Self Reported Functional Measure (SRFM)

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Tool Description

  • Developed to provide clinically useful information pertinent to the different levels of the disablement process.
  • Suitable for people with SCI and was designed to correspond closely in wording, format, and scoring to the Functional Independence Measure (FIM). While the FIM provides seven levels of measurement of 13 motor functions (basic activities of daily living (ADL)) and measurements of cognitive and communication functions, the SRFM has four-level response categories to 13 items of basic ADL and 5 items of instrumental ADL.  (The cognitive and communications domains were excluded due to difficulties with accurate self-report of these items.)
  • Covers personal functioning such as moving around indoors and personal hygiene.
  • Scores of the SRFM can indicate the amount of assistance (burden of care) an individual requires. This may be useful when monitoring treatment efficacy after rehabilitation or when the individual has returned to the community.

ICF Domain:

Activity – Subcategory: Self-Care

Number of Items:

13

Brief Instructions for Administration & Scoring

Administration:

  • Self-report or interview; can be administered either in person or by mail.

Equipment: None.

Scoring:

  • The 4-point scale is as follows: 4 = no extra time or help, 3 = extra time or special tool, 2 = some help, and 1 = total help or never do.
  • Questions are asked based on an average day and the individual’s usual way of doing the activity.
  • Total scores (13-52) are derived by summing the scores from each question.

Interpretability

MCID: not established in SCI
SEM: not established in SCI
MDC: not established in SCI

  • Lower scores indicate greater need for assistance.
  • No cut scores or normative values for the SCI population have been established
  • Published data for the SCI population is available for comparison (see Interpretability section of the Study Details sheet).

Languages:

English.

Training Required:

No specialized administration learning is required.

Availability:

See the ‘How-to use’ page of this tool.

Clinical Considerations

  • The SRFM is comprehensible to persons with a fourth grade reading level.
  • This scale has been adapted specifically for the SCI population from the FIM.

Measurement Property Summary

# of studies reporting psychometric properties: 1

Reliability:

  • Moderate to High Kappa coefficients: ≥0.65 for all but one item:
    Mobility at Home = 0.052 (p=0.003)
  • High Intraclass correlation (95% CI): Answered every SRFM item = 0.90 (0.88) Traumatic injury = 0.92 (0.91)
    Disease = 0.87 (0.84)
    Trauma & disease = 0.92 (0.89)
    Memory deficits = 0.86 (0.80)
    Memory intact = 0.91 (0.89)
    History of head injury = 0.85 (0.80)
    No head injury = 0.91 (0.89)

(Hoenig et al. 1998; N=725 (dual respondants); 48.14% Traumatic, 26.90% Disease, 23.86% Disease & Trauma; data from veterans discharged from a VA medical center <5 years OR included on lists from the Paralyzed Veterans of America)

Validity:

Not Ranked Statistically significant correlations between SRFM score with:
Number of affected limbs Amount of movement Amount of motor dysfunction Motor impairment*

*Correlation still significant after stratifying on self-reported visual, sensory, or memory impairment

(Hoenig et al. 1999; N=6361; data from SCD National Veterans Survey, traumatic SCI, no further information on injury or chronicity)

Not Ranked Odds Ratios for Health Care Utilization of Lowest SRFM Quartile Patients (SRFM 13-22) vs. Highest SRFM Quartile Patients (SRFM 43-52):
(95% CI)

Hospitalized: 1.91 (1.71-2.13)
*Died in hospital: 2.41 (1.62-3.58)
*Hospital length of stay >7 days: 2.18 (1.85-2.57) *Discharged to institution: 2.86 (2.00-4.08)
*Of those hospitalized

(Hoenig et al. 2001; N=8150 (3.7% female); data from SCD National Veterans Survey; N=6361 SCI (2.4% female), N=1789 MS (8.5% female); mean age: 52.9 years, mean duration of diagnosis: 20 years)

Responsiveness:

No values were reported for the reliability of the SRFM for the SCI population.

Floor/ceiling effect:

No values were reported for the presence of floor/ceiling effects in the SRFM for the SCI population.

Reviewer

Dr. Ben Mortenson, Jeff Tan, Ben Mortenson, John Zhu, Gita Manhas

Date Last Updated:

July 22, 2020

Download the measure

Download Worksheet:

Worksheet Document

Video

n/a

Scoring

n/a

Equipment Needed

SRFM:

Hoenig H, Branch LG, McIntyre L, Hoff J, Horner RD. The validity in persons with spinal cord injury of a self-reported functional measure derived from the Functional Independence Measure. Spine, 1999; 24(6):539-543.
http://www.ncbi.nlm.nih.gov/pubmed/10101817