A comprehensive psychometric evaluation of the UK FIM + FAM. (October 2013)

• Record Type: Journal Article
• Authors: Turner-Stokes, Lynne; Siegert, Richard J.
• Is Part Of: Disability and rehabilitation. Volume 35:Number 22(2013:Nov.)
• Page Start: 1885
• Page End: 1895
• Publication Date: 2013-10
• Subjects: People with disabilities -- Periodicals; Rehabilitation -- Periodicals; 617.03
• DOI: 10.3109/09638288.2013.766271
• Languages: English
• ISSNs: 0963-8288

Abstract

<abstract> <title>Abstract</title> <p> <italic>Purpose</italic>: To evaluate the psychometric properties of the UK FIM + FAM. <italic>Methods</italic>: (a) A systematic literature review integrating the evidence for psychometric qualities of both the original and UK versions, and (b) exploratory and confirmatory factor analysis of admission/discharge data from an inpatient general neuro-rehabilitation cohort using parametric and non-parametric techniques. A prospective cohort of 459 patients with a male:female ratio of 57:43 and mean age of 44.5 (SD 14.3) years participated in this study. <italic>Results</italic>: Seven published articles together demonstrated acceptable utility, concurrent validity, inter-rater reliability and responsiveness of the UK FIM + FAM. Factor analysis demonstrated that all items loaded high (>0.58) on the first principal component and distinct <italic>motor</italic> and <italic>cognitive</italic> factors emerged after rotation. A four-factor solution also demonstrated four distinct, interpretable dimensions (Physical, Psychosocial, Communication and Extended Activities of Everyday Living (EADL)). Mokken analysis of the second data set confirmed these dimensions. Cronbach's <italic>α</italic>s were 0.97 and 0.96 for the motor and cognitive domains and 0.90–0.97 for the subscales. Analysis of responsiveness demonstrated "large" effect sizes (0.86–1.29). <italic>Conclusions</italic>: The UK FIM + FAM, including the newer EADL module, is a valid, reliable scale of functional independence. It has high internal consistency in two domains and four subscales and is responsive to changes occurring in a general inpatient neuro-rehabilitation population.<list list-type="bullet"><title>Implications for Rehabilitation</title><list-item><p>The UK FIM + FAM is a valid, reliable scale of functional independence, which is responsive to changes occurring in a general inpatient neuro-rehabilitation population.</p></list-item><list-item><p>It can be used to derive a reliable, single score of overall independence and also yields specific information in two main domains and four separate subscales of independence: <italic>Physical, Psychosocial, Communication</italic> and <italic>Extended Activities of Daily Living (EADL)</italic>.</p></list-item><list-item><p>The newer EADL item module provides added value, measuring functional independence for community-based activities.</p></list-item></list></p> </abstract>