F-3-17-05
RELIABILITY AND VALIDITY OF THE FUNCTIONAL INDEPEHDENCE MEASURE
Ji-Fang Qiu (Zhe Jiang Provincial People's Hospital, Hang Zhou, P. R. China)
Abstract: This study was to investigate the reliability and validity of Functional Independence Measure (FIM) among rehabilitation inpatients. 29 patients were measured. Of them, 19 were mate, 10 being female, average age being 44±13. Diaonoses of 9 were stroke, those of 13 being spinal cord injury, 7 traumatic brain injury. For reliability purpose, internal consistency of the FIM was calculated using Cronbach's α.To assess FIM validity, relationships between FIM and Barthel index (BI). FIM and Minimental state examination (MMSE) were investigated. Results showed the FIM had a relatively high overal internal consistency (admission FIM α= .89, discharge FIM α= .88). As to FIM validity, FIM motor subscale were positively correlated to BI (r= .4616, p< .001). FIM cognitive subscale were also positively correlated to MMSE (r= .9671, p< .001. It is concluded FIM has relatively high internal consistency and is well validated in functional independence evaluation among inpatients with commonly encountered disabilities.
F-3-17-06
THE NORTHWICK PARK DEPENDENCY SCALE - A MEASURE OF NURSING DEPENDENCY WHICH TRANSLATES INTO CARE NEEDS IN THE COMMUNITY
Lynne Turner-Stokes, Pauline Tonge, Maggie Hunter, Stuart Nielson, Kyaw Nyein, Ian Robinson (Regional Rehabilitation Unit, Northwick Park Hospital and Brunel University. UK)
Disability scores such as the Functional Independence Measure and Barthel have been shown to correlate with care needs, but cannot be used to assess them directly as they do not indicate the number of people required to help with a task, not the time taken to complete it. The Northwick Park Dependency Scale (NPDS) is an ordinal scale that can be used to assess impact on nursing time. Together with a short set of additional questions it may be used directly to assess care needs in the community and facilitate discharge planning.
Objective: To develop the scale and evaluate it for reliability and validity.
Methods: Following a survey of existing instruments, tasks were selected on the basis that they impact on nursing time in a rehabilitation setting. Cut-off points for different levels were devised to reflect the number of helpers needed and time taken. Inter- and intra-rater reliability were tested in a cohort of 23 patients using 5 senior nurses. Each patient was assessed independently by 3 nurses on each of three occasions.
Results: The score takes 3-5 minutes to complete. There was an excellent level of association in total score between each pair of nurses (rho .73- .93) with a mean difference of only .36 (the total maximum score is 100). Agreement ± 1 level for individual items ranged from 73-100%. Significant disagreements were followed up and 5 items were felt to require clarification in the manual. In intra-rater reliability, the total score correlation coefficient across all raters was .96, with absolutely no significant differences on any items. The basic care needs section of the NPDS showed good inverse correlation with the Barthel Score (rho -.91)
Conclusion: The Northwick Park Dependency Scale is simple and practical to use and is shown to be valid and reliable in assessment of nursing dependency in a rehabilitation setting.
