate the concordance of the Sickness Impact Profile for Nursing Homes (SIP- NH) and Sickness Impact Profile (SIP) in classifying change. Subjects consisted of 194 consecutive long- stay nursing home residents at one academic department of the V.A. and in 8 community proprietary nursing homes in San Antonio, Texas. They were to have more than 3 months residency; to be ⩾61 years; and to be dependent in at least 2 ADLs with an MMSE score of ⩾15. Subjects were administered a 128- item SIP and a reduced 66- item SIP- NH at baseline and 4, 8, and 12- month follow- up. At each follow- up, subjects were classified into 3 mutually exclusive change categories using a change score of ⩾5 points. Concordance of the classification of subjects by the SIP- NH and SIP was evaluated. The misclassification rate as well as its direction was also assessed. Both instruments classified a little over one- quarter of the subjects as better, over a third as being unchanged, and another third as being worse at the four- month follow- up. More subjects were classified as worse by both instruments at 8 and 12 months. All kappas ranged from 0.52 to 0.78, indicating good to excellent agreement. Overall, the SIP- NH characterized persons as changed more often than the SIP with no systematic directional bias. In conclusion, the SIP- NH was concordant with the SIP in classifying change in subjects. However, we cannot say which of the two is better for detecting change. Future research must focus on defining a change score which has clinical meaning, and evaluate responsiveness to change. (Aging Clin. Exp. Res. 7: 228–233, 1995)

Keywords

Frail elderly functional status health status measures nursing homes questionnaires