Functional autonomy measurement system: development of a social subscale.

The purpose of this study was to develop a subscale assessing social functioning for the functional autonomy measurement system (SMAF). The development of this new dimension was based on consultations (focus groups and nominal groups) of experts from different health care disciplines in Quebec, Canada, and France. Two interrater reliability studies were carried out with older people presenting a loss of functional autonomy and living either in an institution or at home. With the focus groups, the experts clarified the definition of social functioning and identified the factors involved. The nominal groups were used to construct a subscale composed of six items. The results of the first interrater reliability study showed a mean agreement percentage of 60% for the subscale and an intraclass correlation coefficient (ICC) of 0.70 (CI: 0.57-0.80). The results of the second interrater reliability study showed higher coefficients with an agreement percentage of 74% for the subscale and an ICC of 0.83 (CI: 0.61-0.93). These preliminary results demonstrate that the new social functioning subscale has good reliability, but more studies are needed to show its validity. The new SMAF, including the social functioning subscale, should help clinicians and researchers to obtain a comprehensive profile of functional autonomy. It could also contribute to the improvement of health care for older people.