Alcott D, Dixon K, Swann R
Unsted Park Rehabilitation Hospital, Surrey, UK.
Disabil Rehabil. 1997 Sep;19(9):355-8. doi: 10.3109/09638289709166551.
The reliability of the Functional Assessment Measure (FIM+FAM) is an important issue with its increased use in the measurement of neurological disability and rehabilitation outcome. Although the Motor items have good reliability ratings, the Cognitive items are more difficult to complete and their reliability is not as good. This study tests the suggestion that this might be due to the Cognitive items being more abstract. A keyword from each of four Motor items was compared with a keyword from four Cognitive items. Abstractness was measured by measuring the 'imageability' of each keyword. The Motor items were found to have a significantly higher mean imageability rating than the Cognitive items. Thus, there is support for the suggestion that abstractness contributes to the poorer reliability of the Cognitive items. These results led to the proposal that the reliability of the Cognitive items might be improved by various methods of increasing the tangibility of these measures (e.g. subdivision of broad categories of disabilities, enhancing item descriptions, training raters to increase their recognition of relevant observations, and using specific assessment tasks to elicit relevant behaviours).
功能评估量表（FIM+FAM）的可靠性是一个重要问题，因为它在测量神经功能障碍和康复结果方面的应用越来越广泛。虽然运动项目具有良好的可靠性评级，但认知项目更难完成，其可靠性也没那么好。本研究检验了这样一种观点，即这可能是由于认知项目更抽象所致。将四个运动项目中的每个项目的一个关键词与四个认知项目中的一个关键词进行比较。通过测量每个关键词的“可想象性”来衡量抽象程度。结果发现，运动项目的平均可想象性评级显著高于认知项目。因此，有证据支持抽象性导致认知项目可靠性较差这一观点。这些结果促使人们提出，可以通过各种方法提高这些测量的可触知性（例如细分广泛的残疾类别、增强项目描述、培训评分者以提高他们对相关观察结果的识别能力，以及使用特定的评估任务来引发相关行为），从而提高认知项目的可靠性。
