The development of factor-based level of functioning scales from a level of care instrument

Abstract

A factor analysis of data from 1,295 administrations of a level of care instrument produced a seven‐factor solution. The scales developed from these factors through a simple unit weighting procedure were internally reliable and replicable on an additional sample of clients. The seven factors are discussed in terms of level of functioning measures. Results suggest that community living skills and self‐care skills are two among several robust dimensions of level of functioning in psychiatric clients. Implications are discussed.

A systematic review of clinician-rated instruments to assess adults’ levels of functioning in specialised public sector mental health services

“…Developed through a factor analysis of 73 items on the 79-item Missouri Level of Care (MLC) that measure functioning. Factors are community skills, self-care skills, nuisance behaviour, sociability, skilled nursing, proclivity for violence and control of anger (Massey et al, 1989).…”

Cross-Cultural Validation of the St. Louis Inventory of Community Living Skills for Chinese Patients with Schizophrenia in Hong Kong.

“…The factor structure of the SLICLS-C is similar to that of the Independent Living Skills Survey (ILSS, Michie et al, 1998) in which the two factors were labeled as "basic" (personal maintenance or self care) and "higher level" skills (money, health and time management). The Missouri Level of Care (MLC, Massey, Pokorny & Kramer 1989) and the Specific Level of Functioning (SLOF, Schneider & Struening, 1983) both show similar factor structure but they use different terms. The MLC has seven factors, of which two, "self care" and "community skills" are related to community living skills.…”

“…The SLICLS-C has good internal consistency as evidenced by a Cronbach alpha of .96, which is compatible with that of the SLICLSs. The Cronbach alpha values for the most frequently used community living skills scales are as follows: Community Ability Scale .90 (Barker, Massey & Pokorny, 1994); MLC Community Skills subscale .98 (Massey et al, 1989; Kramer et al, 1990); SLOF Community Skills subscale .98 (Schneider & Struening, 1983); Independent Living Skills Survey .69 (Cyr et al, 1994). These figures indicate that the SLICLS-C has excellent internal consistency, implying that the assessment was very reliable.…”

The St. Louis Inventory of Community Living Skills.

“…Unfortunately, such broad-band instruments are often very long (as many as 321 items) or require structured interviews (Wallace, 1986). Some LOF scales include a variety of subscales, which take considerable time to administer (Green & Gracely, 1987; Furman & Schneider, 1980; Massey, Pokorny & Kramer, 1989; Goldberg, et al, 1991). Some assess only social skills (Birchwood, Smith, Cochrane, Wetton & Copestake, 1990).…”