Abstract
Objective
To investigate the psychometric properties of the validated Italian version of the
Facial Disability Index (FDI), a patient-reported outcome measure widely used to assess
individuals with peripheral facial palsy.
Design
Methodological research on cross-sectional data from a convenience sample.
Setting
Outpatient university rehabilitation clinic.
Participants
A total of 168 (N=168) outpatients (66% female; mean age, 44±15 years) with peripheral
facial palsy of diverse etiology (48% postsurgical, 31% Bell palsy, 8% posttraumatic,
3% congenital, 11% other medical conditions) and severity at the first visit.
Interventions
Not applicable.
Main Outcome Measures
The 2 FDI subscales, physical function (FDI-PHY) and social/well-being function (FDI-SWB),
were separately analyzed using classical test theory methods and Rasch analysis.
Results
Cronbach α was 0.79 in FDI-PHY and 0.74 in FDI-SWB, while item-rest correlation ranged
from 0.36-0.67 in FDI-PHY and from 0.43-0.68 in FDI-SWB. In the FDI-PHY, we deleted
2 underused response categories, rescoring the remaining ones. In the FDI-SWB, some
response categories did not function as expected by the Rasch model: their collapse
into a 4-level format solved this problem. In each subscale, all items fitted the
Rasch model except item 4 (eye tearing/becoming dry) in FDI-PHY that showed an unexpectedly
high response variability. The person separation reliability of both subscales indicated
that they are useful only for group-level judgments. In both subscales, principal
component analysis of the residuals showed unidimensionality and absence of locally
dependent items. No significant differential item functioning concerning sex, age,
or time from paralysis emerged.
Conclusions
Our study demonstrated overall positive psychometric characteristics of FDI except
for the functioning of the response categories. We propose a refined version with
4 response categories only and related conversion graphs that may improve the interpretability,
feasibility, and metric performance of this tool.
Keywords
List of abbreviations:
CTT (classical test theory), FDI (Facial Disability Index), PHY (physical), SWB (social/well-being)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 10, 2021
Accepted:
October 21,
2021
Received in revised form:
October 13,
2021
Received:
February 16,
2021
Footnotes
Disclosures: none.
Identification
Copyright
© 2021 by the American Congress of Rehabilitation Medicine.
