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== Objective  ==
== Objective  ==
[[File:Elderly Woman.jpg|right|frameless|251x251px]]
[[File:Elderly Woman.jpg|right|frameless|251x251px]]
Purpose. Measure independence in activities of daily living (ADL).
The purpose of the Index of ADL, or KATZ ADL, is to monitor the prognosis and treatment of older adults and chronically ill people<ref>Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of Illness in the Aged: The Index of ADL: A Standardized Measure of Biological and Psychosocial Function. JAMA''.'' 1963;185(12):914–919. </ref>. In particular, the KATZ ADL measures a person's independence in common activities of daily living (ADL).


Age-related changes and health problems frequently show themselves as declines in the functional status of older adults. This decline often places the older adult on a downwards health spiral. An effective way to evaluate the health status of older adults is through their functional ability. An [[Outcome Measures|objective assessment]] which provides objective data helps indicate decline or improvement in health status, allowing the physiotherapist to plan and intervene appropriately<ref name=":0">Donna McCabe, DNP, APRN-BC, GNP. [https://consultgeri.org/try-this/general-assessment/issue-2.pdf Katz Index of Independence in Activities of Daily Living (ADL).] Best Practices in Nursing Care to Older Adults. Issue Number 2, Revised 2019. Available from: https://consultgeri.org/try-this/general-assessment/issue-2.pdf (last accessed 5.5.2019)</ref>.
Age-related changes and health problems frequently show themselves as declines in the functional status of older adults. This decline often places the older adult on a downwards health spiral. An effective way to evaluate the health status of older adults is through their functional ability. An [[Outcome Measures|objective assessment]] which provides objective data helps indicate decline or improvement in health status, allowing the physiotherapist to plan and intervene appropriately<ref name=":0">McCabe D. [https://consultgeri.org/try-this/general-assessment/issue-2.pdf Katz Index of Independence in Activities of Daily Living (ADL).] Best Practices in Nursing Care to Older Adults. 2019. 2. Accessed 24 June 2019.</ref>.


{{#ev:youtube|https://www.youtube.com/watch?v=ekwu49fH5QM|width}}<ref>Describing occupation. Katz ADL. Available from: https://www.youtube.com/watch?v=ekwu49fH5QM (last accessed 5.5.2019)</ref>  
{{#ev:youtube|https://www.youtube.com/watch?v=ekwu49fH5QM|width}}<ref>Describing occupation. Katz ADL. Available from: https://www.youtube.com/watch?v=ekwu49fH5QM (last accessed 5.5.2019)</ref>  
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== Method of Use  ==
== Method of Use  ==
The Katz Index of Independence in Activities of Daily Living (Katz ADL), is an appropriate tool to assess functional status when measuring the client’s ability to perform activities of daily living independently. It takes less than 5 minutes to perform and requires no training.  
The Katz ADL, is an appropriate tool to assess functional status when measuring the client’s ability to perform activities of daily living independently. It takes less than five minutes to perform and requires training<ref name=":1">Katz P. [https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.11415 Measures of Adult General Functional] [https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.11415 Status]. Arthritis Care Res (Hoboken). 2003. 49; 5S: S15–S27. Accessed 24 June 2019.
</ref>.  


Physiotherapists use the tool when assessing function and detect problems in performing ADL and formulate a plan care. The Index ranks adequacy of performance in six functions of bathing, dressing, toileting, transferring, continence, and feeding. 1 point is independent, 0 points is with supervision, direction, personal assistance or total care.  
Physiotherapists use the tool when assessing function and detect problems in performing ADL and formulate a plan care. The Index ranks adequacy of performance in six functions: bathing, dressing, toileting, transferring, continence, and feeding. One point means the person is independent; zero points means the person requires supervision, direction, personal assistance or total care.  


BATHING  
The following is referenced from McCabe<ref name=":0" />.
 
'''BATHING'''


Points: __________
Points: __________


(1 POINT) Bathes self completely or needs help in bathing only a single part of the body such as the back, genital area or disabled extremity.
1 POINT: Bathes self completely or needs help in bathing only a single part of the body such as the back, genital area or disabled extremity.


