Abstract
Individual items of the Functional Independence Measure (FIM) were analyzed for interinstitutional agreement using a sample of 57 spinal cord injured (SCI) patients at discharge from an acute care rehabilitation setting (ACRS) and at admission to an ongoing rehabilitation setting (ORS). The two FIM ratings were performed within 6 days of each other.
The reliability coefficient for total FIM scores was good: 0.83. Individual items were classified into four groups: (1) above average reliability coefficient, above average proportion agreement, which included the feeding items and items from the mobility category; (2) above average reliability coefficient, below average agreement, which included the majority of items in the selfcare category; (3) below average reliability coefficient, above average agreement, which included items in the sphincter control and communication categories; and (4) below average reliability coefficient, below average agreement, which included items in the social cognition category. Patients received significantly higher ratings on most selfcare items in the ACRS, and significantly higher ratings on social cognition items in the ORS. Implications of these results are discussed in terms of using individual FIM items for research purposes.
Reliability coefficients were acceptably high for subgroups of complete and incomplete paraplegics and for complete quadriplegics, ranging from 0.74 to 0.87, but low for incomplete quadriplegics, r = 0.49. However, these sample sizes were small, ranging from 9 to 17 patients. Data collection will continue in order to increase sample size and permit further analysis of these subgroups.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Guide for Use of the Uniform Data Set for Medical Rehabilitation (1990) Center for Functional Assessment Research, State University of New York at Buffalo, Buffalo, NY.
Whiteneck G (1988) A Functional Independence Measure trial in spinal cord injury model systems. Abstracts Digest, American Spinal Injury Association 14th Annual Scientific Meeting 1988: 48.
Shepard M J (NASCIS III Coordinator) (1992) Personal communication.
Segal M (1992) Analysis of the incidence of falls in the falls risk assessment program. Submitted to Thomas Jefferson University Utilization Review, Philadelphia PA.
Heinemann A W, Linacre M, Hamilton B, Wright B, Mamott B (1991) Rating scale analysis of the Functional Independence Measure. J Am Paraplegia Soc 14: 86.
Kaplan R M, Saccuzzo D P (1989) Psychological Testing: Principles, Applications, and Issues. 2nd ed. Brooks/Cole, Pacific Grove, PA.
Ditunno J F (1992) New spinal cord injury standards. Paraplegia 30: 90–91.
Ditunno J F (1992) Functional assessment measures in CNS trauma. J Neurotrauma 9: S301–S305.
Dollfus P (1992) The scientific committee of the International Medical Society of Paraplegia. Paraplegia. 30: 22.
Hamilton B, Laughlin J A, Granger C V, Kayton R M (1991) Interrater agreement of the seven level Functional Independence Measure (FIM). Arch Phys Med Rehabil 72: 790.
Anastasi A (1982) Psychological Testing. 5th ed. Macmillan, New York.
Spearman C E (1904) The proof and measurement of association between two things. Am J Psychol 15: 72–101.
Cohen J (1960) A coefficient of agreement for nominal scales. Educ Psychol Measurement 20: 37–46.
Feinstein A R, Cicchetti D V (1990) High agreement but low kappa: I. The problems of two paradoxes. J Clin Epidemiol 43: 543–549.
Davidoff G N, Roth E J, Haughton J S, Ardner M S (1990) Cognitive dysfunction in spinal cord injury patients: Sensitivity of the Functional Independence Measure subscales vs neuropsychologic assessment. Arch Phys Med Rehabil 71: 326–329.
Segal M, DeJoseph L (1992) FIM mastery testing: videotapes vs. written case studies. Presentation at the American Paraplegia Society 38th annual conference, Las Vegas, 1992.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Segal, M., Ditunno, J. & Staas, W. Interinstitutional agreement of individual functional independence measure (FIM) items measured at two sites on one sample of SCI patients. Spinal Cord 31, 622–631 (1993). https://doi.org/10.1038/sc.1993.101
Issue date:
DOI: https://doi.org/10.1038/sc.1993.101
Keywords
This article is cited by
-
Inter-Rater-Reliabilit�t von Instrumenten zur Beurteilung der Pflegebed�rftigkeit: Ein Review der internationalen Literatur
Sozial- und Pr�ventivmedizin SPM (1996)
