Development and validation of a self-report version of the Spinal Cord Independence Measure (SCIM III).
METHODS
Cross-sectional validation study.


OBJECTIVE
To develop and validate a self-report version of the Spinal Cord Independence Measure (SCIM III).


METHODS
Two SCI rehabilitation facilities in Switzerland.


METHODS
SCIM III comprises 19 questions on daily tasks with a total score between 0 and 100 and subscales for 'self-care', 'respiration & sphincter management' and 'mobility'. A self-report version (SCIM-SR) was developed by expert discussions and pretests in individuals with spinal cord injury (SCI) using a German translation. A convenience sample of 99 inpatients with SCI was recruited. SCIM-SR data were analyzed together with SCIM III data obtained from attending health professionals.


RESULTS
High correlations between SCIM III and SCIM-SR were observed. Pearson's r for the total score was 0.87 (95% confidence interval (CI) 0.82-0.91), for the subscales self-care 0.87 (0.81-0.91); respiration & sphincter management 0.81 (0.73-0.87); and mobility 0.87 (0.82-0.91). Intraclass correlations were: total score 0.90 (95% CI 0.85-0.93); self-care 0.86 (0.79-0.90); respiration & sphincter management 0.80 (0.71-0.86); and mobility 0.83 (0.76-0.89). Bland-Altman plots showed that patients rated their functioning higher than professionals, in particular for mobility. The mean difference between SCIM-SR and SCIM III for the total score was 5.14 (point estimate 95% CI 2.95-7.34), self-care 0.89 (0.19-1.59), respiration & sphincter management 1.05 (0.18-2.28 ) and mobility 3.49 (2.44-4.54). Particularly patients readmitted because of pressure sores rated their independence higher than attending professionals.


CONCLUSIONS
Our results support the criterion validity of SCIM-SR. The self-report version may facilitate long-term evaluations of independence in persons with SCI in their home situation.
Swiss Paraplegic Research, Nottwil, Switzerland. christine.fekete@paranet.ch
C
C
Fekete
I
I
Eriks-Hoogland
M
M
Baumberger
A
A
Catz
M
M
Itzkovich
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H
Lüthi
M W M
MW
Post
E
E
von Elm
A
A
Wyss
M W G
MW
Brinkhof
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D057187:Independent Living / Q000523:psychology* / Q000706:statistics & numerical data; D007802:Language; D008297:Male; D008875:Middle Aged; D012047:Rehabilitation Centers; D015203:Reproducibility of Results; D057566:Self Report; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000523:psychology*; D011795:Surveys and Questionnaires; D013557:Switzerland; D016896:Treatment Outcome; D055815:Young Adult