Functional Autonomy Measurement System (SMAF)
Hébert‚ 1984‚ revised 1993‚ 2001
نظام اندازه گیری استقلال عملکرد
A. ACTIVITIES OF DAILY LIVING (ADL)
· Feeds self independently
· With difficulty
· Feeds self but needs stimulation or supervision OR food must be prepared or cut or puréed first
· Needs some help to eat OR dishes must be presented one after another
· Must be fed totally by another person OR has a naso-gastric tube or a gastrostomy
naso-gastric‚ tube gastrostomy
2. WASHING
· Washes self independently (including getting in or out of the bathtub or shower)
· With difficulty
· Washes self but needs cueing‚ OR needs supervision‚ OR needs preparation‚ OR needs help for the complete weekly bath‚ only (including washing feet and hair)
· Needs help for the daily wash but participates actively
· Must be washed by another person
3. DRESSING (all seasons)
· Dresses self independently
· With difficulty
· Dresses self but needs cueing‚ OR needs supervision‚ OR clothing must be readied and presented‚ OR needs help for finishing touches (buttons‚ laces)
· Needs help dressing
· Must be dressed by another person
support hose/stocking
4. GROOMING
(brushes teeth or combs hair or shaves or trims finger or toenails or puts on make-up)
· Grooms self independently
· With difficulty
· Grooms self but needs cueing or supervision
· Needs help for grooming
· Must be groomed by another person
5. URINARY FUNCTION
· Normal voiding
· Occasional incontinence‚ OR dribbling‚ OR needs frequent cueing to avoid incontinence
· Frequent urinary incontinence
· Complete urinary incontinence‚ OR wears a diaper or an indwelling catheter or a urinary condom
diaper‚ indwelling catheter‚ urinary condom
day incontinence‚ night incontinence
6. BOWEL FUNCTION
· Normal bowel function
· Occasional incontinence‚ OR needs cleansing enema occasionally
· Frequent incontinence‚ OR needs cleansing enema regularly
· Always incontinent‚ OR wears a diaper or an ostomy
diaper‚ ostomy
day incontinence‚ night incontinence
7. TOILETTING
· Toilets self (including getting on/off toilet‚ wiping self and managing clothing)
· With difficulty
· Needs supervision for toileting‚ OR uses commode‚ bedpan or urinal
· Needs help to go to the toilet‚ OR use commode‚ bedpan or urinal
· Does not use toilet‚ commode‚ bedpan or urinal
commode‚ bedpan‚ urinal
B. MOBILITY
1. TRANSFERS (bed to chair or wheelchair and to stand‚ and vice-versa)
· Gets in and out of bed or chair alone
· With difficulty
· Gets in and out of bed/chair alone but needs cueing‚ supervision or guidance
specify: ______________________________________
· Needs help to get in and out of bed/chair
specify: ______________________________________
· Bedridden (must be lifted in and out of bed)
particular positioning:
lift‚ transfer board
2. WALKING INSIDE (including in the building and going to the elevator)
· Walks independently (with or without cane‚ prosthesis‚ orthosis or walker)
· With difficulty
· Walks independently but needs guidance‚ cueing or supervision in certain circumstances OR unsafe gait
· Needs help of another person to walk
· Does not walk
cane‚ tripod‚ quadripod‚ walker
*Distance of at least 10 meters
3. DONNING PROSTHESIS OR ORTHOSIS
· Does not wear prosthesis or orthosis
· Dons prosthesis or orthosis independently
· With difficulty
· Donning of prosthesis of orthosis needs checking‚ OR needs partial help
· Prosthesis or orthosis must be put on by another person Type of prosthesis or orthosis:
4. PROPELLING A WHEELCHAIR (W/C) INSIDE
· Does not need a wheelchair
· Propels wheelchair independently
· With difficulty
· Needs to have wheelchair pushed
· Unable to use wheelchair (must be transported on stretcher)
standard wheelchair
wheelchair with unilateral axis
motorized wheelchair
three wheeled scooter
four wheeled scooter
5. NEGOTIATING STAIRS
· Goes up and down stairs independently
· With difficulty
· Requires cueing‚ supervision or guidance to negotiate stairs OR does not safely negotiate stairs
· Needs help to go up and down stairs
· Does not negotiate stairs
6. MOVING AROUND OUTSIDE
