Proposal of Functional Scoring (FS) Method From the Viewpoint of Target Setting / 日本農村医学会雑誌

ABSTRACT

This paper proposes a method for evaluating and scoring the activities of rehabilitation service users in order to pinpoint the problems with the health service of this kind and set the adequate targets for each user. Sincs the Nursing Care Insurance System was introduced in Japan in 2000, it has been argued that home-visit rehabilitation services should be excluded from home-nursing care services. However, the methods of certifing that nursing care is required are not fully established yet for setting the rehabilitation targets for service users. As things stand, it is recommended that such a method as the Functional Independence Measure (FIM) or the Barthel Index (BI) should be utilized. However, these methods only evaluate “performing activities” (the activities that a user usually performs). In order to set the users' targets, we thought it necessary to establish a method for evaluating “possible activities” (the activities that a user is able to perform at his/her full capacity). We have established a method called Functional Scoring (FS) which evaluates and scores the both performing and possible activities based on the same evaluation items. We conducted experimental evaluations on the home-visit rehabilitation users for one year from October 2005 to September 2006. When the first evaluations in 2005 were compared with the second evaluations in 2006, the total score of the performing activities significantly increased from 44.1±13.7 to 47.8±14.2 (P<0.05). Although the total score of the possible activities did not significantly increase, it demonstrated an upward trend from 49.6±13.2 to 51.6±13.5. The result suggests that our method is useful for distinguishing between the performing and possible activities. The proposed method enables us to adequately recognize the problems each user has, and to set the rehabilitation target for each user, which can be shared between the user, care personnel, and care service provider.