Department of Physical Therapy, University of Texas Medical Branch, Galveston, TX.
Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX.
Arch Phys Med Rehabil. 2018 Aug;99(8):1479-1482.e1. doi: 10.1016/j.apmr.2018.01.016. Epub 2018 Feb 8.
To examine how similar summary scores of physical functioning using the FIM can represent different patient clinical profiles.
Retrospective cohort study.
Inpatient rehabilitation facilities.
Medicare fee-for-service beneficiaries (N=765,441) discharged from inpatient rehabilitation.
Not applicable.
We used patients' scores on items of the FIM to quantify their level of independence on both self-care and mobility domains. We then identified patients as requiring "no physical assistance" at discharge from inpatient rehabilitation by using a rule and score-based approach.
In those patients with FIM self-care and mobility summary scores suggesting no physical assistance needed, we found that physical assistance was in fact needed frequently in bathroom-related activities (eg, continence, toilet and tub transfers, hygiene, clothes management) and with stairs. It was not uncommon for actual performance to be lower than what may be suggested by a summary score of those domains.
Further research is needed to create clinically meaningful descriptions of summary scores from combined performances on individual items of physical functioning.
研究使用 FIM 进行身体功能的综合评分如何反映不同患者的临床特征。
回顾性队列研究。
住院康复设施。
医疗保险按服务收费受益人的住院康复出院患者（N=765441）。
无。
我们使用患者 FIM 项目的评分来量化他们在自理和移动领域的独立性水平。然后，我们使用规则和基于评分的方法，确定患者在出院时是否需要“无身体协助”。
在那些 FIM 自理和移动综合评分表明不需要身体协助的患者中，我们发现他们实际上经常需要在浴室相关活动（如控制大小便、厕所和浴缸转移、卫生、衣物管理）和上下楼梯方面得到协助。实际表现低于这些领域的综合评分所提示的情况并不少见。
需要进一步研究，以便根据身体功能的个别项目的综合表现，为综合评分创建有临床意义的描述。
