Interview Functional Independence Measure score: self-reporting as a simpler alternative to multidisciplinary functional assessment

Singapore Med J, 2019 · DOI: 10.11622/smedj.2018048 · Published: April 1, 2019

Simple Explanation

The Functional Independence Measure (FIM) is used to assess a patient's functional status during rehabilitation. Multidisciplinary FIM measurement is time-consuming. This study tested the validity of self-reported FIM motor scores in stroke patients. The study compared patient self-reporting of the motor subset of the FIM against multidisciplinary assessment. Cognitive and communication domains were excluded. Agreement between self-reporting and multidisciplinary assessment was assessed. Self-reported FIM motor scores could be an alternative in situations where multidisciplinary FIM assessment is difficult. Future studies could ascertain the robustness of patient self-reporting in the outpatient setting.

Study Duration

October 2013 to May 2014

Participants

33 stroke patients

Evidence Level

Not specified

Key Findings

1
There was substantial agreement on overall FIM motor score between patient self-reporting and multidisciplinary assessment (intraclass correlation coefficient [ICC] 0.651).
2
The scores of individual motor items also showed fair-to-good agreement (ICC range 0.431–0.618), except for eating, grooming, bathing and dressing of the lower body (ICC < 0.400).
3
Self-reporting by patients generally produced higher ratings than assessment by the multidisciplinary team.

Research Summary

This study evaluated the validity of self-reported FIM motor scores in stroke patients as an easier alternative to FIM scoring by a multidisciplinary team. Our study demonstrated modest agreement between patient self-reporting and multidisciplinary assessment of FIM motor scores as a measure of functional ability in stroke patients. Although patients tend to overrate their performance, our results suggest that patient self-reported FIM motor scores could be considered as an alternative in situations where a full multidisciplinary assessment may not be feasible.

Practical Implications

Alternative Assessment Tool

Patient self-reported FIM motor scores could be an alternative in situations where multidisciplinary FIM assessment is difficult.

Resource Utilization

Simple alternative modalities for functional status assessments are useful for long-term follow-up, and could better utilize resources and medical personnel.

Follow-up Improvement

Reliable interviewer-based or telephone FIM assessment can address the key shortcoming of patients lost to follow-up after discharge.

Study Limitations

1
Limited to assessments of functional recovery and coping in stroke patients who completed rehabilitation.
2
The results may not be valid for patient populations with cognitive or communication deficits, or those with low functional capacity.
3
Poor agreement in ratings of basic ADLs (e.g. eating and grooming).

Your Feedback

Was this summary helpful?

Back to Participation