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Social-Adaptive Functioning Evaluation (SAFE): a rating scale for geriatric psychiatric patients
P D Harvey1, M Davidson, K T Mueser
1Dept. of Psychiatry, Mt. Sinai School of Medicine, New York, NY 10029, USA.
Schizophrenia Bulletin
|January 1, 1997
Summary
The Social-Adaptive Functioning Evaluation (SAFE) scale helps assess geriatric psychiatric patients. It effectively differentiates patients who can be discharged from those requiring continued hospitalization.
Area of Science:
- Geriatric Psychiatry
- Psychometric Evaluation
- Adaptive Functioning Assessment
Background:
- Geriatric chronic psychiatric inpatients often have deficits in adaptive life functions, leading to prolonged hospitalization.
- Existing assessment scales do not adequately address age-related complications and adaptive changes in the elderly.
- The Social-Adaptive Functioning Evaluation (SAFE) was developed to fill this gap.
Purpose of the Study:
- To develop and validate the Social-Adaptive Functioning Evaluation (SAFE) scale for geriatric chronic psychiatric inpatients.
- To assess social-interpersonal, instrumental, and life skills functioning in this population.
- To determine the scale's reliability, validity, and predictive utility.
Main Methods:
- The SAFE scale was developed, measuring social-interpersonal, instrumental, and life skills.
- Interrater and test-retest reliability were assessed (n=60).
- Convergent and discriminant validity were evaluated against other measures (n=50).
- Exploratory factor analysis identified a three-factor structure.
- Predictive validity was examined in a preliminary study (n=140).
Main Results:
- The SAFE scale demonstrated adequate interrater and test-retest reliability.
- Convergent and discriminant validity were found to be adequate.
- Exploratory factor analysis revealed a robust three-factor structure.
- The SAFE scale successfully discriminated between patients who remained hospitalized and those discharged to nursing homes or community care.
- Specific SAFE items and subscales showed predictive power.
Conclusions:
- The Social-Adaptive Functioning Evaluation (SAFE) is a reliable and valid instrument for assessing adaptive functioning in geriatric chronic psychiatric inpatients.
- The scale's factor structure is sound, and it possesses predictive validity for discharge potential.
- SAFE can aid in differentiating patient needs and informing treatment and placement decisions for this population.