Purpose: This study investigated whether patients originally evaluated on the swallowing portion of the Functional Assessment Measure (SFAM), an instrument that when used independently of the Functional Assessment Measure (FAM) has questionable reliability and validity, would demonstrate clinically and statistically significant gains if measured on an instrument such as the Functional Oral Intake Scale (FOIS), which is valid and reliable. Second, this study questioned how easily the FOIS could be adopted at Rancho Los Amigos National Rehabilitation Center (RLANRC), a rehabilitation facility currently utilising the Functional Independence Measure and the SFAM. Additionally, this research addressed inter-rater reliability, the relationship between the SFAM and FOIS at admission and at discharge, and the clinical and statistical difference in ratings between the two scales.
Method: Treatment was given at RLANRC in Downey, California. Subjects for this study consisted of 100 first time-documented acute stroke patients with swallowing disorders. Inter-item correlation, intraclass correlation coefficients and Spearman Rho Correlations were used to establish inter-rater reliability, and descriptive statistics, Spearman Rho Correlations and the Wilcoxon Signed Ranks Test were used to explore relationships between the two scales.
Results: It was found that there was high inter-rater reliability, strong significant relationships between the SFAM and FOIS at admission and discharge, and statistically significant differences and clinical change in scores between admission and discharge on the FOIS.
Conclusion: The FOIS is a valid and reliable instrument that is similar in design to the SFAM and requires minimal training for implementation. The transition from the SFAM to the FOIS will provide RLANRC with a reliable and valid assessment protocol.