In this study the fim was compared to the barthel index bi to. Irfpai training manual revised 011602 the process of taking a wellknown clinical tool and making it the basis of a national prospective payment system. Therefore, an effective and efficient method for measuring functional ability is important. The scoring considers the use of adaptive equipment andor the extent of personal assistance or supervision required to complete the task. Center for medicare and medicaid services see figure 6. Her global perspective, clarity of thought, and emphasis on the importance of the research findings has ensured that the system will be. Functional independence measurement fim user manual. After ipr there was a statistically significant improvement in all fim items. The reliability of the functional independence measure. The weefim is a measure of functional ability that can be used for typically developing children, aged 6 months through 7 years, as well as children over 7 years with disabilities and delays in functional development. Administration of the fist was intended for persons who do not have any contraindications to sitting or moving in the. It rates 18 activities of daily living on a 7 point scale ranging from. The selfcare domain includes 8 items eating, grooming. Friedman test was also performed to detect the meaningful changes in fim scores.
The functional independence measure fim is an 18item global measure of disability. Fim is used to track the changes in the functional ability of a patient during an episode of hospital rehabilitation care. It is the product of an effort to resolve the long standing problem of lack of uniform measurement and data on disability and rehabilitation outcomes. The katz index of independence in activities of daily living adl duration. Patients received assessment and treatment by a multidisciplinary team in a regional tertiary care strokespecific rehabilitation program. The functional independence measure for children weefim.
Spinal cord independence measure rehabmeasures database. Secondary measures were 10m walk test 10mwt, 6min walk test 6mwt, timed up and go tug, functional independence measure and length of stay assessed by a blinded assessor. The functional independence measures fim version 1. Administration of the fist was intended for persons who are cleared for sitting and do not have any contraindications for moving in the prescribed manner for the individual test items. Results the average fim motor scores at three months did not differ significantly between the home and hospital treatment groups. The specific fim scores are as follows, from lowest to highest. The functional independence measure fim is widely used and accepted as a functionallevel assessment tool that. Ability of functional independence measure to accurately. The functional independence measure fim is a global measure of disability and can be scored alone or with the additional 12 items that formulate the functional assessment measure fam. Functional independence measure fim in 2011 pdf free download. The functional independence measure fim was developed to be a more comprehensive and sensitive measure of disability than the barthel index bi. To explore the potential of the functional independence measure fim as a prognostic indicator of outcome in stroke survivors, 1 consecutive patients were observed from admission until discharge. Fim functional independence measure flashcards quizlet.
In 2014, the improving medicare postacute care transformation act of 2014 impact act pub. Functional skills complete independence fim 7 modified independence fim 6 supervision or setup fim 5 standby assistance contact guarding minimal contact assistance. Development of a functional assessment measure for manual. Functional independence measure definition of functional. The tool is used to assess a patients level of disability as well as change in patient status in response to rehabilitation or medical intervention.
This measure was developed to track disability in children who are between the ages of 6 months and 7 years. Administered through observation, direct interview, or both. The functional independence measure fim instrument, which includes an assessment of bladder function, is the industry standard and used by the u. Functional independence measure for children springerlink. It is an 18item performance measurement system that documents selfcare, functional mobility, and cognitive abilities. Functional independence measure and functional assessment measure functional independence measure the functional independence measure fim scale assesses physical and cognitive disability. The majority of measurement scales used to evaluate outcome in rehabilitation are ordinal in nature and consequently statistically valid assessments of change are difficult to make. Start studying fim functional independence measure. The functional assessment measure does not stand alone but adds 12 fam items to the fim, specifically addressing cognitive and psychosocial. Faq use of the functional activities questionnaire in. Functional independence measure scores of patients with. Start studying functional independence measure fim. The fim emerged from a thorough developmental process overseen by a national task force of rehabilitation. Expected spinal cord independence measure, third version, scores for various neurological levels after complete spinal cord lesions.
