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Arch Phys Med Rehabil. 2006 Oct;87(10):1382-7.

Agreement between patient and proxy responses during recovery after hip fracture: evidence for the FIM instrument.

Author information

1
Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada. cajones@ualberta.ca

Abstract

OBJECTIVE:

To evaluate the agreement between patient and proxy responses of the FIM instrument at 4 different periods of time during the first 6 months after hip fracture.

DESIGN:

Prospective cohort study.

SETTING:

A large urban health region with 2 tertiary hospitals that treat hip fractures.

PARTICIPANTS:

Patients (n=137) who were 65 years or older, admitted to the health region with a primary diagnosis of hip fracture, who had Mini-Mental State Examination scores greater than 17. Family caregivers (n=137) participated as proxy respondents.

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURE:

The FIM instrument. Agreement was evaluated at each of the 4 assessments during the 6-month follow-up after hip fracture using intraclass correlation coefficient.

RESULTS:

FIM scores improved over the 6 months with the greatest improvement occurring within the first month of recovery. Agreement was higher for more observable activities than less observable ones. The magnitude of agreement improved over the 6 months with the proportion of clinically important systematic differences decreasing over time. Agreement for change scores was lower than the agreement at each of the 4 assessments.

CONCLUSIONS:

Patient-proxy agreement levels are acceptable; the agreement varies with the subscale and the recovery phase. Substitution of proxy for patient responses across time may be used guardedly when patient responses are missing.

Comment in

PMID:
17023250
DOI:
10.1016/j.apmr.2006.06.008
[Indexed for MEDLINE]

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