Abstract

To provide the best possible quality of life for chronically ill persons and for the frail elderly, an evidence based arrangement of health and social services is needed. The services should correspond to the client’s actual needs and be as cost-effective as possible, which enables maximum independence in the client’s everyday life and allows to achieve or maintain the highest practicable level of well-being. To organise evidence based care, reliable data based on reliable comprehensive assessment are required. RAI is an international standardised instrument for comprehensive assessment of clients. The instrument helps to gather information on a client’s strengths and needs, which constitutes a database for drawing up an individualised care plan.

Cross-cultural adaption of an assessment instrument requires special internationally accepted methodology: translation from the original language, analysis by a committee of specialists to adapt an instrument culturally, back-translation into the original language and reliability testing of the adapted instrument. Inculcation of the RAI–NH version in Estonia started in October 2002. Reliability testing was carried out by using the test-retest method and the inter-rater method. Twelve persons from four Estonian hospitals were involved in the pilot project. The results of reliability testing were analysed and the reliability of the RAI-NH was verified. The reliability coefficient κ was 0.945 (test-retest reliability) and 0.76 (inter-rater reliability). From the beginning of 2004, Estonia has the permission of the International RAI organisation (InterRAI) for using the RAI-NH Version 2.