Inter-rater agreement of an alternative guideline for the assessment of the activities of daily living in home nursing

Method A quantitative comparative field study in a stratified random sample of 612 patients receiving home nursing for ADL deficiencies. A proportional stratification according to mutuality membership, region (Flanders, Brussels and the Walloon region) and the patient’s level of ADLdependency in 5 categories: minor dependency (T2 en T7), level A, level B, level C (which is the highest level) was performed. Home care nurses were invited by the ‘National College of Advising Physicians (NCAPh) and the Belgian sickness funds, to participate in the study and to perform ADL assessments according to two guidelines: the current guideline of the Belgian Evaluation Scale (BES) and an alternative guideline which was written by a workgroup of the Agreement Commission for home care nursing of the National Institute for Health and Disability Insurance. The weighted kappa statistic (κ) (and its 95% confidence interval) and the proportion agreement were the main outcome measures.