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Reliability and validity of the Functional Status Questionnaire
Abstract
The Functional Status Questionnaire (FSQ) originally was developed to allow the comprehensive and efficient assessment of physical, psychosocial, social, and role functioning in ambulatory patients. It is a self-administered survey that takes approximately 15 min to complete and can be scored to produce a one-page report for clinicians to use in their practices. It has been translated into Swedish, French, and German. Since the FSQ was first published, it has been used in a variety of other settings, including assessment of the impact of variations in hospital practice patterns, the study of relationships between hospital processes of care and outcomes, and other applications, including randomized controlled trials of pharmaceuticals. In this paper we provide selected data on the reliability and validity of the FSQ in different populations. Many of the data are from previously published studies. However, because of the emphasis of this issue of Quality of Life Research, we also present new data from two large studies of persons over the age of 65.
... After extensive literature review, the researchers found three commonly used instruments for measuring functional status and could be used in the older adult's population they are: (1) Short Physical Performance Battery (SPPB) (Guralnik et al., 1994), (2) Functional Status Questionnaire (FSQ) (Cleary & Jette, 2000;Jette et al., 1986), and (3) The Physical Performance Test (PPT) (Reuben & Siu, 1990;Sherman & Reuben, 1998). The criteria used to determine the instrument to be used for this study include (1) has passed the validity and reliability test, (2) easy to use (no special training required), (3) free of charge, (4) required short time for the assessment for a maximum of 10 minutes and (5) can be used for the older adults who are less educated. ...
... In Indonesia the instrument used to assess functional status is still very limited. The SPBB, FSQ, and PPT are not too often used in Indonesia although the psychometric properties of these three instruments have been recognized globally (Cleary & Jette, 2000;Freiberger et al., 2012;Gill, 2010). In addition, systematic reviews from the literature review have confirmed the validity and reliability of SPBB, FSQ and PPT, even recommending the three instruments to be used in clinical practice (Freiberger et al., 2012;Moore, Palmer, Patterson, & Jeste, 2007). ...
For year research on quantifying how well individual’s function has been reported. Assessing function is particularly important in the older adults, as the prevalence of functional disability increases with age. In Indonesia, there is a lack of studies that measure the functional status of the older adults. There is even less research on evaluating the psychometric properties of an instrument. Therefore, this study aimed to compare the psychometric properties of the evidence supported functional status instrument consisting of the Short Physical Performance Battery (SPPB), the Functional Status Questionnaire (FSQ) and the Physical Performance Test (PPT). This study using the validation design with descriptive approach. And 401 subjects aged more than 60 years old were recruited purposively from five districts in Aceh. Every instrument showed good validity and reliability and has been used either for research purposes or in clinical setting. All subjects completed the FSQ, SPBB, and FSQ assessment. Correlation between SPPB and PPT were higher than FSQ when assessed for convergent validity the FSQ had comparable correlations with the reported health status. However, relationship between SPPB, PPT and FSQ were inconsistent. The findings of this study is expected to support the psychometric properties of all three instrument for functional status assessment in Indonesian Older adults, and SPPB appear to be the best among the other instruments to use in the nursing practice.
... The patient reported outcome measure of HRQL was assessed using the Functional Status Questionnaire (FSQ). The FSQ is a generic multidimensional measure initially developed and validated for use in ambulatory patients and was subsequently used in a variety of settings, with established psychometric validity and reliability, and sensitive to change over time [21]. The FSQ includes two daily living scales assessing physical functioning; items in the 'activity of daily living' scale (basic ADL 3 items) range from taking care of oneself to walking indoors and the 'intermediate activities of daily living' scale (intermediate ADL 6 items) range from household works, grocery shopping, driving a car or using public transportation to vigorous activities. ...
