19. Preliminary report on the reliability and validity of the Alpha FIMTM at the John Radcliffe Hospital (139)

Janice Hinkle, Senior Research Fellow, School of Health & Social Care, Oxford Brookes University, Oxford, United Kingdom
Co authors:  Jacqueline McClaren & Janette Davies
janice.hinkle@ndm.ox.ac.uk

Abstract:

Background:

Reliable and valid tools are an important aspect of discharge planning (Shepperd et al., 2004) The Functional Independence Measure (FIMTM) was developed to help rehabilitation clinicians reliably document a patient’s level of disability. It is widely used in the United States (US) (Hinkle, 2000) and has been implemented tentatively in the United Kingdom (UK). A newer Alpha FIMTM, formulated for the acute care setting, is beginning to be used in the US (Clark et al., 2000) but has yet to be validated in the UK. The purpose of this study was to investigate the reliability and validity of the Alpha FIMTM at the John Radcliffe Hospital.

Method:

This prospective descriptive study used an audit methodology for data collection. During the first 11 weeks the research nurse collected demographic data, FIMTM, Alpha FIMTM, and the Barthel Index (BI) on 260 patients.

Results:

Of the 258 patients on whom data were available 43% (111) were male and the mean age was 79 years, range 20-99 (SD + 12.77). The FIMTM was assessed between 5 and 11 days following admission. The mean FIMTM score was 72, range 18-126 (SD + 31.75), Alpha FIMTM was 28, range 6-42 (SD + 11.53) and BI was 10, range 1-20 (SD + 6.5). The Cronbach’s alpha coefficents were: FIMTM .958, Alpha FIMTM .904, and BI .935. There were significant differences in all three tools across discharge destinations (p < .01).

Discussion:

The FIMTM, Alpha FIMTM, and BI are all reliable and valid tools in this study population. The FIMTM and the Alpha FIMTM have a greater score spread and give the nurse a better view of the patient’s function.

Conclusion:

This research is still investigating the most appropriate measure that informs the discharge process, with implications for discharge destination, in acute general medical patients.

Recommended reading list:

• Clark, G. S., Stillman, G. R., Linn, R. T. and Granger, C. V. (2000) In Annual meeting of the Association of Academic Physiatrists, Vol. 79 Lippincott Williams & Wilkins Inc., San Diego, California, pp. 214-215
• Hinkle, J. L. (2000) Topics in Stroke Rehabilitation, 7, 1-21.
• Shepperd, S., Parkes, J., McClaran, J. and Phillips, C. (2004) Oxford, pp. 36

Source of Funding:  UK - Health Service (Local)
Oxfordshire Health Services Research Committee (Ohsrc)


Amount in Funding:  1,000 - 10,000

Biography:

The author is currently a senior research fellow at Oxford Brookes University with an honorary nurse consultant contract at the John Radcliffe Hospital.