Comparing the functional independence measure and the interRAI/ XXXX for use in the functional assessment of older adults: a review of the literature.

@entity1 @entity4289 @entity15467
BACKGROUND: The rehabilitation of older @entity1 is often complicated by increased frailty and medical complexity - these in turn present challenges for the development of health information systems. Objective investigation and comparison of the effectiveness of geriatric rehabilitation services requires information systems that are comprehensive, reliable, valid, and sensitive to clinically relevant changes in older @entity1 . The Functional Independence Measure is widely used in rehabilitation settings - in Canada this is used as the central component of the National Rehabilitation Reporting System of the Canadian Institute of Health Information. An alternative system has been developed by the interRAI consortium. We conducted a literature review to compare the development and measurement properties of these two systems. METHODS: English language literature published between 1983 (initial development of the @entity15467 ) and 2008 was searched using Medline and CINAHL databases, and the reference lists of retrieved articles. Relevant articles were summarized and charted using the criteria proposed by Streiner. Additionally, attention was paid to the ability of the two systems to address issues particularly relevant to older rehabilitation clients, such as medical complexity, comorbidity, and responsiveness to small but clinically meaningful improvements. RESULTS: In total, 66 articles were found that met the inclusion criteria. The majority of @entity15467 articles studied inpatient rehabilitation settings; while the majority of interRAI/ @entity4289 articles focused on nursing home settings. There is evidence supporting the reliability of both instruments. There were few articles that investigated the construct validity of the interRAI/ @entity4289 . CONCLUSION: Additional psychometric research is needed on both the @entity15467 and @entity4289 , especially with regard to their use in different settings and with different client groups.
