Bartelās self-care scale is one of the most well-known methods of studying the patientās condition, allowing to determine the level of patient independence with an accuracy of 98%. Also on the Dorothea Barthel scale, you can easily determine whether a patient needs self-care, help from a nurse, or whether he can perform simple physical exercises himself and is capable of complete self-care.
Since 1958, Bartelās self-care index has been a reference measure for a quick examination of a patient, allowing him to determine his condition as soon as possible without resorting to a full and lengthy medical examination.
Home or boarding
Often, many of the people with seriously ill relatives find it difficult to decide on their future fate. Someone is afraid of difficulties and immediately wants to take a sick loved one to a boarding school for the disabled, and someone wants to be with their loved one until the last, hoping to alleviate his suffering.
Many people try to understand how seriously their relative is sick, because it is precisely the severity of the condition of such people that often determines their fate, as well as their further place of residence.
If a person is really in serious condition, it will be much better for him and his family if the patient is taken to a special boarding school, where highly qualified medical staff will look after him.
If the patientās condition is not a threat, then he does not need to leave his home and loved ones.
The Barthel and Lauton scale is one of the most popular patient assessment scales.
The human condition is very easy to qualify on special scales of life and physical activity. Many well-known doctors compiled such author's indexes, but the Barthel scale is the most popular and convenient measure of human health at the moment.
Lawton Scale
Before the Barthel index appeared in medical practice, the Lauton scale was actively used. Despite the apparent similarity of these two evaluation indices, there is one fundamental difference between them: the Lauton scale was created to assess only the physical capabilities of the patient, while the Barthel index allows us to evaluate his psychological state. Later, in the field of psychiatry, a joint Barthel-Lauton scale will appear, which, however, will not receive much distribution.
Barthel
Dorothea Veronica Barthel was born in 1911 in New York, in a simple working-class family. In order to somehow help her parents feed her family, immediately after completing school, she gets a job as a nurse in a local hospital, where she is assigned to work in a ward for seriously ill patients. Everyday life of the girl takes place in incredibly hard work on the disposal of patients' waste, cleaning ducks, mopping. Her direct responsibilities also included caring for the sick, escorting them to the dining room and toilet, as well as helping people with disabilities to take a bath.
A year later, Dorothea receives the title of nurse for excellent work and specializes in the hospital training center, where he confirms the title, writing all the necessary verification tests brilliantly.
Barthel Scale
Soon, after several years of working as a nurse, Dorothea begins to observe patients, revealing patterns in their behavior and trying to categorize them to facilitate the work of young hospital staff who have not yet had much experience working with such people.
Observations of patients gradually turn into regular records of their behavior, character, actions and standard requests. Dorothea writes in her diaries absolutely all the details, one way or another connected with the manifestation of the activity of patients.
During the holidays, the girl systematizes, classifies and combines the materials received in a series of essays on the vital activity of patients. Each of the essays was dedicated to one of the severity of the patient's condition. Similar essays, the themes of which range from āExtremely satisfactory conditionā to āExtremely unsatisfactory positionā, were written about twenty.
Realizing that her works are still cumbersome and difficult to understand for unprepared young people, Dorothea creates the āPatient Life Scaleā consisting of only a few items. This index will later become known as the Barthel Rating Scale.
From 1958 to the present time, this index has been the most convenient for medical staff to work with and allows you to easily, without difficulty determine the condition of the patient, without resorting to a lengthy comprehensive examination.
Barthel scale (index)
The Barthel scale in points (table) is one of the most convenient scales for determining the patient's level of independence. Some of its points are presented in the images below.
Traditionally, the index consists of ten criteria, although less often you can find a scale in which there will be only eight points:
- Eating This criterion is an indicator of whether the patient himself can eat without assistance or the help of any devices.
- Personal toilet. This is an indicator of the patient's legal capacity in the bathroom. The criterion shows whether the patient can wash, brush his teeth and put himself in order without the help of medical personnel.
- Dressing. This item is intended to check whether the patient can dress without assistance, wear lower and upper clothes on their own.
- Take a bath. This criterion indicates the patient's level of competence in hygiene issues and shows whether the patient can wash himself and put himself in order.
- Pelvic function control. This criterion is responsible for the patient's ability to independently and fully visit the toilet and defecate without resorting to outside help.
- Access to the toilet. This item is intended to check whether the patient can independently get to the toilet and use all the devices of the toilet room.
- Getting out of bed. This criterion is responsible for the patientās ability to independently get out of bed without assistance.
- The transition from bed to chair. This is an indicator of the patient's legal capacity in relation to complex movements. The criterion shows whether the patient can independently get out of bed and sit on a chair, as well as perform reverse manipulation.
- Movement. The criterion responsible for the independent movement of the patient, showing whether the patient can independently move around the ward or building of the hospital.
- Climbing the stairs. This criterion shows whether the patient needs help in moving up the stairs, or whether he can cope without assistance.
Each of these criteria is evaluated on a fifteen-point scale. The higher the score, the more independent the patient, and the lower, the more he needs the care of an outsider.
The results are interpreted as follows: in front of the selected item with a description of the patientās capabilities, a checkmark is put confirming one or another selected score. Next, the nurse looks at the card, noting which figure was chosen more often, and also displays the overall average score - an assessment of the patient's condition. If a small score was most often chosen, then the average score will be small: this will mean that the patient is in a serious condition. If a high score was more often chosen, then the average score will be high, which indicates that the patient's condition is satisfactory.
Confession
Initially, the Barthel scale (Barthel index) was used only for nosocomial consultation of young orderlies, who received it as a reminder for patient care. However, later it began to be used in other hospitals, which contributed to its fairly rapid spread throughout the health system as a whole.
Soon, the Bartel index was adopted as an official analytical survey, mandatory applied to patients in order to clarify their physical and mental state.
The Barthel scale owes its popularity, first of all, to simplicity, ease of use, and also its almost absolute accuracy. Since 1958, only about ten cases were recorded when the Barthel index was calculated incorrectly.
The Bartel Index is built on the screening method, which allows you to assess the condition of the patient in a matter of minutes, without initial full-fledged medical examinations.
In addition to the initial examination using the Barthel index, it is possible to monitor the patient's condition throughout his stay in a medical institution.
A Barthel score is a simple operation, accessible even to the most unskilled medical personnel.
Who works with the Barthel index
The Bartel index is considered incredibly convenient for determining not only the initial level of activity of the patient, but also the severity of his condition. Typically, the patient's condition is assessed on a Barthel scale immediately after the first admission to a medical institution.
Based on the results obtained during the study, decisions are made on further hospitalization and treatment of the patient.
The Bartel index gained the most popularity among representatives of medical psychiatry and workers of rehabilitation centers, since the indicators of human activity described in it can be used as criteria for the psychological health of a person. Also, the self-service scale serves as a direct indicator of how much the patient is abstracted from society and needs rehabilitation.