BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet

Test: Older Americans Resources and Services (OARS) Multidimensional Functional Assessment Questionnaire (OMFAQ)

Year: 1975

Domain: Biological, Psychological and Social

Assessment Tool Category: Functional Status and Service Use

Variations/Translations: Original OMFAQ was revised in 1988 (same title)

Setting: Community, Clinic and Long-Term Care

Method of Delivery: Information is usually sought during a personal interview with the subject or an informant, although sections of the assessment can be obtained by mail or telephone.

Description: The OMFAQ can be used as a screening instrument, as an outcomes evaluation and as a measure in modeling the cost-effectiveness of alternative approaches to providing care. The OMFAQ is a structured questionnaire divided into part A, the Multidimensional Functional Assessment Questionnaire and part B, the Services Assessment Questionnaire. Part A seeks information on five dimensions of functioning: Social Resources, Economic Resources, Mental Health, Physical Health, and ability to carry out Activities of Daily Living.

Scoring/Interpretation: Questions in the first section of OMFAQ are graded on a 6-point scale. There are five types of questions and the scale ranges from 1-6 with 6 indicating impairment and 1 indicating non-impairment. The scores are summed to produce a Cumulative Impairment Score (CIS) with a maximum score of 30 (totally impaired) and a minimum score of five (excellent functioning in all areas). Scores below ten suggest excellent functioning; those over 18 indicate significant impairment in several areas.

Time to Administer: Total administration time for the entire OMFAQ (sections one and two) is about 45 minutes.

Availability: The tool and accompanying manual is available for a fee (electronic version only) through Duke University at http://www.geri.duke.edu/service/oars.htm.

Software: N/A

Website:  http://www.geri.duke.edu/index.html.

Quantitative/Qualitative: Quantitative

Validity (Quantitative): Content and consensual validity were ensured by the manner of construction. Fillenbaum and Smyer (1981) presented criterion validity results for the OMFAQ on 22 family medicine patients using separate criterion ratings for each section in the questionnaire. Information on criterion validity was obtained for all dimensions except social. Spearman correlations between the OMFAQ and these ratings were 0.68 for the economic section, 0.67 for mental health, 0.82 for physical health and 0.89 for self-care capacity. OMFAQ scores have been compared with health care expenditures, showing an increase in expenditures by a factor of 13 as the OMFAQ scores rose from the lowest to the highest level of impairment.

Reliability (Quantitative): Reliability testing has been carried out on part A of the OMFAQ. Fillenbaum and Smyer reported inter-rater agreement for the OMFAQ for 11 raters who evaluated 30 patients. Intra-class correlations were 0.60 for physical health, 0.78 for economic resources, 0.80 for mental health, 0.82 for social resources and 0.87 for self-care. Raters were in complete agreement for 74% of the ratings. Five-week test-retest correlations for 30 elderly subjects were 0.82 for the physical ADL questions, 0.71 for the Instrumental Activities of Daily Living (IADL) questions and 0.79 for those on economic resources. The test-retest correlation for the objective questions on social resources was 0.71 and that for the subjective questions was 0.52. Coefficients for life satisfaction and mental health were lower, 0.42 and 0.32 respectively. Alpha internal consistency for the IADL scale was 0.68 contrasting with 0.81 for the Functional Status Questionnaire IADL section.

References:

Burholt, V., Windle, G., Ferring, D., Balducci, C., Fagerstrom, C., Thissen, F., …Fillenbaum, G. (2007). Reliability and validity of the Older Americans Resources and Services (OARS) Social Resources Scale in six European countries. The Journal of Gerontology, 62(6), S371-S379.

Fillenbaum, G. (1978). Conceptualization and development of the Multidimensional Functional Assessment Questionnaire. In Center for the Study of Aging and Human Development, Multidimensional Functional Assessment: The OARS methodology (pp. 16-24). Durham, NC: Duke University.

Fillenbaum, G., & Smyer, M.A. (1981). The development, validity, and reliability of the Oars Multidimensional Functional Assessment Questionnaire. Journal of Gerontology, 36(4), 428-434.

McDowell, I. (2006). Measuring health: A guide to rating scales and questionnaires (3^rd ed.). Canada: Oxford University Press.

Comments: The manual provides clear details of the development, administration and quality of the instrument.