Basic activities of daily living ability in Chinese hospitalized elderly patients with heart failure: a cross-sectional study

To evaluate the measurement properties of the Barthel Index using Rasch analysis and to characterize the basic activities of daily living ability profile in hospitalized elderly patients with heart failure. From December 2021 to December 2022, 237 elderly heart failure patients fulfilled the inclusion and exclusion criteria in the Department of Cardiology, The First Affiliated Hospital of Soochow University, were chosen using a convenience sampling method. A general information questionnaire and the Barthel Index were used to assess the patients. SPSS 25.0, Winsteps 3.72.3 and R4.5.3 software were used for statistical analysis, and statistical methods included descriptive statistics and Rasch analysis with test level α = 0.05. Impairment in basic activities of daily living was present in 69.2% of patients; mild impairment was present in 57.4% of all patients. Rasch analysis supported unidimensionality but identified bathing as the hardest item, transfers easiest, and misfit for walking and grooming. The Wright map showed targeting gaps at ability extremes. The Barthel Index demonstrated unidimensionality in older heart failure inpatients but revealed a distinct difficulty hierarchy: transfers was the easiest item and bathing the hardest, while grooming was unexpectedly challenging. Walking showed misfit, and the person-item map indicated poor targeting at ability extremes. These findings suggest careful score interpretation and may inform the design of future rehabilitation interventions, such as attending to bathing tolerance, upper-extremity training, and safe mobility. Not applicable.