RELATIONSHIPS BETWEEN DISABILITY MEASURES AND NURSING EFFORT DURING MEDICAL REHABILITATION FOR PATIENTS WITH TRAUMATIC BRAIN AND SPINAL-CORD INJURY

Objective: The increasing use of disability measures requires that the validity of these instruments be adequately demonstrated. This study sought to evaluate the concurrent validity of one disability measure, the Functional Independence Measure (FIM(SM)) using minutes of care re ported by nursing staff. Study Design: Correlational, cohort design. S etting: Eight inpatient medical rehabilitation hospitals that subscrib e to the Uniform Data System for Medical Rehabilitation. Patients or O ther Participants: 129 patients with traumatic brain injury (TBI) and 53 patients with traumatic spinal cord injury (SCI). Interventions: Ro utine rehabilitation care. Main Outcome Measures: Patient-nurse contac t times were recorded with a stop watch for a 24-hour period during th e first and last weeks of inpatient rehabilitation. The FIM was also c ompleted during the first and last weeks of rehabilitation. Results: C ontact times declined from the first to last weeks of rehabilitation, concurrent with improving scores on motor and cognitive measures deriv ed from the FIM. Statistically significant correlations between contac t times and FIM measures were observed for medication dispensing, trea tment provision, and teaching/activities of daily living at admission and discharge. Smaller and usually nonsignificant correlations were ob served in activities that did not involve direct patient contact. Cont act times increased exponentially as disability increased. Conclusions : These results support the construct validity of the FIM by demonstra ting strong relationships (r values in the range of .40 to .60) betwee n burden of care and a measure of disability. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physi cal Medicine and Rehabilitation.