Underestimating Physical Function Gains: Comparing FIM Motor Subscale and interRAI Post Acute Care Activities of Daily Living Scale
| Autor: | Mary E. Thompson, Katherine Berg, Paul Stolee, Christine Glenny, Janice A. Husted |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Geriatric rehabilitation Activities of daily living Frail Elderly medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation Rehabilitation Centers Cohort Studies Physical medicine and rehabilitation Activities of Daily Living Health care medicine Health Status Indicators Humans Disabled Persons Functional ability Geriatric Assessment Physical Therapy Modalities Aged Aged 80 and over Ontario Rehabilitation Rasch model business.industry Reproducibility of Results Construct validity Recovery of Function Motor Skills Physical therapy Ceiling effect Female Cognition Disorders Psychology business Follow-Up Studies |
| Zdroj: | Archives of Physical Medicine and Rehabilitation. 93:1000-1008 |
| ISSN: | 0003-9993 |
| DOI: | 10.1016/j.apmr.2011.12.027 |
| Popis: | Glenny C, Stolee P, Thompson M, Husted J, Berg K. Underestimating physical function gains: comparing FIM motor subscale and interRAI Post Acute Care activities of daily living scale. Objective To investigate the construct validity of the activities of daily living (ADLs) sections of 2 major systems developed to measure functional ability in rehabilitation settings. Health assessment systems can inform care planning as well as policy decision-making on service effectiveness. Frailty, comorbidity, and heterogeneity make it difficult to accurately measure health outcomes for older adults. Objective investigation of the value of geriatric rehabilitation services requires assessment systems that are comprehensive, reliable, valid, and sensitive to clinically relevant changes in older patients. Design Trained health care workers assessed patients with both tools at admission and discharge. We used Rasch analysis to compare the instruments' dimensionality, item difficulty, item fit, differential item function, and number of response options. Setting Musculoskeletal and geriatric rehabilitation units in 2 Ontario hospitals. Participants Older adults receiving rehabilitation (N=209; mean age ± SD, 78.5±9.3; 67% women). Interventions Not applicable. Main Outcome Measures FIM and the interRAI Post Acute Care Assessment (interRAI PAC). Results For both the FIM motor and the interRAI PAC ADLs items, the difficulty level of the items was much lower than the participant's level of ability, resulting in a large ceiling effect. Also, on both scales, less actual change in functional ability was required to move between the midlevel response options. Conclusions Both scales have limited ability to discriminate between subjects with higher functional ability, which indicates that they may underestimate the effectiveness of inpatient rehabilitation for this group of patients when used alone. |
| Databáze: | OpenAIRE |
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