(0 POINTS) Need help with bathing more than one part of the body, getting in or out of the tub or shower. Requires total bathing.
0 POINTS: Need help with bathing more than one part of the body, getting in or out of the tub or shower. Requires total bathing.


DRESSING
'''DRESSING'''


Points: __________
Points: __________


(1 POINT) Get clothes from closets and drawers and puts on clothes and outer garments complete with fasteners. May have help tying shoes.
1 POINT: Get clothes from closets and drawers and puts on clothes and outer garments complete with fasteners. May have help tying shoes.


(0 POINTS) Needs help with dressing self or needs to be completely dressed.
0 POINTS: Needs help with dressing self or needs to be completely dressed.


TOILETING
'''TOILETING'''


Points: __________
Points: __________


(1 POINT) Goes to toilet, gets on and off, arranges clothes, cleans genital area without help.
1 POINT: Goes to toilet, gets on and off, arranges clothes, cleans genital area without help.


(0 POINTS) Needs help transferring to the toilet, cleaning self or uses bedpan or commode.
0 POINTS: Needs help transferring to the toilet, cleaning self or uses bedpan or commode.


TRANSFERRING
'''TRANSFERRING'''


Points: __________
Points: __________


(1 POINT) Moves in and out of bed or chair unassisted. Mechanical transfer aids are acceptable.
1 POINT: Moves in and out of bed or chair unassisted. Mechanical transfer aids are acceptable.


(0 POINTS) Needs help in moving from bed to chair or requires a complete transfer.
0 POINTS: Needs help in moving from bed to chair or requires a complete transfer.


CONTINENCE
'''CONTINENCE'''


Points: __________
Points: __________


(1 POINT) Exercises complete self control over urination and defecation.
1 POINT: Exercises complete self control over urination and defecation.


(0 POINTS) Is partially or totally incontinent of bowel or bladder
0 POINTSIs partially or totally incontinent of bowel or bladder.


FEEDING
'''FEEDING'''


Points: __________
Points: __________


(1 POINT) Gets food from plate into mouth without help. Preparation of food may be done by another person.
1 POINT: Gets food from plate into mouth without help. Preparation of food may be done by another person.


(0 POINTS) Needs partial or total help with feeding or requires parenteral feeding.
0 POINTS: Needs partial or total help with feeding or requires parenteral feeding.


TOTAL POINTS: ________ SCORING: 6 = High (patient independent) 0 = Low (patient very dependent)  
'''TOTAL POINTS:''' ________ SCORING: 6 = High (patient independent) 0 = Low (patient very dependent)  


== Evidence ==
== Evidence ==
=== Reliability  ===
The interrater reliability is 0.95 or better after training (1,4). The coefficient of reproducibility, (a measure of the internal consistency of an ordered measure), is 0.96 – 0.99


=== Validity  ===
=== Validity  ===
The Katz tool was originally developed in the late 1950s and has consistently demonstrated its utility in evaluating functional status in the elderly population.It is used extensively as a flag signalling functional capabilities of older adults in clinical and home environments.<ref name=":0" />


Construct validity. Scores on the Katz ADL Index are correlated with scores on the Barthel index (r  0.78, kappa  0.77).
==== Construct Validity ====
Scores on the Katz ADL Index are correlated with scores on the Barthel Index<ref name=":0" />.


Predictive validity. Correlation with mobility dysfunction (0.50) and house confinement (0.39) among older adult patients 2 years later.
==== Predictive Validity ====
There is an indication the KATZ may have a predictive quality in regards to living situation and mortality<ref>Brorsson B, Asberg KH.Katz index of independence in ADL. Reliability and validity in short-term care. Scand J Rehabil Med. 1984;16(3):125-32.</ref>, as well as stroke prognosis<ref>Asberg KH, Nydevik I. Early prognosis of stroke outcome by means of Katz Index of activities of daily living. Scand J Rehabil Med. 1991;23(4):187-91.</ref>.