Functional independence measure description general description. Of the tools just mentioned, the fim has been widely adopted by the rehabilitation industry as a tool to be used with diverse patient populations. Patient function is assessed using the fim instrument at the start of a. The function in sitting test fist was created to allow healthcare providers to better describe patient abilities to move and perform functional tasks in sitting. The functional independence measure fim instrument is a basic indicator of patient disability. Welcome to the updated function page, current as of august 2018. Other scales test specific aspects of mobility, such as balance and gait eg, berg balance scale19 and. The current form structure represents the version of fim developed between 1984 and 1987 by a national task force sponsored by the american academy of physical medicine and. Functional independence measure rehabmeasures database. Fim compare favorably to most standardized health measures used in medical practice. The fim can be used for measuring disability in a wide range of conditions.
The ability to quantify the functional ability of poststroke patients engaged in a rehabilitation program may assist in prediction of their functional outco me. The functional independence measure fim scale is a basic indicator of patient disability. Functional independence measure tm and functional assessment measure brain injury scale. Functional independence measure fimz instrument admission discharge followup selfcare a. The weefim instrument consists of a minimal data set of 18 items that measure functional performance in three domains. Hartford institute for geriatric nursing recommended for you. The functional independence measure fim is an outcome measure of the severity of disability for an inpatient rehabilitation setting. Each item is scored on a 7 point ordinal scale ranging from 1 total dependence to a score of 7 total independence.
The functional independence measure fim can be weighted to possess interval properties, potentially allowing more accurate analysis of change. Independence in activities of daily living,15 and the functional independence measure16 or are diseasespecific in looking at functional mobility eg, motor assessment scale for persons with stroke17 and the parkinson activity scale18. The weefim can be administered to children over the age of 7 if their functional abilities are below those expected of children aged 7 who do not have disabilities. Fim scale fill out and sign printable pdf template signnow. Her global perspective, clarity of thought, and emphasis on the importance of the research findings has ensured that the system will be of the highest quality.
Check ahead to make sure the bathroom is accessible to ensure comfort and security. Using the spinal cord independence measure iii to measure functional recovery in a postacute spinal cord injury program. A valid tool in this field is functional independence measure fim. The functional independence measure fim was developed to address the issues of sensitivity and comprehensiveness that were criticized as being problematic with the barthel index another measure of functional independence. The functional independence measure fim is widely used and accepted as a functional level assessment tool that evaluates the functional status of patients. The fim was also developed to offer a uniform system of measurement for disability based on the international classification of impairment, disabilities and handicaps for. Functional independence measure fim the fim is an 18item, seven level ordinal scale. Grasp and release test for measuring functional limitation of persons. The functional activities questionnaire faq measures instrumental activities of daily living. Functional independence measure fim spinal cord injury. It rates 18 activities of daily living on a 7 point scale ranging from fully dependent 1 to independent with no aids 7. Evaluation of complete functional status of patients with stroke by.
Learn vocabulary, terms, and more with flashcards, games, and other study tools. Functional independence measure fim flashcards quizlet. Its area of use can include skilled nursing facilities and hospitals aimed at acute, subacute and rehabilitation care. Note the us system allows a score 0 for some fim items on admission. Functional skills complete independence fim 7 modified independence fim 6. The reliability of the functional independence measure fim sm for adults was examined using procedures of metaanalysis. Measures that describe a patients functioning, activities, andor participation in adls e. The function in sitting test fist was created to allow healthcare providers to better describe and document patientclient abilities to move and perform functional tasks in a seated position.
The fim motor scale had highexcellent reliability testretest and interrater reliability and highexcellent validity. Administration of the fist was intended for persons who do not have any contraindications to. Findings provide support for the motor and cognitive subscales as used in. Functional independence measure an overview sciencedirect. The functional activities questionnaire faq measures instrumental activities of. The functional independence measure fim is an 18item measurement tool that. The fim is an 18item 7level functional assessment designed to evaluate the. Tenet irfs shall utilize the functional independence measure fim instrument to assist in classifying a patient into a case mix group cmg. Eleven published studies reporting estimates of reliability for the fim were located using computer searches of index medicus, psychological abstracts, the functional assessment information service, and citation tracking. In addition, baseline functional independence measure fim scores at baseline and during three months of followup were also compared. Although the fim is widely used and has been shown to be reliable and valid, there is limited information about its responsiveness, particularly in comparison with the bi.
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