The PSFS – patient-specific functional scale – is one of the rare outcome measures that we consider compulsory to assess during every assessment, no matter the client or condition.
It’s simple, quick, and easy to complete – yet it gives us hugely valuable information.
To complete a PSFS assessment, the client is asked to identify 3 to 5 activities that they would usually be capable of, but are currently unable to complete, due to their injury, condition or disability.
Once these activities have been identified, they are requested to provide a number between 0 and 10 which rates their perceived ability to complete those tasks if they were required to complete them today. “0” represents them believing themself to be unable to perform their chosen task, and “10” reflects their belief of full ability to perform at their prior level. The sum of these numbers is added together, to provide a total PSFS score.
We complete this assessment at the initial assessment, as well as at all progress reassessments that follow. Here’s why we use this assessment religiously.
Why We Love the PSFS
1. The PSFS gives us insight into what that individual finds most limiting.
The PSFS items reflect a client’s perceived ability to complete everyday tasks that are important and necessary for them. It can be in a work-related sense, such as lifting 10kg boxes overhead, standing up for 1 hour continuously, or concentrating for a 2 hour long meeting. But it’s just as useful in a personal life sense too! Hanging out the washing, getting up and down from the floor, running for 5km, or being able to complete a sudoku puzzle in one sitting – it’s all fair game. If it’s important to them, it’s important to us.
2. We can use the tasks that they have identified as sub-goals within the program.
In a return to work program, these identified tasks often relate to work and can therefore become benchmarks for us to work towards. In fact, we often use PSFS tasks as part of our outcome measures to report on! The closer we are to getting them back to a 10/10 rating, the closer they are to meeting the demands of work.
In a Wellness based program where there is no return to work goal involved, achieving the tasks that they have identified is likely to improve wellbeing as a whole. They are just as relevant for us to report on in these circumstances!
3. The PSFS is highly adaptable – it’s relevant to anyone and everyone!
Because the client is choosing tasks that relate to them and their life, it is applicable to all clinical cohorts at all stages of recovery. Whether the limitation is physical or psychological makes no difference. They identify their limitations, and we work to remove them.
4. It helps us remind clients how far they have come.
Because the client is gradually recovering over time and living in their own body every day, they sometimes forget what their starting point was. Asking clients to rate their ability at the end of the program (without telling them what their score was at the start!) is a great way to show them the progress that they have made. Many clients are surprised by their initial ratings!
The PSFS is short, sweet, and simple. It’s function-based, keeps us goal-orientated, and encourages us to look for improvements in a way that is meaningful to the client. This ensures the best outcome for all involved!
Author: Yolanda van Vugt
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