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Definition

An assessment of the severity of patient disability.

Comments

Guide for use:
Patient function is assessed using the FIM™ instrument at the start of a rehabilitation episode of care and at the end of a rehabilitation episode of care. Admission assessment is collected within 72 hours of the start of a rehabilitation epsiode. Discharge assessment is collected within 72 hours prior to the end of a rehabilitation episode.

Context:
The Functional Independence Measure (FIM™) instrument is a basic indicator of patient disability. FIM™ is used to track the changes in the functional ability of a patient during an episode of hospital rehabilitation care.

Origin:

FIM™ is a trademark of the Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities Incorporated.

Australasian Rehabilitation Outcomes Centre holds the territory license for the use of the FIM™ instrument in Australia.

Comments:

FIM™ is comprised of 18 items, grouped into 2 subscales - motor and cognition.

The motor subscale includes:

  • Eating
  • Grooming
  • Bathing
  • Dressing, upper body
  • Dressing, lower body
  • Toileting
  • Bladder management
  • Bowel management
  • Transfers - bed/chair/wheelchair
  • Transfers - toilet
  • Transfers - bath/shower
  • Walk/wheelchair
  • Stairs

The cognition subscale includes:

  • Comprehension
  • Expression
  • Social interaction
  • Problem solving
  • Memory

Each item is scored on a 7 point ordinal scale, ranging from a score of 1 to a score of 7. The higher the score, the more independent the patient is in performing the task associated with that item.

1 - Total assistance with helper

2 - Maximal assistance with helper

3 - Moderate assistance with helper

4 - Minimal assistance with helper

5 - Supervision or setup with helper

6 - Modified independence with no helper

7 - Complete independence with no helper

The total score for the FIM motor subscale (the sum of the individual motor subscale items) will be a value between 13 and 91.

The total score for the FIM cognition subscale (the sum of the individual cognition subscale items) will be a value between 5 and 35.

The total score for the FIM instrument (the sum of the motor and cognition subscale scores) will be a value between 18 and 126.

References

Uniform Data System for Medical Rehabilitation. 2009. The FIM System® Clinical Guide, Version 5.2. Buffalo: UDSMR.

What is the FIM™ Instrument? Australasian Rehabilitation Outcomes Centre, University of Wollongong. Viewed 19 September 2012. http://ahsri.uow.edu.au/aroc/whatisfim/index.html


This content Based on Australian Institute of Health and Welfare material. Attribution provided as required under the AIHW CC-BY licence.

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