... Patients were asked additional questions (additional HRQL items) about days spent in bed related to disability in the past month, days cut down from usual normal activities, satisfaction with sexual relationships (5 choices ranging from very satisfied to did not have any sexual relationship), frequencies of social interactions (6 choices ranging from every day to not at all), and feelings of overall health status (5 choices from very satisfied to very dissatisfied) [21][22][23]. ...
... Also content and construct validity was established. (Cleary & Jette, 2001). ...
... Prior research has identified a suite of concerns that injured people have articulated are important for their posthospitalization recovery, including: achieving independence, re-establishing physical and mental wellbeing, resuming family roles and returning to work (34). To address these priority areas survey items were derived from the Functional Status Questionnaire (FSQ) to assess functional recovery in the domains of physical function, mental health, work User acceptability survey Multiple choice questions Post-implementation 72% [18] performance, level of social interaction, and quality of social interaction (36). Sleep disturbance has been shown to predict poorer recovery during post-acute rehabilitation (37). ...
Background:
Traumatic injuries are a health event that can begin a trajectory towards chronic health and social challenges. Mobile technology-based prevention and treatment interventions have been used to monitor and transform outcomes across a myriad of health conditions, but their potential in long-term injury recovery is unexplored. The goal of this pilot study was to assess the acceptability and feasibility of mobile health monitoring for long-term outcomes in a population of trauma patients with known barriers to health and social care after injury.
Methods:
We re-recruited 25 individuals, 12-36 months after acute hospitalization, from a recently concluded study of psychological outcomes in seriously injured Black men in Philadelphia, Pennsylvania. This mixed- methods pilot study was conducted in three phases: (I) qualitative interviews and development of a pilot monitoring platform; (II) a 3-month feasibility trial of mobile monitoring of patient-reported outcomes and biometric data using a wrist-worn commercial fitness monitor (n=18); (III) post-implementation qualitative interviews.
Results:
Analysis of data from pre-implementation interviews indicated that the majority of participants used smartphones as a primary means of communicating with their social network and to access the internet. The 90-day pilot trial of mobile monitoring indicated participants' preference text-delivered communication and survey elicitation. Response rates for 12 automated surveys ranged from 84-92%. Twenty-four hours a day adherence to optional biometric monitoring was generally lower than 50% but ranged widely indicating both very low adherence and very high adherence. Four of 25 participants, 2 who had opted for Fitbit monitoring, were lost to follow-up at the end of the 90-day pilot trial. In post-implementation assessments, participants endorsed the acceptability of mobile monitoring highlighting the benefit of its convenience and flexibility over in-person outcome monitoring. Participants also perceived its potential benefit in long-term engagement with health and social services to assist with the challenges they faced when attempting to achieve physical, psychological, social, and financial recovery after hospitalization. These findings were reinforced through qualitative interviews which highlighted, in addition to acceptability, the perceived value of self-monitoring through the use of wearable devices to track health data like physical activity and sleep.
Conclusions:
This study indicates the feasibility and acceptability of mobile health monitoring used to examine long-term injury sequalae. Future research may leverage this novel strategy, refining its application to address current limitations in the reliability and accuracy of commercially available wearable technology, relative costs and benefits of different mobile data collection strategies, integration within current clinical paradigms and generalizability across injured populations and socio-ecological environments.
... Principal Component Analysis was used to create a single physical health indicator from the four indicators (supported by scree plots) with higher scores indicating better health. Each of these scales has shown evidence of reliability and validity (Cleary and Jette, 2000;DeSalvo et al., 2006;Martin et al., 2000;Weitzner et al., 1995). ...
Personality is associated with health, but studies examining this association in patients with serious illnesses are lacking. This cross-sectional study involved 168 participants without cancer, 212 men with prostate cancer, and 55 women with breast cancer. We examined whether the Big Five personality dimensions were associated with health behaviors, health history, functional status, physical symptoms, and perceived health. Higher conscientiousness and lower neuroticism were associated with better health behaviors and health (rmax=.31), with few cross- sample differences. Findings emphasize the importance of personality in cancer and call for research on the implications of personality in patients with chronic and serious illnesses.
... The social/role items ask the respondent to qualify any changes in the type or quantity of work they perform as a result of their health in comparison to others in similar jobs over their past month of employment. The 6 item work performance subscale has demonstrated reliability and validity across diseases and in patient populations of diverse backgrounds (Cleary & Jette, 2000). This subscale of the FSQ is transformed to a standardized score from 0 to 100, with 100 indicating optimal work performance. ...
Background:
The mental health consequences of injuries can interfere with recovery to pre-injury levels of function and long term wellbeing.
Objectives:
The purpose of this study was to explore the relationship between psychological symptoms after minor injury and long-term functional recovery and disability.
Design:
This exploratory study uses secondary data derived from a longitudinal cohort study of psychological outcomes after minor injury.
Setting:
Participants were recruited from the Emergency Department of an urban hospital in the United States.
Participants:
A cohort of 275 patients was randomly selected from 1100 consecutive emergency department admissions for minor injury. Potential participants were identified as having sustained minor injury by the combination of three standard criteria including: presentation to the emergency department for medical care within 24h of a physical injury, evidence of anatomical injury defined as minor by an injury severity score between 2 and 8 and normal physiology as defined by a triage-Revised Trauma Score of 12. Patients with central nervous system injuries, injury requiring medical care in the past 2 years and/or resulting from domestic violence, and those diagnosed with major depression or psychotic disorders were excluded.
Methods:
Psychological symptom severity was assessed within 2 weeks of injury, and outcome measures for functional limitations and disability were collected at 3, 6 and 12 months. A quasi-least squares approach was used to examine the relationship between psychological symptom scores at intake and work performance and requirement for bed rest in the year after injury.
Results:
Adjusting for demographic and injury covariates, depression symptoms at the time of injury predicted (p≤0.05) both poorer work performance and increased number of days in bed due to health in the year after injury. Anxiety symptoms predicted (p≤0.05) bed days at 3, 6, and 12 months and work performance at 3 months.
Conclusions:
Depression and anxiety soon after minor injury may help predict important markers of long-term recovery. With further research, simple assessment tools for psychological symptoms may be useful to screen for patients who are at higher risk for poor long-term recoveries and who may benefit from targeted interventions.
... Internal consistency has ranged from 0.79 to 0.84 for the BADL and 0.82 to 0.89 for the IADL. 23 In the present study, internal consistency was 0.80 for the BADL and 0.86 for the IADL. The FSQ also contains an item about self-rated health, which is rated on a Likert scale ranging from 1 (poor) to 5 (excellent). ...
Objective: To determine the psychometric properties of a menopause symptom rating scale developed on nondisabled women in a sample of women polio survivors with physical disabilities. Design: The 25-item Menopause Symptom List (MSL) was administered to 190 women between ages 40 and 65 not taking hormone or estrogen therapy. Factor analysis, bivariate correlation, and analysis of variance were performed to determine the scale's underlying structure, construct validity, and association with menopausal status. Results: Factor analysis revealed four factors: (1) psychological, (2) somatic- sensory, (3) somatic-sleep, and (4) vasomotor. Factors 1 and 3 were associated with postpolio sequelae, self-rated health, positive and negative affect, life satisfaction, and perceived stress. Factor 2 was associated with postpolio sequelae, basic activities of daily living, self-rated health, negative affect, life satisfaction, and perceived stress. Factor 4 was associated with postpolio sequelae, self-rated health, negative affect, and perceived stress. Comparison by menopause status found Factors 1 and 3 significantly differed between groups (F-2,F-181 = 6.68 and 4.17, respectively; P = 0.02). Contrary to expectations, vasomotor factor severity was not distinguished by menopause status. Conclusions: Menopause symptom scales standardized on nondisabled women should be used cautiously with women with physical disabilities. Associations between construct validity measures and menopause symptomatology suggest a complex relationship between physical disability and menopause.
Introduction
Physical activity is an integral part of healthy ageing, yet the majority of older adults 65+ years are not sufficiently active. Web-based physical activity interventions hold much promise to reach older adults. Preliminary evidence suggests that web-based interventions with tailored advice and Fitbits may be well suited for older adults.
Methods and analysis
This study aims to test the effectiveness of ‘Active for Life’, a 12-week computer-tailored web-based physical activity intervention using Fitbits for older adults. We will recruit 300 participants who will be randomly assigned to one of three trial arms: (1) web-based physical activity intervention with tailored advice only, (2) web-based physical activity intervention with tailored advice and Fitbit or (3) a wait-list control. The primary outcome, objective moderate to vigorous physical activity (MVPA) and secondary outcomes of objective sedentary behaviour, objective sleep, quality of life, social support, physical function and satisfaction with life will be assessed at baseline and week 12. The secondary outcomes of self-reported physical activity, sitting time and sleep will be assessed at baseline, week 6, 12 and 24. Website usability and participant satisfaction will be assessed at week 12 and website usage and intervention fidelity will be assessed from week 1 to 24. Intention-to-treat linear mixed model analyses will be used to test for group (tailoring only, tailoring +Fitbit, control) differences on changes in the main outcome, MVPA and secondary outcomes. Generalised linear models will be used to compare intervention groups (tailoring only, tailoring +Fitbit) on website usability, participant satisfaction, website usage and intervention fidelity.
Ethics and dissemination
The study has received ethics approval from the Central Queensland University Human Research Ethics Committee (H16/12-321). Study outcomes will be disseminated through peer-reviewed publications and academic conferences and used to inform improvements and dissemination of a tailored, web-based physical activity intervention for adults 65+ years.
Trial registration number
Australian and New Zealand Clinical Trials Registry Number: ACTRN12618000646246
Background:
This study was designed to determine a clinically significant point drop in function to define functional decline and the required sensitivity for a clinical decision tool to identify elderly patients at high risk of functional decline following a minor injury.
Methods:
After a rigorous development process, a survey questionnaire was administered to a random sample of 178 geriatricians selected from those registered in a national medical directory. The surveys were distributed using a modified Dillman technique.
Results:
We obtained a satisfactory response rate of 70.5%. Ninety percent of the geriatricians required a sensitivity of 90% or less for a clinical decision tool to identify injured seniors at high risk of functional decline 6 months post injury. Our results indicate that 90% of the respondents considered a drop in function of at least 2 points in activities of daily living (ADL) as clinically significant when considering all 14 ADL items. Considering only the 7 basic ADL items, 90% of physicians considered a 1 point drop as clinically significant.
Conclusions:
A tool with a sensitivity of 90% to detect patients at risk of functional decline at 6 months post minor injury would meet or exceed the sensitivity required by 90% of geriatric specialists. These findings clearly define what is a clinically significant decline following a "minor injury."
De noodzaak om binnen de gezondheidszorg te komen tot economisch verantwoorde zorg dwingt artsen en hulpverleners in de revalidatie ertoe de doelmatigheid en effectiviteit van de door hen verleende zorg aan te tonen. Een logisch beginpunt hiervoor is het patiëntonderzoek. De evolutie van de geneeskunde en de revalidatie is voortgekomen uit een mengsel van wetenschap, filosofie, sociologie en intuïtie. Somigen van de beste behandelaars zijn wellicht de slechtste wetenschappers, maar ze kunnen wel een uitzonderlijk goed ontwikkelde intuïtie hebben. Vanwege dit delicate mengsel is het moeilijk het patiëntonderzoek, de behandeling en de behandelresultaten te kwantificeren. Toch moet dit gebeuren. In de laatste twintig jaar is het patiëntonderzoek in de gezondheidszorg exponentieel gegroeid. Er zijn veel nieuwe onderzoeksinstrumenten ontwikkeld; behandelingen en de resultaten daarvan worden steeds strenger geëvalueerd.
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