THE EDMONTON FUNCTIONAL ASSESSMENT-TOOL - PRELIMINARY DEVELOPMENT ANDEVALUATION FOR USE IN PALLIATIVE CARE

The purpose of this article is to report the development and psychomet ric testing of the Edmonton Functional Assessment Tool (EFAT). The EFA T was developed as a functional outcome measure for use with a palliat ive care population. The assessment identified ten functional activiti es important to patients even in the terminal stage of their illness. In addition, a global performance status rating (PS) asked for an over all judgment of functional status after the ten EFAT functions were ev aluated. Tests for interrater reliability and concurrent validity were conducted on a sample of 25 inpatients on the Palliative Care Unit (P CU) at the Edmonton General Hospital (EGH) who were evaluated independ ently by two raters. Interrater reliability of the EFAT expressed as a n intraclass correlation (ICC) was established at 0.88. The interrater reliability of these two raters was 0.71 for the Karnofsky Performanc e Status (KPS) and 0.81 for the performance status measure of the East ern Cooperative Oncology croup (ECOG). Concurrent validity of the EFAT was demonstrated by correlating the total EFAT score with the KPS (r = -0.79, P = 0.0001) and the ECOG (r = 0.85, P = 0.0001). The total EF AT score was also strongly correlated with the global PS rating scale (r = 0.90 P = 0.0001). Construct validity of the EFAT was tested with a sample of 101 patients admitted to the unit, which was later divided into the unit group (N = 88) and the home group (N = 13). Our finding s provided initial evidence that the EFAT distinguished between the fu nctional status of these two groups. The results of this preliminary s tudy suggest that the EFAT requires further research and development, but shows potential to evolve as a useful clinical tool in palliative care. (C) U.S. Cancer Pain Relief Committee, 1997.