比较 FIM 和 interRAI 急性后期护理评估工具在老年人康复中的反应性。

Comparison of the responsiveness of the FIM and the interRAI post acute care assessment instrument in rehabilitation of older adults.

机构信息

Department of Health Studies and Gerontology, University of Waterloo, Waterloo, ON, Canada.

出版信息

Arch Phys Med Rehabil. 2010 Jul;91(7):1038-43. doi: 10.1016/j.apmr.2010.03.014.

DOI:10.1016/j.apmr.2010.03.014

PMID:20537315

Abstract

OBJECTIVE

To compare the responsiveness of 2 major systems developed for rehabilitation settings--the FIM and the interRAI Post Acute Care (PAC) assessment--in older patients.

DESIGN

Trained raters assessed patients with both tools at admission and discharge.

SETTING

Musculoskeletal (MSK) and geriatric rehabilitation units (GRUs) in 2 rehabilitation hospitals.

PARTICIPANTS

Older adults receiving rehabilitation (N=208; mean age +/- SD, 78.5+/-9.3; 67% women).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Responsiveness was evaluated using effect size (ES) and standardized response mean (SRM).

RESULTS

ES and SRM were somewhat higher for the FIM motor (GRU ES=1.68, SRM=1.31; MSK ES=2.12, SRM=2.25) than the PAC (GRU ES=1.64, SRM=1.29; MSK ES=1.57, SRM=1.89) in both patient groups. Both tools were more responsive in MSKs than GRUs. This may reflect the greater frailty and clinical complexity of GRU patients.

CONCLUSIONS

Both the FIM motor and the PAC were able to detect clinically relevant improvement in functional ability in older rehabilitation inpatients.

摘要

目的

比较 2 种专为康复环境开发的主要评估系统——功能独立性测量（FIM）和 interRAI 急性后期护理（PAC）评估——在老年患者中的反应能力。

设计

经过培训的评估员在入院和出院时使用这两种工具评估患者。

地点

2 家康复医院的肌肉骨骼（MSK）和老年康复病房（GRU）。

参与者

接受康复治疗的老年人（N=208；平均年龄 +/- 标准差，78.5+/-9.3；67%为女性）。

干预措施

不适用。

主要观察指标

使用效应大小（ES）和标准化反应均值（SRM）评估反应能力。

结果

在 2 个患者组中，FIM 运动（GRU ES=1.68，SRM=1.31；MSK ES=2.12，SRM=2.25）的 ES 和 SRM 略高于 PAC（GRU ES=1.64，SRM=1.29；MSK ES=1.57，SRM=1.89）。这两种工具在 MSK 中的反应能力均强于 GRU。这可能反映了 GRU 患者的身体脆弱性和临床复杂性更大。