Hawley C A, Taylor R, Hellawell D J, Pentland B
Centre for Health Services Studies, University of Warwick, Coventry, CV4 7AL, UK.
J Neurol Neurosurg Psychiatry. 1999 Dec;67(6):749-54. doi: 10.1136/jnnp.67.6.749.
The drive to measure outcome during rehabilitation after brain injury has led to the increased use of the functional assessment measure (FIM+FAM), a 30 item, seven level ordinal scale. The objectives of the study were to determine the psychometric structure, internal consistency, and other characteristics of the measure.
Psychometric analyses including both traditional principal components analysis and Rasch analysis were carried out on FIM+FAM data from 2268 assessments in 965 patients from 11 brain injury rehabilitation programmes.
Two emergent principal components were characterised as representing physical and cognitive functioning respectively. Subscales based on these components were shown to have high internal consistency and reliability. These subscales and the full scale conformed only partially to a Rasch model. Use of raw item ratings, as opposed to transformed ratings, to produce summary scores for the two subscales and the full scale did not introduce serious distortion.
The full FIM+FAM scale and two derived subscales have high internal reliability and the use of untransformed ratings should be adequate for most clinical and research purposes in comparable samples of patients with head injury.
在脑损伤康复过程中，对结果进行测量的需求促使功能评估量表（FIM+FAM）的使用增加，该量表有30个项目，采用七级顺序量表。本研究的目的是确定该量表的心理测量结构、内部一致性及其他特征。
对来自11个脑损伤康复项目的965例患者的2268次评估中的FIM+FAM数据进行了心理测量分析，包括传统主成分分析和拉施分析。
出现的两个主成分分别表征身体功能和认知功能。基于这些成分的分量表具有较高的内部一致性和信度。这些分量表和总量表仅部分符合拉施模型。使用原始项目评分而非转换后的评分来生成两个分量表和总量表的汇总分数，并未造成严重偏差。
完整的FIM+FAM量表和两个派生的分量表具有较高的内部信度，对于头部受伤的可比患者样本，使用未转换的评分应足以满足大多数临床和研究目的。
