Purpose: The most frequently used assessment instrument in the early stage of rehabilitation is the Functional Independence Measure (FIM), which quantifies patient's level of independence in basic daily life activities. The FIM is a multidimensional measure. Postulated dimensions within the FIM are the motor and the cognitive dimension. Until now the psychometric properties of the FIM in patients with more severe functioning limitations are not sufficiently known. The objective of this study is therefore to study the psychometric properties of the FIM in patients with more severe functioning limitations in the early stages of rehabilitation. The specific aims are to examine (1) whether there are floor effects and hence whether the FIM discriminates functioning across patients with neurological conditions in early post-acute rehabilitation facilities and (2) whether the two dimensional structure also applies to our study population.
Purpose. The purpose of this article is to utilise the perspective of persons with a spinal cord injury (SCI), gained from focus groups, to validate recommended clinical measures of outcome.Method. Clinical measures of outcome as recommended by Wood-Dauphinee and the SCI Consensus Group were categorised using the World Health Organisation's International Classification of Functioning, Disability and Health (ICF). These were then cross-referenced to the problems of functioning identified by patients in 10 focus groups held in New Zealand as part of the International ICF Core Set project. The focus groups were performed separately for people in the post-acute situation and in the chronic situation to address different experiences since SCI.Results. In the post-acute group, the recommended measures of functioning, the Functional Independence Measure (FIM), Hospital Anxiety and Depression Scale and Visual Analogue Scale for pain correlated well against the focus groups identification of problems of functioning. In the chronic group, the short-form Craig Handicap Assessment and Reporting Technique (sf-CHART), the SF-12 and the Life Satisfaction Questionnaire (LSQ) largely captured the problems of functioning identified. There were some categories that were common to both patient groups and were not changed by time since SCI. In addition, there were some problems of functioning identified by the patient groups that were not covered by the suggested measures.Conclusions. Utilisation of a battery of outcome measures based on a theoretical framework can quantify problems of functioning in the SCI population. Although the measures suggested by SCI Consensus Group largely capture the problems of functioning, other outcome measures have been shown to be more responsive to the changes in the SCI population and also incorporate more of the identified problems of functioning.
AbstractPurpose: The objectives of this study were (1) to determine whether the ICF covers the goals of nursing interventions and (2) to identify the areas of functioning, disability and health most relevant to nursing practice of neurological patients with early post-acute rehabilitation needs.Methods: This cross-sectional study on nursing interventions is part of a larger multicentric cross-sectional study describing functioning, disability and health. The nursing interventions were recorded by nurses in charge of the patient. According to established rules, the recorded nursing interventions were linked to the ICF.Results: One hundred and eighteen different nursing interventions were documented by the nursing staff. The intervention goals were linked to 67 different second-level ICF categories. Thirty belong to the component Body Functions, 19 to the component Body Structures, 13 to the component Activities and Participation, and five to the component Environmental Factors.Conclusions: The fact that all nursing interventions in early post-acute rehabilitation facilities could be linked to ICF categories supports the usefulness of the ICF in nursing. Initial problems in adapting profession-specific terminology to the ICF framework can be overcome, as shown by our linking exercise. Further analyses will be needed to show if these theoretical findings are supported by empirical evidence.Nursing processrehabilitation nursingICFpost-acute rehabilitation
