Validity of the functional independence measure (FIM) for elderly patients receiving rehabilitation

The Functional independence Measure (FIM) was developed to assess the burden of care of persons receiving rehabilitation services in regard to self-care activities and social and cognitive skills. Until now, no study has evaluated the validity of the FIM with the elderly without distinction of diagnosis. The purpose of this study was to examine the MIF's factorial structure using a principal components analysis. As a secondary goal, the predictive validity and the internal consistency of the instrument were also examined. Data collected from 120 subjects generated a solution consisting of three factors accounting for 67.6 per cent of the total variance. The first factor (46.6%) represents the handicap concept, the second factor (14.7%) measures disability and the third factor (6.3%) represents disability with a major component of physical involvement of lower extremities. The results of this analysis confirm the multidimensional structure of the FIM and reveal the possibility of a third factor for the elderly. With this population, internal consistency of the instrument, obtained from admission and discharge data, is estimated at 0.92 and 0.96 with Cronbach's alpha. Total FIM score at discharge as well as items related to the handicap factor as measured on admission allow us to correctly predict place of discharge in a proportion of 72.9 per cent of the cases. These results indicate that the FIM bears an interesting potential for measuring rehabilitation outcomes for the elderly.