· Walks independently (with or without cane‚ prosthesis‚ orthosis or walker)
· With difficulty
· Uses a wheelchair or scooter independently
W/C with difficulty
OR walks independently but needs guidance‚ cueing‚ or supervision in certain circumstances‚ OR unsafe gait1
· Needs help of another person to walk1‚ OR to use W/C
· Cannot move around outside (must be transported on a stretcher)
1 Distance of at least 20 meters
C. COMMUNICATION
1. VISION
· Sees adequately with or without corrective lenses
· Visual problems but sees enough to do ADLs
· Only sees outlines of objects and needs guidance in ADLs
· Blind
corrective lenses‚ magnifying glass
2. HEARING
· Hears adequately with or without hearing aid
· Hears if spoken to in a loud voice‚ OR needs hearing aid put in by another person
· Only hears shouting or certain words‚ OR reads lips‚ OR understands gestures
· Completely deaf and unable to understand what is said to him/her
hearing aid
3. SPEAKING
· Speaks normally
· Has a speech/language problem but able to express him/herself
· Has a major speech/language problem but able to express basic needs
OR answer simple questions (yes‚ no)
OR uses sign language
· Does not communicate technical aid:
computer
communication board
D. MENTAL FUNCTIONS
1. MEMORY
· Normal memory
· Minor recent memory deficit (names‚ appointments‚ etc.) but remembers important facts
· Serious memory lapses (shut off stove‚ medications‚ putting things away‚ eating‚ visitors)
· Almost total memory loss or amnesia
2. ORIENTATION
· Oriented to time‚ place and persons
· Sometimes disoriented to time‚ place and persons
· Only oriented for immediate events (i.e.‚ time of day) and in the usual living environment and with familiar persons
· Complete disorientation
3. COMPREHENSION
· Understands instructions and requests
· Slow to understand instructions and requests
· Partial understanding even after repeated instructions OR is incapable of learning
· Does not understand what goes on around him/her
4. JUDGMENT
· Evaluates situations and makes sound decisions
· Evaluates situations but needs help in making sound decisions
· Poorly evaluates situations and only makes sound decisions with strong suggestions
· Does not evaluate situations and dependent on others for decision making
5. BEHAVIOUR
· Appropriate behaviour
· Minor behavioural problems (whimpering‚ emotional lability‚ stubbornness‚ apathy) requiring occasional supervision or a reminder or stimulation
· Major behavioural problems requiring more intensive supervision (aggressive towards self or others‚ disturbs others‚ wanders‚ screams out constantly)
· Dangerous‚ requires restraint OR harmful to others or self-destructive OR tries to run away
E. INSTRUMENTAL ACTIVITIES OF DAILY LIVING
1. HOUSEKEEPING
· Does housekeeping alone (including daily housework and occasional big jobs)
· With difficulty
· Does housekeeping but needs supervision or cueing to ensure cleanliness (including washing the dishes) OR needs help for big jobs (floors‚ windows‚ painting‚ lawn‚ clearing the snow‚ etc.)
· Needs help for daily housework
· Does not do housework
2. MEAL PREPARATION
· Prepares own meals independently
· With difficulty
· Prepares meals but needs cueing to maintain adequate nutrition
· Only prepares light meals OR heats up pre-prepared meals (including handling the plates)
· Does not prepare mea
3. SHOPPING
· Plans and does shopping independently (food‚ clothes)
· With difficulty
· Plans and shops independently but needs delivery service
· Needs help to plan or shop
· Does not shops
4. LAUNDRY
· Does all laundry independently
· With difficulty
· Does laundry but needs cueing or supervision to maintain standards of cleanliness
· Needs help to do laundry
· Does not do laundry
5. TELEPHONE
· Uses telephone independently (including use of directory)
· With difficulty
· Answers telephone but only dials a few memorized numbers or emergency numbers
· Communicates by telephone but does not dial numbers or lift the receiver off the hook
· Does not use the telephone
6. TRANSPORTATION
· Able to use transportation alone (car‚ adapted vehicle‚ taxi‚ bus‚ etc.)
· With difficulty
· Must be accompanied to use transportation OR uses paratransit independently
· Uses car or paratransit only if accompanied and has help getting in and out of the vehicle
· Must be transported on a stretcher
7. MEDICATION USE
· Takes medication according to prescription OR does not need medication
· With difficulty
· Needs weekly supervision (including supervision by telephone) to ensure compliance to prescription OR uses a medication dispenser aid (prepared by someone else)
· Takes medication if prepared daily
· Must be given each dosage of medications (as prescribed) medication dispenser aid
8. BUDGETING
· Manages budget independently (including banking)
· With difficulty
· Needs help for certain major transactions
· Needs help for some regular transactions (cashing checks‚ paying bills) but uses pocket money wisely
· Does not manage budget
شرح سایت روان سنجی: مقیاس رده بندی بالینی برای اندازه گیری استقلال عملکردی در افراد مسن برای ارزیابی معمولی، برای هدایت تصمیم گیری درباره مراقبت خانگی، و یا تصمیم گیری برای پذیرش در موسسه است. آن را برای نیازهای پایه ای برنامه ریزی، ارزیابی و برآوردهای مراقبت های سلامتی نیز به کار برده اند. زیربنای این ابزار طبقه بندی سازمان بهداشت جهانی از ناتوانی است.
هفت ماده درباره "فعالیت های روزمره"، ، شش ماده درباره "پویایی"، "ارتباطات" 3 ماده، "عملکرد ذهن" در پنج زمینه، و 8 ماده درباره "کاربرد وسایل در زندگی روزمره" دارد.
اعتبار: از آنجایی که مقیاس از گونه رده بندی است، ضریب توافق میان ارزیابی کنندگان (در اینجا نرس ها، پرستاران، مراقبان) و بازآزمایی در میان است. نزد سی ارزیاب کاپا 0.76، همبستگی درون رده ای ICC برای نمره کلی 0.96 و برای بخش ها از "ارتباطات" 0.74 تا "کیفیت زندگ روزمره" 0.95 و کاربرد وسیله 0.96
بازآزمایی ، ضریب کاپا از 0.45 تا 0.95
نمره گذاری: توجه شود، برای آگاهی از شیوه نمره گذاری، باید به منابع مراجعه کنید.
Scoring/Interpretation: For each item‚ the disability is scored on a 5-level scale: 0 (independent)‚ -0.5 (with difficulty)‚ -1 (needs supervision)‚ -2 (needs help)‚ -3 (dependent) (Hebert et al.‚ 2001).
چگونگی دستیابی
منبع برای آگاهی بیشتر
Hébert‚ R.‚ Carrier‚ R.‚ & Buodeau‚ A. (1984). Le système de mesure de l'autonomie fonctionnelle: description d'un instrument de mesure des handicaps. In W. Van Eimeren‚ R. Engelbrecht‚ & C.D. Fiagle (Eds.)‚ Third International Conference on System Science in Health Care (pp.241-244). Berlin: Springer-Verlag.
Hébert‚ R.‚ Carrier‚ R.‚ & Bilodeau‚ A. (1988). The Functional Autonomy Measurement System (SMAF): description and validation of an instrument for the measurement of handicaps. Age and Ageing‚ 17(5)‚ 293-302.
Desrosiers‚ J.‚ Bravo‚ G.‚ Hébert‚ R.‚ & Dubuc‚ N.‚ A. (1995). Reliability of the Revised Functional Autonomy Measurement System (SMAF) for Epidemiological Research‚ Age and Ageing‚ 24:402-406
Hébert‚ R.‚ Guilbault‚ J.‚ Desrosiers‚ J.‚ & Dubuc‚ N. (2001). The functional autonomy measurement system (SMAF): A clinical-based instrument for measuring disabilities and handicaps in older people. Geriatrics Today: Journal of Canadian Geriatric Society‚ Sept. 2001‚ 1-7.
Pinsonnault‚ E.‚ Desrosiers‚ J.‚ Dubuc‚ N.‚ Kalfat‚ H.‚ Colvez‚ A.‚ & Delli-Colli‚ N. (2003). Functional autonomy measurement system: development of a social subscale. Archives of Gerontology and Geriatrics‚ 37‚ 223-233.
McDowell‚ Ian. (2006). Measuring Health: A Guide to Rating Scales and Questionnaires‚ Third Edition. OXFORD UNIVERSITY PRESS