The edmonton functional assessment tool: Preliminary development and evaluation for use in palliative care

Abstract

The purpose of this article is to report the development and psychometric testing of the Edmonton Functional Assessment Tool (EFAT). The EFAT was developed as a functional outcome measure for use with a palliative care population. The assessment identified ten functional activities important to patients even in the terminal stage of their illness. In addition, a global performance status rating (PS) asked for an overall judgment of functional status after the ten EFAT functions were evaluated. Tests for interrater reliability and concurrent validity were conducted on a sample of 25 inpatients on the Palliative Care Unit (PCU) at the Edmonton General Hospital (EGH) who were evaluated independently by two raters. Interrater reliability of the EFAT expressed as an intraclass correlation (ICC) was established at 0.88. The interrater reliability of these two raters was 0.71 for the Karnofsky Performance Status (KPS) and 0.81 for the performance status measure of the Eastern Cooperative Oncology Group (ECOG). Concurrent validity of the EFAT was demonstrated by correlating the total EFAT score with the KPS (r = -0.79, P = 0.0001) and the ECOG (r = 0.85, P = 0.0001). The total EFAT score was also strongly correlated with the global PS rating scale (r = 0.90, P = 0.0001). Construct validity of the EFAT was tested with a sample of 101 patients admitted to the unit, which was later divided into the unit group (N = 88) and the home group (N = 13). Our findings provided initial evidence that the EFAT distinguished between the functional status of these two groups. The results of this preliminary study suggest that the EFAT requires further research and development, but shows potential to evolve as a useful clinical tool in palliative care.

Physical Function in Hospice Patients and Physiotherapy Interventions: A Profile of Hospice Physiotherapy

“…Laakso et al 32 used an adapted version of the Functional Independence Measure (FIM); however, published validation studies are warranted. Kaasa et al 38 found that traditional functional tools, such as the Barthel Index and the FIM, were not sensitive enough to detect changes in poorly functioning palliative patients and therefore devised the Edmonton Functional Assessment Tool for physiotherapists and occupational therapists. It correlates with KPS (r = 0.79) and ECOG (r = 0.85), and detects change over time.…”

“…It correlates with KPS (r = 0.79) and ECOG (r = 0.85), and detects change over time. 38 The second version of the Edmonton Functional Assessment Tool (EFAT-2) 39 measures 10 domains that may affect function: communication, pain, mental status, dyspnea, balance, mobility, locomotion, daily activities, fatigue, and motivation (See Appendix). Scoring is from 0 to 30, low scores indicating higher function and vice versa.…”

Assessment, treatment goals and interventions for oedema/lymphoedema in palliative care

“…The most common method of assessment was circumferential measurements (78%), followed by skin descriptors (73%) and function (72%) using EFAT-2 (Kaasa and Wessel 2001). See Figure 1.…”

Symptom Control in Palliative Care—Part I: Oncology as a Paradigmatic Example

“…The EFAT is a validated tool that allows a physiotherapist or trained nurse to determine the functional performance of patients with advanced cancer, as well as the evaluation of factors that contribute to the functional impairment, such as communication, mental status, pain, and dyspnea, among others. 36,37 The functional status of advanced cancer patients can be assessed in the research setting using the FIM. 38,39 The FIM includes 18 items covering independence in self-care, sphincter control, mobility, locomotion, communication, and social cognition.…”