Hetherington H, Earlam R J, Kirk C J
Royal London Hospital, UK.
Injury. 1995 Mar;26(2):97-101. doi: 10.1016/0020-1383(95)92185-d.
The type and severity of disability following major trauma was evaluated using the Functional Independence Measurement (FIM) in 93 patients brought to the Royal London Hospital (RLH) by helicopter. The range of values for FIM is from 18 (dependent) to 126 (fully independent) in the six sections of self-care, sphincter control, mobility, locomotion, communication and social cognition. The sections are divided into 18 separate items and graded 1-7. Forty-eight patients were discharged directly to home with a median FIM score of 124; 11 were transferred to another acute hospital with a median FIM of 63 and seven went to rehabilitation unit with a median FIM of 58. At six months, 79 per cent of the patients reported no disability and 89 per cent of the original 93 patients were at home with a median FIM of 126. The mean amount of rehabilitation provided at the RLH for all patients was 11 h 20 min with a mean in-patient length of stay of 14 days. The actual and optimal amount of therapy for rehabilitation worked out at less than 1 h per day in the acute hospital. FIM is a useful, practical and simple methodology for recording disability in the acute hospital. It provides a measure for assessing the original disability, its progress and residual limitations. Nurses, doctors and therapists can use it for establishing care plans and goals as well as deciding the transfer of the patient to the most appropriate place for future care.
采用功能独立性测量（FIM）对93名由直升机转运至皇家伦敦医院（RLH）的患者在严重创伤后的残疾类型和严重程度进行了评估。FIM的取值范围在自我护理、括约肌控制、活动能力、移动能力、沟通能力和社会认知这六个方面为18分（依赖）至126分（完全独立）。这些方面又分为18个单独项目，并按1 - 7级评分。48名患者直接出院回家，FIM中位数为124分；11名患者转至另一家急症医院，FIM中位数为63分，7名患者前往康复机构，FIM中位数为58分。六个月时，79%的患者报告无残疾，最初93名患者中的89%在家中，FIM中位数为126分。RLH为所有患者提供的康复平均时长为11小时20分钟，平均住院时长为14天。急症医院康复治疗的实际和最佳时长计算得出每天少于1小时。FIM是一种用于记录急症医院残疾情况的实用且简单的方法。它为评估初始残疾情况、其进展及残留限制提供了一种手段。护士、医生和治疗师可利用它来制定护理计划和目标，以及决定将患者转至最适合其未来护理的场所。
