The functional independence measure: Tests of scaling assumptions, structure, and reliability across 20 diverse impairment categories
The functional independence measure: Tests of scaling assumptions, structure, and reliability across 20 diverse impairment categories
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DOI：
10.1016/s0003-9993(96)90130-6
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发表时间：
1996-11-01
影响因子：
4.3
通讯作者：
Granger, CV
中科院分区：
文献类型：
--
作者：
Stineman, MG;Shea, JA;Granger, CV
目的：本文的分析评估了功能独立性测量（FIM）作为一种综合评定量表在FIM-功能相关组（FIM- frg）系统的20个损伤类别中的心理测量特性。设计：本研究包括对患者记录的横断面分析，利用因素分析和多特征量表技术来验证FIM的运动和认知维度的总结特性，并研究入院FIM评分的统计特性。病人：包括1992年历年从252家独立康复医院和单位出院的93,829名病人。排除了缺失或超出范围值或非典型停留时间的病例。这些标准是先前与临床专家小组共同制定的，并通过统计分析得到证实。结果：因素分析支持所有20种损伤类别的运动和认知维度。所产生的子量表在96.9%的测试中超过了项目内部一致性的最低标准，在100%的测试中超过了项目区分效度的最低标准。两个分量表中每个损伤类别的信度系数范围为。86到97。没有主要的天花板效应，但某些损伤类别的患者在入院时无法爬楼梯。结论：综合FIM的心理测量特性优于医学实践中使用的大多数标准化健康测量。研究结果为FIM-FRGs中使用的运动和认知亚量表提供了支持。FIM作为一种单维量表，量化了护理负担。它分为运动和认知（如FIM-FRGs中使用的），将身体残疾与由沟通或认知困难引起的残疾区分开来。(C) 1996年由美国康复医学大会和美国物理医学与康复学会颁发
Objective: The analysis presented here evaluated the psychometric properties of the Functional Independence Measure (FIM) as a summated rating scale within context of the 20 impairment categories of the FIM-Function Related Group (FIM-FRG) system.Design: This study involved a cross-sectional analysis of patient records, utilizing factor analysis and techniques of multitrait scaling to verify the summative properties of the motor and cognitive dimensions of the FIM and to study the statistical properties of admission FIM scores.Patients: Included were a total of 93,829 patients discharged from 252 freestanding rehabilitation hospitals and units during calendar year 1992. Cases were excluded that had missing or out-of-range values or atypical lengths of stay. These criteria were developed previously in conjunction with an expert clinical panel and confirmed through statistical analyses.Results: Factor analyses supported the motor and cognitive dimensions across all 20 impairment categories. The resulting subscales exceeded minimum criteria for item internal consistency in 96.9% of tests and item discriminant validity in 100% of tests. Reliability coefficients for each impairment category for both subscales ranged from .86 to .97. There were no major ceiling effects, but patients in certain impairment categories were unable to climb stairs at admission.Conclusion: The psychometric properties of the summated FIM compare favorably to most standardized health measures used in medical practice. Findings provide support for the motor and cognitive subscales as used in the FIM-FRGs. As a unidimensional scale, the FIM quantifies care burden. Split into the motor and cognitive (as used in the FIM-FRGs) it distinguishes physical disabilities from those arising from communication or cognitive difficulties. (C) 1996 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation