Harvey P D, Davidson M, Mueser K T, Parrella M, White L, Powchik P
Dept. of Psychiatry, Mt. Sinai School of Medicine, New York, NY 10029, USA.
Schizophr Bull. 1997;23(1):131-45. doi: 10.1093/schbul/23.1.131.
Geriatric chronic psychiatric inpatients often remain in a chronic psychiatric hospital because of serious deficits in adaptive life functions. Because the additional complications and adaptive changes associated with aging have not been considered in previous scales, the Social-Adaptive Functioning Evaluation (SAFE) was developed. The items in the scale measure social-interpersonal, instrumental, and life skills functioning and are designed to be rated by observation, caregiver contact, and interaction with the subject if possible. Interrater and test-retest reliability were examined (n = 60) and convergent and discriminant validity were rated against other relevant measures (n = 50) in separate studies, with all being found adequate. The factor structure of the scale was examined with exploratory factor analysis, revealing a three-factor structure. Finally, predictive validity was examined in a preliminary study of 140 patients, 45 of whom were discharged after the assessment. The results indicate that patients who remained hospitalized could be discriminated from those who were sent to nursing homes or community care on the basis of certain SAFE items and subscales. These results support the use of this instrument in later studies of geriatric psychiatric patients.
老年慢性精神病住院患者常常因适应性生活功能严重缺陷而长期滞留在慢性精神病医院。由于以往的量表未考虑与衰老相关的额外并发症和适应性变化，因此开发了社会适应功能评估量表（SAFE）。该量表中的项目测量社会人际、工具性和生活技能功能，并且在可能的情况下，设计通过观察、与照料者联系以及与受试者互动来进行评分。在单独的研究中检验了评分者间信度和重测信度（n = 60），并对照其他相关测量方法评定了聚合效度和区分效度（n = 50），结果均显示充分。用探索性因素分析检验了该量表的因素结构，揭示出一个三因素结构。最后，在一项对140例患者的初步研究中检验了预测效度，其中45例患者在评估后出院。结果表明，根据SAFE量表的某些项目和分量表，可以区分出仍住院的患者与被送往养老院或接受社区护理的患者。这些结果支持在后续老年精神病患者研究中使用该工具。
