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      In search of parsimony: reliability and validity of the Functional Performance Inventory-Short Form

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          Abstract

          Purpose:

          The 65-item Functional Performance Inventory (FPI), developed to quantify functional performance in patients with chronic obstructive pulmonary disease (COPD), has been shown to be reliable and valid. The purpose of this study was to create a shorter version of the FPI while preserving the integrity and psychometric properties of the original.

          Patients and methods:

          Secondary analyses were performed on qualitative and quantitative data used to develop and validate the FPI long form. Seventeen men and women with COPD participated in the qualitative work, while 154 took part in the mail survey; 54 completed 2-week reproducibility assessment, and 40 relatives contributed validation data. Following a systematic process of item reduction, performance properties of the 32-item short form (FPI-SF) were examined.

          Results:

          The FPI-SF was internally consistent (total scale α = 0.93; subscales: 0.76–0.89) and reproducible ( r = 0.88; subscales: 0.69–0.86). Validity was maintained, with significant ( P < 0.001) correlations between the FPI-SF and the Functional Status Questionnaire (activities of daily living, r = 0.71; instrumental activities of daily living, r = 0.73), Duke Activity Status Index ( r = 0.65), Bronchitis-Emphysema Symptom Checklist ( r = −0.61), Basic Need Satisfaction Inventory ( r = 0.61) and Cantril’s Ladder of Life Satisfaction ( r = 0.63), and Katz Adjustment Scale for Relatives (socially expected activities, r = 0.51; free-time activities, r = −0.49, P < 0.01). The FPI-SF differentiated patients with an FEV l% predicted greater than and less than 50% ( t = 4.26, P < 0.001), and those with severe and moderate levels of perceived severity and activity limitation ( t = 9.91, P < 0.001).

          Conclusion:

          Results suggest the FPI-SF is a viable alternative to the FPI for situations in which a shorter instrument is desired. Further assessment of the instrument’s performance properties in new samples of patients with COPD is warranted.

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          Most cited references 30

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          Determination and quantification of content validity.

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            Lung function testing: selection of reference values and interpretative strategies. American Thoracic Society.

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              Value of functional status as a predictor of mortality: results of a prospective study.

              To assess the value of functional status questions in predicting mortality, we conducted a 4-year prospective longitudinal follow-up study of functionally impaired community-dwelling elderly persons. A total of 282 elderly (aged 64 years or older) patients of 76 community-based physicians who were UCLA clinical faculty members were assessed at baseline and at an average of 51 months later using scales from the Functional Status Questionnaire. By the end of the study, 24% of the sample had died. By means of a multivariate model, the following baseline characteristics were independently predictive of death: greater dysfunction on a scale of intermediate activities of daily living, male gender, living alone, white race, better quality of social interactions, and age. Initial baseline functional measures were also predictive of follow-up health status perceptions. The assessment of information on physical functioning and the quality of social interactions provides prognostic information regarding mortality. Furthermore, of the independent predictors of death identified in this sample, only functional impairment and living alone are remediable. Whether improving functional status can reduce the risk of mortality remains to be determined.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                1176-9106
                1178-2005
                2010
                2010
                25 November 2010
                : 5
                : 415-423
                Affiliations
                [1 ]Center for Health Outcomes Research, United BioSource Corporation, Bethesda, MD, USA;
                [2 ]Office of the Assistant Secretary for Preparedness and Response, US Department of Health and Human Services, Washington, DC, USA
                Author notes
                Correspondence: Nancy Kline Leidy, Center for Health Outcomes Research, United BioSource Corporation, 7101 Wisconsin Avenue, Suite 600, Bethesda, MD 20814, USA, Tel +1 301 654 7272, Fax +1 301 654 9864, Email nancy.leidy@ 123456unitedbiosource.com
                Article
                copd-5-415
                10.2147/COPD.S13389
                3008327
                21191436
                © 2010 Leidy and Knebel, publisher and licensee Dove Medical Press Ltd.

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                Categories
                Original Research

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