NFI Background

The NFI was developed as a clinical and research tool to quantify a variety of postinjury behaviors and symptoms characteristic of neurologic disability and encountered in daily life. The Inventory is comprised of 76 items organized into six factor analytically derived scales: Depression, Somatic, Memory/Attention, Communication, Aggression, and Motor plus an additional six "critical items." The critical items identify areas which may require urgent intervention (e.g., seizures, blackout spells). Separate patient and family forms are provided to collect the unique perspectives offered by both the injured individual and a second party observer. Normative scales are provided based upon patient age and injury severity. The inventory was standardized on persons aged 16 and older. The NFI has been translated into a variety of languages including Spanish, Swedish, French, German, and Italian.

Respondents are asked to rate items as occurring "never", "rarely", "sometimes", "often", or "always." Typically, questionnaires can be completed in 10-15 minutes. The inventory can be mailed in advance of appointments. Completion rates for mailed questionnaires have been relatively good. Omitted responses can readily be clarified with a simple phone call or in person, during the patient's next visit.

Raw scores for each scale are summed and converted into t-scores and percentiles based on patient's age and injury severity. Response patterns can be examined by plotting scores on a profile sheet. The relative severity of problems is indicated by t-score and percentile values as well as comparisons between individual scale scores. The comparability of different people's perceptions (e.g., patient vs. spouse) is ascertained by comparing respondent's scale scores. Change is examined by comparing scale scores from the same respondent over time.

In clinical settings the NFI has proven useful for:

• identifying areas of least and greatest concern
• writing clinical reports and case summaries
• treatment planning
• compensatory strategy development
• measuring change as a function of treatment or natural recovery

Responses can also provide information relevant to competency concerns in the areas of medication management, driving, employment, education, and financial management. The measure can also help address concerns relating to home safety, judgement in dangerous situations, interpersonal difficulties, and inappropriate behavior.