Activities of Daily Living Assessment among Nursing Home Residents with Advanced Dementia: Psychometric Reevaluation of the Bristol Activities of Daily Living Scale.

The purpose of this study was to conduct psychometric reevaluation of the Bristol Activities of Daily Living Scale (BADL) among a population logistically difficult to observe beyond cross-sectional analysis: nursing home residents with advanced dementia (AD). Data from observation-based measures were collected by nursing home staff at two intervals within a three-month time frame among 43 residents identified with AD via medical records and nursing home staff. Three broad properties of BADL were examined: factor structure, reliability, and validity. Principal components analysis determined underlying components. BADL internal consistency was assessed by Cronbach's and Guttman coefficients; test-retest reliability was also observed. Convergent validity was assessed by correlating BADL with theoretically linked measures of quality of life (QOL) and social engagement. Compared with the original evaluation, BADL showed inconsistent factor structure at interval 1 but comparable at interval 2. Reliability coefficients at both intervals were robust and comparable to the original evaluation. BADL demonstrated significant convergence with QOL and social engagement. Psychometric potency of BADL was confirmed, suggesting practice applicability with this AD population. Future research calls for further examination of tools to guide effective interventions with this vulnerable population.