Albandary Alhadlaq et al.
INTRODUCTION
The Functional Autonomy Measurement System (FAMS)
is a tool which developed in 1984 by a team from the
Community Health Department at Hôtel-Dieu in Lévis to
measure the demands and needs of the elderly handi-
capped (Hébert, Guilbault, Desrosiers, & Dubuc, 2001;
Hébert, Carrier, & Bilodeau, 1988). SMAF quanti es the
functional ability on 29-items scale which developed by
World Health Organization’s classi cation of impair-
ments, handicaps and disabilities (Hébert, Robichaud,
Roy, Bravo, & Voyer, 2001). It measures functional abil-
ity in 5 sectors: mobility [6 items], activities of daily
living (ADL) [7 items], instrumental activities of daily
living (IADL) [8 items], mental functions [5 items] and
communication [3 items] (Hébert, et al, 2001). These
items were standardized using four-level measurement
scale. Level 0: autonomous, Level 1: needs supervision
or stimulation, Level 2: needs help, and Level 3: depend-
ent (Hébert, et al 2001; Hébert et al, 1988; Hébert, et al,
2001). According to the occupational therapy practice
framework: Doman & process, activities of daily living
(ADLs) are activities that are specialized toward taking
care of one’s own body. Which are bathing, shower-
ing, toileting and toilet hygiene, dressing, swallowing/
eating, feeding, functional mobility, personal device
care, personal hygiene and grooming, and sexual activ-
ity (Amini, D. A., Kannenberg, K., Bodison, S., Chang,
P., Colaianni, D., Goodrich, B., & Lieberman, D., 2014).
Not all the ADLs covered in the SMAF. The seven items
included in SMAF are eating, washing, dressing, groom-
ing, urinary continence, facial continence, and toileting
(Hébert, Guilbault et al 2001).
Instrumental activities of daily living (IADLs) as in
occupational therapy practice framework are “activities
to support daily life within the home and community”
(Amini et al, 2014) Care of others, care of pets, child
rearing, communication management, driving and com-
munity mobility, nancial management, health manage-
ment and maintenance, home establishment and man-
agement, meal preparation and cleanup, religious and
spiritual activities and expression, safety and emergency
maintenance, and shopping are all considered IADLs”
(Amini et al, 2014)
IADLs in the SMAF are meal preparation and cleanup,
nancial management, shopping, health management
and maintenance, driving and community mobility,
home establishment and maintenance (cleaning the
house, and doing the laundry), and communication
(Hébert, et al, 2001).
Disability is any restriction or lack (resulting from
an impairment) of ability to perform an activity in the
manner or within the range considered normal for a
human being (World Health Organization,1980) World
Health Organization classi ed the disability into 9 cate-
gories (World Health Organization,1980). The rst one is
behavior disabilities which mention to a person’s aware-
ness of himself, others, their roles and occupations,
places, and time (World Health Organization,1980). The
second one is communication disabilities that refer to
person’s ability to communicate with other such as dis-
ability in speaking, listening, seeing, and writing (World
Health Organization,1980). The third is personal care
disabilities which mean the person’s ability to take care
of himself, his personal hygiene, dressing, feeding, and
getting to bed (World Health Organization,1980). The
fourth is locomotor disabilities which are disability in
the walking, climbing stairs, running, transfer, transport,
and lifting (World Health Organization,1980). The fth
is body disposition disabilities that mean the person’s
ability to carry out his own activities such as prepar-
ing food, cocking, serving food, reaching, and kneeling
(World Health Organization,1980). The sixth is dexterity
disabilities that refer to skill body movement such as
modify the environment, moving and handling objects,
ne motor control, and body control (World Health
Organization,1980).
The seventh is situational disabilities that are disabil-
ity in dependence, endurance, and disability in tolerance
in the temperature, noise, and work stress (World Health
Organization,1980).
The eighth is particular skill disabil-
ities that is disability in behavior such as intelligence,
motivation, perception, learning, orientation, and con-
centration, and disability in achievement the tasks such
as problem solving, adaptability, and accuracy (World
Health Organization,1980). The last one is other activity
restrictions; this section has been developed, in order to
develop some of the categories that were not mentioned in
the previous classi cations (World Health Organization,
1980).
FAMS was validated into many languges such as
English, Spanish, Japanese and Dutch, but it was not
validated into Arabic. So, it may not suit our cultures
and society (Desrosiers et al., 1995). Thus, the validation
of FAMS into Arabic is vital (Desrosiers et al, 1995). It
would help occupational therapists who work with peo-
ple with disabilities and elderly who live in Arab coun-
teries and speak Arabic languges in evaluating the areas
of disability in them (Desrosiers et al, 1995).
Validation and realibility are independent on each
other. A measurement maybe valid but not reliable,
or reliable but not valid. Relibility is the reapition of
ndings (Kimberlin, & Winterstein, (2008). Validity of
a test is that it measure what it is supposed measures
(Kimberlin et al, 2008). We conducted this study to vali-
ate SMAF culturally into Arabic culture. We choose pro-
spective cross-sectional design to insure the willing of
the participants.
BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS CROSS CULTURAL VALIDATION OF FUNCTIONAL AUTONOMY MEASUREMENT SYSTEM 549