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1.
Can J Occup Ther ; 79(3): 167-74, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22822694

RESUMO

BACKGROUND: Selecting and utilizing appropriate assessments to evaluate outcomes is an important aspect of evidence-based occupational therapy practice. The Functional Independence Measure (FIM), to which occupational therapists contribute motor and cognitive scores, is currently the only required assessment for evaluating change from admission to discharge on an inpatient rehabilitation unit. However, occupational therapists are also using the motor and process scales from the Assessment of Motor and Process Skills (AMPS) to assess clients and evaluate change. PURPOSE: To compare responsiveness of the AMPS and the FIM on an inpatient rehabilitation unit. METHODS: A retrospective chart review of AMPS measures and FIM scores at admission and discharge was undertaken. Standardized response means and effect sizes were calculated to estimate responsiveness. FINDINGS: No significant difference was found in the ability of the AMPS motor and FIM motor scales to detect change. The AMPS process scale was more responsive to change than the FIM cognitive scale. IMPLICATIONS: Using the AMPS as an assessment to evaluate outcomes allows practitioners to detect changes that may not be detected through the exclusive use of the FIM.


Assuntos
Avaliação da Deficiência , Idoso , Idoso de 80 Anos ou mais , Hospitalização , Humanos , Centros de Reabilitação , Estudos Retrospectivos
2.
Disabil Rehabil ; 40(26): 3177-3184, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-28891345

RESUMO

PURPOSE: To determine whether there was a difference in the sensitivity to change of the subscales of the Functional Independence Measure and the Assessment of Motor and Process Skills within three different post-acute inpatient rehabilitation populations. MATERIAL AND METHODS: We conducted retrospective chart review of patients consecutively admitted to inpatient rehabilitation units, with both admission and discharge Functional Independence Measure and Assessment of Motor and Process Skills scores. A total of 276 participants were included and categorized into diagnostic groups (orthopedic, oncology, and geriatric). Within group, sensitivity to change was evaluated for the subscales of each measure by calculating the difference in standardized response means (SRM) and 95% confidence intervals (CI). RESULTS: The Functional Independence Measure motor subscale was more sensitive to change than the Assessment of Motor and Process Skills in the orthopedic and geriatric groups (SRMdifference = 1.53 [95% CI 0.93, 2.3] and 0.65 [95% CI 0.3, 1.02], respectively) but not in the oncology group (SRMdifference = 0.42 [95% CI -0.2, 1.04]). For the cognitive subscales, the Assessment of Motor and Process Skills was more sensitive to change than the Functional Independence Measure in all three groups (SRMdifference = 0.38 [95% CI 004, 0.74], 0.65 [95% CI 0.45, 0.90], and 1.15 [95% CI 0.77, 1.69] for orthopedic, geriatric, and oncology, respectively). CONCLUSIONS: The Functional Independence Measure is a mandated measure for all rehabilitation units in Canada. As the cognitive subscale of the Assessment of Motor and Process Skills is more sensitive to change than the Functional Independence Measure, we recommend also administering the Assessment of Motor and Process Skills to better detect changes in the cognitive aspect of function. Implications for rehabilitation When deciding between the Functional Independence Measure or the Assessment of Motor and Process Skills, it is important to consider whether patients' functional status is expected to change similarly or differently. The difference in sensitivity to change between the subscales of the two outcome measures varies with the characteristics of change (similar or different) in patients' functional status. We recommend using the Assessment of Motor and Process Skills, along with the Functional Independence Measure, for patients who are expected to make similar amounts of change in functional status, as the cognitive subscale of the Assessment of Motor and Process Skills is more sensitive to change and can better detect changes in the cognitive aspect of functioning. For patients whose functional status are expected to change differently (diverse diagnoses), the Functional Independence Measure may be more useful as the motor subscale was more sensitive to change when comparing between rehabilitation populations.


Assuntos
Destreza Motora , Doenças Musculoesqueléticas/reabilitação , Neoplasias/reabilitação , Alta do Paciente , Desempenho Físico Funcional , Idoso , Idoso de 80 Anos ou mais , Canadá , Feminino , Avaliação Geriátrica/métodos , Humanos , Pacientes Internados/psicologia , Pacientes Internados/estatística & dados numéricos , Masculino , Avaliação de Resultados em Cuidados de Saúde/métodos , Alta do Paciente/normas , Alta do Paciente/estatística & dados numéricos , Psicometria/métodos , Estudos Retrospectivos , Autoimagem
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