Article

OBJECTIVES: To determine whether the UK Functional Assessment Measure (UK
FIM+FAM) fits the Rasch model in stroke patients with complex disability and, if
so, to derive a conversion table of Rasch-transformed interval level scores.
METHODS: The sample included a UK multicentre cohort
of 1,318 patients admitted
for specialist rehabilitation following a stroke. Rasch analysis was conducted
for the 30-item scale including
3 domains of items measuring physical,
communication and psychosocial functions.
The fit of items to the Rasch model was
examined using 3 different analytical approaches referred to as "pathways".
RESULTS: The best fit was achieved in the pathway where responses from motor,
communication and psychosocial domains were summarized into 3 super-items and
where some items were split because of differential item functioning (DIF)
relative to left and right hemisphere location
(chi2 (10) = 14.48, p = 0.15).
Re-scoring of items showing disordered thresholds did not significantly improve
the overall model fit. CONCLUSION:
The UK FIM+FAM with domain super-items
satisfies expectations of the unidimensional Rasch model without the need for
re-scoring. A conversion table was produced to convert the total scale scores
into interval-level data based on person estimates of the Rasch model. The clinical benefits of interval-transformed scores require further evaluation.

Langue : ANGLAIS