Identifying Clinically Relevant Functional Strata to Direct Mobility Preservation Among Patients Hospitalized With Medical Conditions.

Autor:	Marfeo E; Department of Occupational Therapy, Tufts University, Medford, MA. Electronic address: elizabeth.marfeo@tufts.edu., Ni P; Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA., Wang C; College of Education, University of Washington, Seattle, WA., Weiss D; Department of Psychology, University of Minnesota; Minneapolis, MN., Cheville AL; Department of Physical Medicine and Rehabilitation Mayo Clinic, Rochester, MN.
Jazyk:	angličtina
Zdroj:	Archives of physical medicine and rehabilitation [Arch Phys Med Rehabil] 2022 May; Vol. 103 (5S), pp. S78-S83.e1. Date of Electronic Publication: 2021 Jun 16.
DOI:	10.1016/j.apmr.2021.05.009
Abstrakt:	Objective: To develop a system to guide interpretation of scores generated from the newly developed item response theory (IRT)-based Functional Assessment in Acute Care Multidimensional Computerized Adaptive Test (FAMCAT), which assesses 3 important domains of function: Mobility, Daily Activities, and Applied Cognition. Design: Cross-sectional data was used to inform a modified Delphi approach to establish FAMCAT cutpoints delineating various functional ability levels. Setting: Large midwestern academic teaching hospital. Participants: Patients hospitalized to an inpatient medical service (N=2049). Interventions: Not applicable. Main Outcome Measures: FAMCAT Basic Mobility, Daily Activity, and Applied Cognition scores. Results: IRT-based score estimation data was successfully integrated with expert clinical feedback using a modified Delphi process to arrive at consensus yielding 4 functional level strata (ranging from bed-based mobility to independent mobility) for both the FAMCAT Mobility and Daily Activity scales; 1 cutpoint was supported to delineate 2 functional strata for Applied Cognition. Conclusions: Meaningful cutpoints were established for each FAMCAT domain using a data-informed, modified Delphi process for achieving consensus. The resulting FAMCAT interpretation guide may be used to develop an ability-matched mobility preservation program and identify patients who may require a higher level of supervision based on the resulting FAMCAT scores. (Copyright © 2021 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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