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Jahani Tabesh S, Arsalani N, Shirozhan S, Nourozi K, Vahedi M, Nozari Mirarkalaie M. Comparison of the Barthel Index and Northwick Park Dependency Scale (NPDS-H) in Assessing the Functional Status of Hospitalized Neurological Patients. IJRN 2025; 12 (1) : 9
URL: http://ijrn.ir/article-1-969-en.html
URL: http://ijrn.ir/article-1-969-en.html
Sona Jahani Tabesh Mrs 
, Narges Arsalani Dr * , Shima Shirozhan Dr , Kian Nourozi Dr , Mohsen Vahedi Dr , Mitra Nozari Mirarkalaie Mrs
, Narges Arsalani Dr * , Shima Shirozhan Dr , Kian Nourozi Dr , Mohsen Vahedi Dr , Mitra Nozari Mirarkalaie Mrs
Associate Professor, Iranian Research Center of Aging, Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran nargesarsalani@gmail.com
Abstract: (42 Views)
Introduction: Accurate assessment of functional dependency levels in neurological patients is a key component in nursing care planning within rehabilitation centers. The Barthel Index, as a simple scale, focuses on basic daily activities, whereas the Northwick Park Dependency Scale – Hospital Version (NPDS-H), with its multidimensional structure, offers a more precise evaluation of the care needs of hospitalized patients. Given the role of assessment tools in improving care quality and resource allocation, this study aimed to compare the efficiency, correlation, and agreement between these two tools in assessing functional dependency among hospitalized neurological patients in Iran.
Methods: This descriptive-analytical study was conducted in 2025 at Rofaydeh Rehabilitation Hospital. The study population included hospitalized patients diagnosed with neurological disorders (such as stroke, multiple sclerosis, spinal cord injury, and traumatic brain injury), selected through convenience sampling based on inclusion criteria: age over 18, ability to respond, and confirmed neurological diagnosis. Each patient was independently assessed using both tools by two trained evaluators—a nurse with a PhD in nursing and a rehabilitation expert with a master’s degree. The assessments were conducted one day apart, with the order of tool administration kept consistent across all participants. Data analysis was performed using descriptive statistics, Pearson correlation coefficient, and Intraclass Correlation Coefficient (ICC).
Results: A significant inverse correlation was found between the Barthel Index and NPDS-H scores (r = -0.78, p < 0.001), indicating that lower Barthel scores were associated with higher dependency levels on the NPDS-H. The mean Barthel score was 29.5 (±15.4), while the mean NPDS-H score was 37.9 (±10.2). Score ranges were 0 to 70 for the Barthel Index and 18 to 58 for NPDS-H. The agreement between the two evaluators for NPDS-H was exceptionally high, with an ICC above 0.99. Additionally, NPDS-H demonstrated broader coverage of patient care aspects compared to the Barthel Index.
Conclusion: Findings suggest that while both tools are useful in assessing functional dependency, NPDS-H offers greater precision and differentiation due to its multidimensional structure and focus on complex care needs. This tool can serve as a more accurate complement or alternative to the Barthel Index in rehabilitation settings. Utilizing NPDS-H can significantly aid rehabilitation nurses in designing personalized care plans, prioritizing care needs, and allocating human resources effectively. Future studies with larger sample sizes and diverse clinical environments are recommended to enhance generalizability and explore the tool’s practical applicability across different settings.
Methods: This descriptive-analytical study was conducted in 2025 at Rofaydeh Rehabilitation Hospital. The study population included hospitalized patients diagnosed with neurological disorders (such as stroke, multiple sclerosis, spinal cord injury, and traumatic brain injury), selected through convenience sampling based on inclusion criteria: age over 18, ability to respond, and confirmed neurological diagnosis. Each patient was independently assessed using both tools by two trained evaluators—a nurse with a PhD in nursing and a rehabilitation expert with a master’s degree. The assessments were conducted one day apart, with the order of tool administration kept consistent across all participants. Data analysis was performed using descriptive statistics, Pearson correlation coefficient, and Intraclass Correlation Coefficient (ICC).
Results: A significant inverse correlation was found between the Barthel Index and NPDS-H scores (r = -0.78, p < 0.001), indicating that lower Barthel scores were associated with higher dependency levels on the NPDS-H. The mean Barthel score was 29.5 (±15.4), while the mean NPDS-H score was 37.9 (±10.2). Score ranges were 0 to 70 for the Barthel Index and 18 to 58 for NPDS-H. The agreement between the two evaluators for NPDS-H was exceptionally high, with an ICC above 0.99. Additionally, NPDS-H demonstrated broader coverage of patient care aspects compared to the Barthel Index.
Conclusion: Findings suggest that while both tools are useful in assessing functional dependency, NPDS-H offers greater precision and differentiation due to its multidimensional structure and focus on complex care needs. This tool can serve as a more accurate complement or alternative to the Barthel Index in rehabilitation settings. Utilizing NPDS-H can significantly aid rehabilitation nurses in designing personalized care plans, prioritizing care needs, and allocating human resources effectively. Future studies with larger sample sizes and diverse clinical environments are recommended to enhance generalizability and explore the tool’s practical applicability across different settings.
Article number: 9
Keywords: Functional dependency, neurological patients, Barthel Index, NPDS-H, rehabilitation, nursing care
Type of Study: Applicable |
Subject:
Rehabilitation Nursing
Received: 2025/06/12 | Accepted: 2025/09/4 | Published: 2025/10/19
Received: 2025/06/12 | Accepted: 2025/09/4 | Published: 2025/10/19
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