Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.
Cooperativa Laboratorio Sociale, Trento, Italy.
J Intellect Disabil Res. 2023 Jun;67(6):560-572. doi: 10.1111/jir.13028. Epub 2023 Mar 13.
The United Nations has declared that people with disabilities should be enabled to live as independently as possible, since independence is correlated with a better quality of life. Consequently, services need to have common and validated measurement tools for the evaluation of the different levels of personal support needs in order to promote independent living skills. We aimed to create and validate the Adult Independence Living Measurement Scale (AILMS) to estimate personal skills considered tantamount for independent living in adult persons with intellectual and developmental disabilities.
AILMS is a short informant-rated assessment tool consisting of 19 items (goals) regarding the most important skills related to independent living. AILMS total score is directly proportional to the degree of independence, with scores ranging from 19 to 76. Our validation is a multicentre study attended by 243 subjects, 110 female and 123 males, with a median age of 37 years and with an interquartile range (IQR) of 18 (25th percentile [Q1] 29 years to 75th percentile [Q3] 47 years). All subjects had a diagnosis of intellectual disability associated with various neurodevelopmental disorders or syndromic conditions.
The AILMS shows a wide range of scores with a minimum score of 21 and a maximum of 72. We found no floor or ceiling effects for the total score on the AILMS. Cronbach's α coefficient (= 0.95), based on the 19 AILMS items, indicated high internal consistency. The tool demonstrates a very good agreement even when comparing the results submitted by two different interviewers. It also shows an excellent temporal stability of 1 week, with intraclass correlation coefficients both of 0.97. AILMS total scores do not differ by sex or age, while statistically significant differences are observed between people with different levels of severity of ID. Convergent validity of AILMS was analysed by correlating its total scores with the Italian validated versions of the Support Intensity Scale (SIS-I) and the Alzheimer's Functional Assessment Tool (AFAST-I) scores. Strong inverse Spearman correlations coefficients (r ) were found both for the Support Need Index of the SIS-I (r = -0.66; P < 0.001) and AFAST-I (r = -0.73; P < 0.001). Scores of support needs in exceptional health disorders of the SIS-I appear unrelated to AILMS total scores (r = -0.01; P = 0.05), confirming the divergent validity of the new scale. Exploratory factor analysis reveals three underlying factors within the AILMS, with factor 1 explaining 51.2% of the total variance (Cronbach's α = 0.92) composed of predominantly nine advanced daily activities.
The AILMS has good psychometric properties and user friendliness and may therefore be a valuable addition to the current informant-rated tools for screening and assessment of independent living skills of individuals with intellectual and developmental disabilities.
联合国已经宣布，残疾人应该能够尽可能独立地生活，因为独立性与更高的生活质量相关。因此，为了促进独立生活技能的发展，服务机构需要有共同的和经过验证的测量工具来评估不同程度的个人支持需求。我们旨在创建和验证成人独立生活测量量表（AILMS），以评估智力和发育障碍成人独立生活所需的个人技能。
AILMS 是一个简短的知情者评定评估工具，由 19 个与独立生活相关的最重要技能的项目（目标）组成。AILMS 总分为直接与独立性成正比，分数范围从 19 到 76。我们的验证是一项多中心研究，共有 243 名受试者参加，其中 110 名女性和 123 名男性，中位年龄为 37 岁，四分位间距（IQR）为 18（25 百分位数 [Q1]为 29 岁至 75 百分位数 [Q3]为 47 岁）。所有受试者均被诊断为智力残疾，伴有各种神经发育障碍或综合征。
AILMS 的得分范围很广，最低分为 21，最高分为 72。我们没有发现 AILMS 总分的地板或天花板效应。基于 19 个 AILMS 项目，Cronbach 的 α 系数（=0.95）表明内部一致性很高。即使比较两位不同的访谈者提交的结果，该工具也显示出非常好的一致性。它还显示出 1 周的极好的时间稳定性，组内相关系数均为 0.97。AILMS 总分不因性别或年龄而异，但在 ID 严重程度不同的人群之间存在显著差异。通过与意大利验证的支持强度量表（SIS-I）和阿尔茨海默病功能评估工具（AFAST-I）的总分进行相关性分析，评估了 AILMS 的收敛效度。发现 SIS-I 的支持需求指数（r=-0.66；P<0.001）和 AFAST-I（r=-0.73；P<0.001）的反向斯皮尔曼相关系数（r）均为强负相关。SIS-I 中特殊健康障碍的支持需求评分与 AILMS 总分无关（r=0.01；P=0.05），这证实了新量表的发散效度。探索性因子分析揭示了 AILMS 中的三个潜在因素，其中第一个因素解释了总方差的 51.2%（Cronbach's α=0.92），主要由九个高级日常活动组成。
AILMS 具有良好的心理测量特性和易用性，因此可能是智力和发育障碍个体独立生活技能筛查和评估的现有知情者评定工具的有价值的补充。
