The Barthel Self-Service Scale is one of the most well-known ways to study the patient's condition, allowing to determine the level of patient's independence with an accuracy of 98%. Also, according to the Dorothea Barthel scale, you can easily determine whether the patient needs self-care, the help of a nurse, or he can perform simple physical exercises himself and is capable of complete self-care.
Since 1958, the Barthel Self-Service Index has been the reference measure for a rapid examination of a patient, allowing him to quickly determine his condition without resorting to a full and lengthy medical examination.
Home or boarding school
Often, many of the people who have seriously ill relatives find it difficult to make a decision about their future fate. Someone is afraid of difficulties and immediately wants to take a sick loved one to a boarding school for the disabled, while someone wants to be with their loved one to the last, hoping to alleviate his suffering.
Many people try to understand how seriously ill their relative is, becauseit is on the severity of the condition of such people that their fate often depends, as well as their further place of residence.
If a person is really in a serious condition, it will be much better for him and his relatives if the patient is taken to a special boarding school, where he will be looked after by highly qualified medical personnel.
If the patient's condition does not pose a threat, then he does not need to leave his home and loved ones.
The Barthel and Lawton scale is one of the most popular scales for assessing the patient's condition.
The state of a person is very easy to qualify according to special scales of life and physical activity. Many well-known doctors have compiled similar author's indices, but the Barthel scale is the most popular and convenient measure of human he alth at the moment.
Laughton scale
Before the appearance of the Barthel index, the Lawton scale was actively used in medical practice. Despite the seeming similarity of these two assessment indices, there is one fundamental difference between them: the Lawton scale was created to assess only the physical capabilities of the patient, while the Barthel index also allows you to evaluate his psychological state. Later, in the field of psychiatry, the joint Barthel-Laughton scale will appear, which, however, will not receive much distribution.
Bartel
Dorotea Veronica Barthel was born in 1911 in New York, in a simple working-class family. In order to somehow help parents feed their families, immediately after completionWhile studying at school, the girl gets a job as a nurse at a local hospital, where she is assigned to work in a ward for seriously ill patients. The everyday life of the girl is spent in the incredibly hard work of disposing of the waste of patients, cleaning ducks, mopping floors. Also, her direct duties included caring for the sick, escorting them to the dining room and toilet, as well as helping the disabled in taking a bath.
A year later, Dorothea receives the title of nurse for excellent work and specializes in a hospital training center, where she confirms her title by brilliantly writing all the necessary screening tests.
Bartel Scale
Soon after several years as a nurse, Dorothea begins to observe patients, identifying 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 on patients are gradually turning into regular records of their behavior, character, actions and standard requests. Dorothea enters in her diaries absolutely all the details, one way or another connected with the manifestation of the activity of patients.
During the vacation, the girl systematizes, classifies and combines the materials received into a series of essays on the life of patients. Each of the essays was devoted to one of the degrees of severity of the patient's condition. About twenty such essays, ranging from "Extremely Satisfactory" to "Extremely Unsatisfactory", have been written.
Realizing that her labors are stillcumbersome and difficult to understand for unprepared young people, Dorothea creates a "Scale of the Patient's Vital Activity" consisting of only a few points. This index would later become known as the Barthel Rating Scale.
From 1958 to the present, this index has been the most convenient for medical personnel to use and makes it easy, without difficulty, to determine the patient's condition without resorting to a lengthy comprehensive examination.
Bartel scale (index)
The Barthel scale in points (table) is one of the most convenient scales for determining the level of patient independence. Some of her items are shown in the images below.
Traditionally, the index consists of ten criteria, although it is rarer to find a scale with only eight points:
- Eating. This criterion is an indicator of whether the patient can eat on his own without assistance or the help of any devices.
- Personal toilet. This is an indicator of the capacity of the patient in the bathroom. The criterion shows whether the patient can wash himself, brush his teeth and put himself in order without resorting to the help of medical personnel.
- Dressing up. This item is designed to check whether the patient can dress without assistance, put on underwear and outerwear on his own.
- Taking a bath. This criterion indicates the level of capacity of the patient in matters of hygiene and indicates whether the patient can wash himself and leadclean yourself up on your own.
- Control of pelvic functions. This criterion is responsible for the patient's ability to independently and fully go to the toilet and defecate without resorting to outside help.
- Going to the toilet. This item is designed to check if the patient can independently get to the toilet and use all the devices in the toilet room.
- Getting out of bed. This criterion is responsible for the patient's ability to get out of bed on their own without assistance.
- Transition from bed to chair. This is an indicator of the patient's capacity for 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 stairs. This criterion indicates 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: a tick is placed next to the selected item with a description of the patient's capabilities, confirming one or another selected score. Next, the nurse looks at the card, notingwhich figure was chosen more often, and also displays the overall average score - an assessment of the patient's condition. If a small score was chosen most often, then the average score would also be small: this would mean that the patient's condition was serious. If a high score was chosen more often, then the average score will be high, indicating that the patient's condition is satisfactory.
Recognition
Initially, the Barthel scale (Bartel index) was used only for in-hospital consultation of young orderlies, who received it as a reminder of patient care. However, later it was used in other hospitals, which contributed to its fairly rapid spread throughout the he alth care system as a whole.
Soon the Barthel index was adopted as an official analytical examination, mandatory applied to patients in order to clarify their physical and mental condition.
The Barthel scale owes its popularity, first of all, to its simplicity, ease of use, and also to its almost one hundred percent accuracy. Since 1958, there have been only about ten cases where the Barthel index was calculated incorrectly.
The Barthel index is based on a screening method that allows you to assess the patient's condition in minutes, without primary 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.
The Barthel score isa simple operation accessible to even the most unskilled medical personnel.
Who works with the Barthel index
The Barthel index is recognized as incredibly convenient for determining not only the patient's initial level of activity, but also the level of severity of his condition. Usually the patient's condition is assessed on the Barthel scale immediately after admission to a medical facility.
Based on the results of the study, decisions are made on further hospitalization and treatment of the patient.
The Barthel index has won the greatest popularity among representatives of medical psychiatry and employees of rehabilitation centers, since the indicators of human activity described in it can also be used as criteria for a person's psychological he alth. Also, the self-service scale serves as a direct indicator of how the patient is abstracted from society and needs rehabilitation.
