Function Assessment Scale

Abstract

The Function Assessment Scale (FAS) is a specialized psychometric instrument designed to measure the perceived ability of perinatal women (pregnant women and new mothers) to engage in essential daily tasks and community activities. Developed by Bah et al. (2025) in the context of Sierra Leone, the FAS provides a culturally sensitive evaluation of functional status, focusing on activities related to self-care, family maintenance, and social engagement. The final version of the scale comprises five items, refined through rigorous psychometric testing and linguistic validation processes.

Keywords

Function Assessment Scale, Perinatal health, Functional status, Daily living activities, Sierra Leone, Psychometric scale, Maternal health, Cronbach’s alpha.

Authors

Bah, Abdulai Jawo, Wurie, Haja Ramatulai, Samai, Mohamed, Horn, Rebecca, Ager, Alastair.

Purpose

The primary purpose of the Function Assessment Scale is to quantify and evaluate how perinatal women perceive their capacity to execute routine daily tasks, comparing their self-assessed difficulty level against peers. This scale serves as a tool for researchers and clinicians working in low-resource settings, specifically targeting the impact of the perinatal period on a woman’s ability to maintain her household and social roles.

The scale’s development was anchored in a need to capture functional limitations specific to women in settings like Sierra Leone, ensuring cultural relevance. The final items reflect essential daily chores and social participation, moving beyond purely clinical definitions of function to include community engagement.

Construct

The FAS measures the psychological construct of Perceived Functional Status (PFS) among pregnant women and new mothers. This construct is defined as the individual’s subjective evaluation of their ability to perform necessary daily activities for themselves, their families, and their communities, often referred to as Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). The scale captures the perceived difficulty, rather than objective performance, in executing these tasks.

The development process highlighted the importance of culturally appropriate items. For instance, the elimination of the “engage in income-generating activities” item, despite its potential relevance to overall functional status, was necessary because of the low participation rates reported in the study sample, which negatively impacted the scale’s internal consistency.

Validity

Specific measures of construct validity (e.g., convergent, divergent) or criterion validity were not explicitly reported in the source documentation provided for the Function Assessment Scale. Future research would benefit from establishing external validity by correlating FAS scores with established measures of physical health, quality of life, or other indicators of functional capacity.

Reliability

The reliability of the FAS was primarily evaluated using internal consistency measures, specifically Cronbach’s alpha. The initial 7-item version demonstrated strong reliability with an alpha value of 0.890. Subsequent refinement led to further improvement in the scale’s consistency.

The removal of the item pertaining to “Engage in income-generating activities” resulted in an enhanced internal consistency, raising the final 5-item scale’s Cronbach’s alpha to 0.92. This high value suggests excellent inter-relatedness among the final five items, indicating that they reliably measure the same underlying construct of functional status.

Factor Analysis

No results from formal factor analysis (e.g., Exploratory Factor Analysis or Confirmatory Factor Analysis) were provided in the source documentation to confirm the underlying factor structure of the Function Assessment Scale. This analysis would be crucial for determining if the five items load onto a single, cohesive factor representing overall functional ability or multiple sub-domains.

Instrument

Test Type: Self-report psychometric scale focusing on perceived difficulty in daily tasks.

Format: Four-point Likert scale. Participants rate the level of difficulty they face compared to their age-matched peers. The response format utilized visual aids (an image of a man carrying weights) to symbolize the degrees of difficulty.

Language Available: English (original development language), Krio (used for linguistic validation and administration in Sierra Leone).

Population Group: Perinatal women (pregnant women and new mothers).

Age Group: Adulthood (18 years and older).

Population Details: The scale was developed and validated among women residing in the Western Area and Bombali regions of Sierra Leone.

Test Methodology: The scale followed a rigorous development process involving initial item generation, translation into Krio and back-translation into English to ensure semantic and cultural equivalence. Items were selected based on relevance to daily chores and contribution to high internal consistency.

Keywords

Perinatal women, Functional status, Krio language, Sierra Leone, Self-report measure, Activities of Daily Living, Likert scale.

Authors

Author ORCID Identifier: Abdulai Jawo Bah: 0000-0002-3334-7882; Rebecca Horn: 0000-0002-9869-544X; Alastair Ager: 0000-0002-9474-3563.

Affiliation Email addresses: Abdulai Jawo Bah: [email protected].

Correspondence Address: Institute for Global Health and Development, Queen Margaret University (Affiliation of lead author Bah, A. J.).

Permissions & Fee and Test Year

The Function Assessment Scale was published in 2025 as part of the research paper by Bah et al. (2025). Information regarding specific usage permissions, licensing fees, or general availability beyond the academic publication was not detailed in the source material.

Reference’s

Bah, A. J., Wurie, H. R., Samai, M., Horn, R., & Ager, A. (2025). Developing and validating the Sierra Leone perinatal psychological distress scale through an emic-etic approach. Journal of Affective Disorders Reports, 19, Article 100852. https://doi.org/10.1016/j.jadr.2024.100852

The scale development was conceptually inspired by the methodological work of Bolton and Tang (2002), though the specific reference citation for Bolton and Tang was not provided in the source content.

Items of the Function Assessment Scale

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The final version of the Function Assessment Scale consists of five items:

1. Perform personal hygiene activities
2. Prepare meals for the household
3. Clean living spaces
4. Care for children
5. Engage in social interactions with family and community