Agreement among occupational therapists in the use of the Functional Independence Measure: a comparison between different reference resources

Abstract

The Functional Independence Measure (FIM) is one of the most used scales to assess performance in activities of daily living in neurological rehabilitation worldwide. Although it is a scale with proven validity and reliability, some studies report little agreement between evaluators when scoring it. A prospective, longitudinal, experimental and quantitative study was carried out with the purpose of analyzing and comparing the degree of agreement between occupational therapists (OT) in the scoring of the FIM scale items when using different reference resources. This was carried out in a neurological rehabilitation center in Argentina in 2019-2020. The study was divided into 4 stages using different reference resources. As a result, although there is satisfactory agreement, variations were detected in the degree of agreement in the FIM scale score administered by the TOs between the stages studied. No consistent pattern was found in the degree of agreement between the items on the scale. The item with the greatest agreement in general was the use of stairs. No influence of the reference resources used on the degree of agreement between TO in the FIM score was observed since no statistically significant differences were found in the different stages. It is concluded that although the degree of agreement in the scale scores was satisfactory, it is necessary to reduce the variability in the scores assigned by TO, to increase the precision in the qualification of the FIM scale items.