<ref name=":1">Arthritis & Rheumatism (Arthritis Care & Research) Vol. 49, No. 5S, October 15, 2003, pp S15–S27 DOI 10.1002/art.11415
Turkish<ref>Arika G, Varana, HD, Yavuza BB, Karabulutb E, Karaa O, Kilica MK. [https://toad.halileksi.net/sites/default/files/pdf/katz-index-of-independence-in-activities-of-daily-living-scale-katz-adl-toad.pdf Validation of Katz index of independence in activities of daily living in Turkish older adults]. Arch Gerontol Geriatr. 2015. 61: 344–350. Accessed 24 June 2019.
© 2003, American College of Rheumatology [https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.11415 Measures of Adult general function]. Available from: https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.11415 (last accessed 5.5.2019)
</ref> and Spanish<ref>Cabañero-Martínez MJ, Cabrero-García J, Richart-Martínez M, Muñoz-Mendoza CL. The Spanish versions of the Barthel index (BI) and the Katz index (KI) of activities of daily living (ADL): a structured review. Arch Gerontol Geriatr. 2009 Jul-Aug;49(1):e77-84. doi: 10.1016/j.archger.2008.09.006. Epub 2008 Nov 5.</ref> versions have been translated and assessed for validity.
</ref>


=== Responsiveness  ===
=== Responsiveness  ===
Sensitivity/responsiveness to change. This scale has a significant floor effect, in that it is relatively insensitive to variations at low levels of disability<ref name=":1" />
The KATZ  has a significant floor effect, i.e. it is unable to detect change at low levels of disability<ref>McDowell I, Newell C. [https://pdfs.semanticscholar.org/33f5/6f2796d171358061bd88c36f86e7edd0426f.pdf Measuring health: a guide to rating scales and questionnaires]. 2nd Ed. New York: Oxford University Press; 1996. p. 63–7. Accessed 24 June 2019.</ref>.
 
This occurs as it does not assess more advanced activities of daily living and it is limited in its ability to measure small increments of change seen in the rehabilitation of older adults. A [[Comprehensive Geriatric Assessment|comprehensive geriatric assessment]] should follow when appropriate. The Katz ADL Index is very useful in that is in a simple form all involved in a care plan can interpret.<ref name=":0" />


=== <span style="font-size: 20px; font-weight: normal;" class="Apple-style-span"></span>References  ===
This occurs as it does not assess more advanced activities of daily living and it is limited in its ability to measure small increments of change seen in the rehabilitation of older adults. A [[Comprehensive Geriatric Assessment|comprehensive geriatric assessment]] should follow when appropriate.


<references />
== References ==
<span style="font-size: 20px; font-weight: normal;" class="Apple-style-span"></span><references />
[[Category:Activities of Daily Living]]
[[Category:Activities of Daily Living]]
[[Category:Outcome Measures]]
[[Category:Outcome Measures]]
[[Category:Older People/Geriatrics]]
[[Category:Older People/Geriatrics]]
[[Category:Outcome Measures - Older People/Geriatrics]]
[[Category:Older People/Geriatrics - Outcome Measures]]

Latest revision as of 22:23, 13 September 2019

Original Editor - Lucinda hampton Top Contributors - Lucinda hampton, Lauren Lopez and Kim Jackson

Top Contributors - Lucinda hampton, Lauren Lopez and Kim Jackson  

Objective[edit | edit source]

Elderly Woman.jpg

The purpose of the Index of ADL, or KATZ ADL, is to monitor the prognosis and treatment of older adults and chronically ill people[1]. In particular, the KATZ ADL measures a person's independence in common activities of daily living (ADL).

Age-related changes and health problems frequently show themselves as declines in the functional status of older adults. This decline often places the older adult on a downwards health spiral. An effective way to evaluate the health status of older adults is through their functional ability. An objective assessment which provides objective data helps indicate decline or improvement in health status, allowing the physiotherapist to plan and intervene appropriately[2].

[3]

Intended Population[edit | edit source]

Older adults and individuals with chronic diseases.

Method of Use[edit | edit source]

The Katz ADL, is an appropriate tool to assess functional status when measuring the client’s ability to perform activities of daily living independently. It takes less than five minutes to perform and requires training[4].

Physiotherapists use the tool when assessing function and detect problems in performing ADL and formulate a plan care. The Index ranks adequacy of performance in six functions: bathing, dressing, toileting, transferring, continence, and feeding. One point means the person is independent; zero points means the person requires supervision, direction, personal assistance or total care.

