Linkage between International Classification of Functioning, Disability and Health Qualifiers to levels of the Functional Independence Measure: A proposal for applicability in clinical practice in a Developing Country
Keywords:International Classification of Functioning, Disability and Health, Patient Outcome Assessments, functional outcome, Functional Independence Measure
AbstractAim: To propose a link between Functional Independence Measure (FIM) levels and International Classification of Functioning, Disability and Health (ICF) qualifiers for use in a developing country (Brazil). Methods: A multidisciplinary committee was formed that discussed the need for standardization of the classification so that different professionals could accurately record the functioning and, at the same time, be meaningful for the individual and his support group, allowing observation and participation in the rehabilitation process. They proposed steps to adapt linking ICF qualifiers with FIM scores and functional levels: 1. Transposition, 2. Parity, 3. Inversion and 4. Adaptation. Results: FIM’s seven levels of functioning have been linked to the five ICF qualifiers. FIM levels "7" (independent) and "6" (modified independence) have been linked to qualifiers ("0 = no problem" and "1 = mild problem)", respectively. FIM levels "4" and "5" have been grouped and linked to ICF qualifier "2 = moderate". FIM levels "3" and "2" have been related to qualifier "3 = severe". FIM level 1 which indicates complete dependence has been linked to qualifier "4 = complete". Conclusion: This methodology allows us to create a link between the FIM and ICF preserving clinically important information and having a description and clear relationship, thus being able to facilitate clinical use of the ICF.
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