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Document Type

Thesis - University Access Only

Award Date


Degree Name

Master of Science (MS)


Graduate Nursing

First Advisor

Marcelline Harris


older people, functional assessment, outcome assessment databases


Interest in using existing databases for outcomes analysis is growing. The MDS+ is one of the few clinical data sets available, however, no studies have been published that have looked at the functional status elements within this dataset for use usefulness in outcomes analysis. The purpose of this study was to examine the frequency of dependence in tasks associated with functional status as documented in the South Dakota MDS+ and to compare dependencies to the National Long Term Care Survey, the National Medical Expenditure Survey, the National Health Interview Survey, and the National Nursing Home Survey. Secondary analysis of 11,793 admission assessments was performed. The sample consisted of all South Dakota Nursing Home admission assessments from October 1990 through January 1995. Reliability of ADL measures within the MDS has been previously reported as .75. Inter-rater reliability in the South Dakota MDS+ dataset has been reported to be at least .81 on each variable. Over 37% of All assessments report dependencies in all six ADL tasks. In addition, another 35%report dependencies in at least four ADL tasks. The MDS+ data and the NNHS data were found to have similar frequencies which strengthen the validity of the MDS+ as a hypothesis generating research instrument on nursing home residents. Both the MDS+ and the NNHS ADL tasks present a hierarchical order. In addition, a previously undescribed hierarchical relationship was found within the Lawton lADL tasks when data from the four national surveys were compared. This study provides the basis for future work using the MDS+ for functional status outcomes analysis. Issues are raised regarding the inclusion of lADL items in the MDS+ if we are to link databases and inform health policy across settings of care.

Library of Congress Subject Headings

Older people -- Functional assessment -- Databases
Outcome assessment (Medical care) Databases



Number of Pages



South Dakota State University


Copyright © 1996 Denise Hemphill. All rights reserved