The following is referenced from McCabe[2].

BATHING

Points: __________

1 POINT: Bathes self completely or needs help in bathing only a single part of the body such as the back, genital area or disabled extremity.

0 POINTS: Need help with bathing more than one part of the body, getting in or out of the tub or shower. Requires total bathing.

DRESSING

Points: __________

1 POINT: Get clothes from closets and drawers and puts on clothes and outer garments complete with fasteners. May have help tying shoes.

0 POINTS: Needs help with dressing self or needs to be completely dressed.

TOILETING

Points: __________

1 POINT: Goes to toilet, gets on and off, arranges clothes, cleans genital area without help.

0 POINTS: Needs help transferring to the toilet, cleaning self or uses bedpan or commode.

TRANSFERRING

Points: __________

1 POINT: Moves in and out of bed or chair unassisted. Mechanical transfer aids are acceptable.

0 POINTS: Needs help in moving from bed to chair or requires a complete transfer.

CONTINENCE

Points: __________

1 POINT: Exercises complete self control over urination and defecation.

0 POINTS: Is partially or totally incontinent of bowel or bladder.

FEEDING

Points: __________

1 POINT: Gets food from plate into mouth without help. Preparation of food may be done by another person.

0 POINTS: Needs partial or total help with feeding or requires parenteral feeding.

TOTAL POINTS: ________ SCORING: 6 = High (patient independent) 0 = Low (patient very dependent)

Evidence[edit | edit source]

Validity[edit | edit source]

Construct Validity[edit | edit source]

Scores on the Katz ADL Index are correlated with scores on the Barthel Index[2].

Predictive Validity[edit | edit source]

There is an indication the KATZ may have a predictive quality in regards to living situation and mortality[5], as well as stroke prognosis[6].

Turkish[7] and Spanish[8] versions have been translated and assessed for validity.

Responsiveness[edit | edit source]

The KATZ has a significant floor effect, i.e. it is unable to detect change at low levels of disability[9].

This occurs as it does not assess more advanced activities of daily living and it is limited in its ability to measure small increments of change seen in the rehabilitation of older adults. A comprehensive geriatric assessment should follow when appropriate.

References[edit | edit source]

  1. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of Illness in the Aged: The Index of ADL: A Standardized Measure of Biological and Psychosocial Function. JAMA. 1963;185(12):914–919. 
  2. 2.0 2.1 2.2 McCabe D. Katz Index of Independence in Activities of Daily Living (ADL). Best Practices in Nursing Care to Older Adults. 2019. 2. Accessed 24 June 2019.
  3. Describing occupation. Katz ADL. Available from: https://www.youtube.com/watch?v=ekwu49fH5QM (last accessed 5.5.2019)
  4. Katz P. Measures of Adult General Functional Status. Arthritis Care Res (Hoboken). 2003. 49; 5S: S15–S27. Accessed 24 June 2019.
  5. Brorsson B, Asberg KH.Katz index of independence in ADL. Reliability and validity in short-term care. Scand J Rehabil Med. 1984;16(3):125-32.
  6. Asberg KH, Nydevik I. Early prognosis of stroke outcome by means of Katz Index of activities of daily living. Scand J Rehabil Med. 1991;23(4):187-91.
  7. Arika G, Varana, HD, Yavuza BB, Karabulutb E, Karaa O, Kilica MK. Validation of Katz index of independence in activities of daily living in Turkish older adults. Arch Gerontol Geriatr. 2015. 61: 344–350. Accessed 24 June 2019.
  8. Cabañero-Martínez MJ, Cabrero-García J, Richart-Martínez M, Muñoz-Mendoza CL. The Spanish versions of the Barthel index (BI) and the Katz index (KI) of activities of daily living (ADL): a structured review. Arch Gerontol Geriatr. 2009 Jul-Aug;49(1):e77-84. doi: 10.1016/j.archger.2008.09.006. Epub 2008 Nov 5.
  9. McDowell I, Newell C. Measuring health: a guide to rating scales and questionnaires. 2nd Ed. New York: Oxford University Press; 1996. p. 63–7. Accessed 24 June 2019.