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A factor analysis of Functional Independence and Functional Assessment Measure scores among focal and diffuse brain injury patients: The importance of bi-factor models.

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posted on 25.05.2018, 11:17 by Sarah Gunn, Gerald H. Burgess, John Maltby
OBJECTIVE: To explore the factor structure of the UK Functional Independence Measure and Functional Assessment Measure (FIM+FAM) among focal and diffuse acquired brain injury patients. DESIGN: Criterion standard. SETTING: An NHS acute acquired brain injury inpatient rehabilitation hospital. PARTICIPANTS: Referred sample of 447 adults (835 cases after exclusions) admitted for inpatient treatment following an acquired brain injury significant enough to justify intensive inpatient neurorehabilitation. INTERVENTION: Not applicable. OUTCOME MEASURE: Functional Independence Measure and Functional Assessment Measure. RESULTS: Exploratory Factor Analysis suggested a two-factor structure to FIM+FAM scores, among both focal-proximate and diffuse-proximate acquired brain injury aetiologies. Confirmatory Factor Analysis suggested a three-factor bi-factor structure presented the best fit of the FIM+FAM score data across both aetiologies. However, across both analyses, a convergence was found towards a general factor, demonstrated by high correlations between factors in the Exploratory Factor Analysis, and by a general factor explaining the majority of the variance in scores on Confirmatory Factor Analysis. CONCLUSION: Our findings suggested that although factors describing specific functional domains can be derived from FIM+FAM item scores, there is a convergence towards a single factor describing overall functioning. This single factor informs the specific group factors (e.g. motor, psychosocial and communication function) following brain injury. Further research into the comparative value of the general and group factors as evaluative/prognostic measures is indicated.

History

Citation

Archives of Physical Medicine and Rehabilitation, 2018

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/Biological Sciences/Neuroscience, Psychology and Behaviour

Version

AM (Accepted Manuscript)

Published in

Archives of Physical Medicine and Rehabilitation

Publisher

Elsevier for American Congress of Rehabilitation Medicine

eissn

1532-821X

Acceptance date

03/04/2018

Copyright date

2018

Available date

28/04/2019

Publisher version

https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0003999318302740?returnurl=https://linkinghub.elsevier.com/retrieve/pii/S0003999318302740?showall=true&referrer=

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The file associated with this record is under embargo until 12 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.

Language

en

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