Reliability of the Revised Functional Autonomy Measurement System (SMAF) for Epidemiological Research

摘要

The Functional Autonomy Measurement System (SMAF) is an instrument designed to assess disabilities related to 29 functions with a four-point scale (from 0: independent to -3: dependent). For epidemiological studies, a total score and five sub-scores can be obtained. A revised version was developed adding a -0.5 level to many items to indicate an activity accomplished independently but with difficulty. The objective of the study was to verify the test-retest and inter-rater reliability of the total score and sub-scores of the SMAF. Ninety subjects were randomly recruited in nine different residential settings ranging from home to long-term-care hospitals. Half of the subjects were assessed by the same nurse within a 2-week interval (test-retest) and the other half were assessed twice by two different nurses within the same interval (inter-rater). Results show intra-class correlation coefficients (ICC) of 0.95 and 0.96 for the total scores on test-retest and inter-rater reliability, respectively. The ICC were over 0.74 for all sub-scores for both types of reliability. A small systematic bias was present for two SMAF subscores on the inter-rater reliability. The addition of a new level did not modify the reliability of the scale.