{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T23:16:31Z","timestamp":1788390991946,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aus Occup Therapy J"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The revised functional autonomy measurement system (SMAF\u2010R) is an outcome measure of activity performance and resource needs. This study aimed to measure the implementability of the SMAF\u2010R as a routine outcome measure in acute and subacute inpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a mixed\u2010methods implementation study. Occupational therapists were asked to complete the SMAF\u2010R in hospitalised people with an anticipated length of stay greater than 48\u2009hours over a 12\u2010month period (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u200913,348). A baseline audit of SMAF\u2010R completion rates was conducted, and behaviour change interventions were delivered over 12\u2009months. The Implementability of Healthcare Interventions conceptual framework was used to evaluate fidelity (completion rates), acceptability (staff survey with quantitative and qualitative responses), and feasibility (change in SMAF\u2010R scores from admission to discharge). Quantitative and qualitative (analysed thematically) data were integrated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Consumer involvement<\/jats:title>\n                    <jats:p>Occupational therapists and other staff working to improve outcome measure completion within the electronic medical record and other allied health teams were consulted when developing and delivering behaviour change interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Peak completion of the SMAF\u2010R did not meet an 80% fidelity success rate (admission: 32% in acute and 66% in subacute; discharge: 12% in acute and 48% in subacute). Two thirds of occupational therapists reported the SMAF\u2010R was an acceptable measure to use, but only 38% liked using it. Thematic analysis revealed three themes: (1) A greater understanding of the relevance of the SMAF\u2010R influenced acceptability; (2) using the SMAF\u2010R within an electronic medical record may facilitate completion; and (3) it takes more time to complete SMAF. Patients made clinically significant improvements in SMAF\u2010R scores during their hospital stay (median difference 16.5 [6.5\u201327.0],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u20090.001,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u2009764).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although most occupational therapists reported the SMAF\u2010R was acceptable, there were mixed opinions regarding the relevance of the SMAF\u2010R in this setting, which may have impacted fidelity. Additional prompting and training (especially regarding understanding SMAF\u2010R relevance to practice) may assist with improving SMAF\u2010R completion. Further research is required to assess the psychometric properties of the SMAF\u2010R in the hospital environment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PLAIN LANGUAGE SUMMARY<\/jats:title>\n                    <jats:p>The revised functional autonomy measurement system (SMAF\u2010R) is an assessment tool used to measure performance in everyday activities (such as showering) and the resources needed to complete these tasks (e.g., a shower chair or someone's help). Occupational therapists can use it at the start of a patient admission and again at the end in different hospital settings to assess patients' needs and see if they improve.<\/jats:p>\n                    <jats:p>This study aimed to measure (1) how often occupational therapists use the SMAF\u2010R with patients in hospital, (2) how acceptable occupational therapists find the SMAF\u2010R, and (3) whether the SMAF\u2010R shows changes in patients' abilities during their hospital stay. Before the study, usual completion of the SMAF\u2010R was measured, and it was found to be completed in less than 1% of patients. Strategies were introduced to improve SMAF\u2010R completion over 12\u2009months. After this, completion of the SMAF\u2010R improved to between 9% and 38% in different hospital settings. Changes in SMAF\u2010R scores showed that patients improved during their time in hospital. Most occupational therapists reported the SMAF\u2010R was an acceptable measure, but less than half liked using it. The low completion rates suggested that either the SMAF\u2010R was not fit for purpose in this setting or that more support is needed to increase completion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1440-1630.13006","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T21:33:27Z","timestamp":1730324007000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Fidelity, acceptability, and feasibility of the revised functional autonomy measurement system for hospitalised people: An implementation study"],"prefix":"10.1111","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2510-109X","authenticated-orcid":false,"given":"Aruska N.","family":"D'Souza","sequence":"first","affiliation":[{"name":"The Royal Melbourne Hospital, Allied Health The Royal Melbourne Hospital  Parkville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0686-7436","authenticated-orcid":false,"given":"Casey L.","family":"Peiris","sequence":"additional","affiliation":[{"name":"The Royal Melbourne Hospital, Allied Health The Royal Melbourne Hospital  Parkville Australia"},{"name":"Academic and Research Collaborative in Health (ARCH) La Trobe University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1852-3566","authenticated-orcid":false,"given":"Susan","family":"Darzins","sequence":"additional","affiliation":[{"name":"School of Allied Health, Faculty of Health Sciences Australian Catholic University  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7136-5037","authenticated-orcid":false,"given":"Tamara","family":"Tse","sequence":"additional","affiliation":[{"name":"Occupational Therapy, School of Allied Health, Human Services and Sport La Trobe University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Seymour","sequence":"additional","affiliation":[{"name":"The Royal Melbourne Hospital, Allied Health The Royal Melbourne Hospital  Parkville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan","family":"Hunt","sequence":"additional","affiliation":[{"name":"The Royal Melbourne Hospital, Allied Health The Royal Melbourne Hospital  Parkville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riley","family":"Hodgson","sequence":"additional","affiliation":[{"name":"The Royal Melbourne Hospital, Allied Health The Royal Melbourne Hospital  Parkville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6400-804X","authenticated-orcid":false,"given":"Celia","family":"Marston","sequence":"additional","affiliation":[{"name":"The Royal Melbourne Hospital, Allied Health The Royal Melbourne Hospital  Parkville Australia"},{"name":"Allied Health, Peter MacCallum Cancer Centre  Melbourne Australia"},{"name":"Medicine, Nursing and health Sciences Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,30]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Allied Health Professions (AHP) Outcome Measures UK Working Group. 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