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A community ability scale for chronically mentally Ill consumers: Part I. Reliability and validity

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Abstract

The authors describe the development, reliability testing, and validation of a 17-item instrument that measures the level of functioning of chronically mentally ill persons living in the community. The Multnomah Community Ability Scale is designed to be completed by case managers. The instrument provides a measure of the consumer's severity of disability which can, in turn, be used to: (a) describe an agency's “case mix” of clients; (b) measure consumer progress; (c) assign clients to different levels of service; and (d) assist payors in determining reimbursement. The Multnomah Community Ability Scale is aimed specifically at persons with chronic mental illness, is sensitive to differences among individuals within this special population, and is quick and easy to complete. The scale's reliability and validity have been examined in detail. Inter-rater and test-retest reliability are good. Criterion variables such as length of psychiatric hospitalization and clinicians' global ratings correlated highly with scale scores. Finally, the instrument predicts subsequent state and local hospital admissions.

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References

  • Anthony, W.A., Kennard, W.A., O'Brien, W.F., & Forbess, R. (1986). Psychiatric rehabilitation: past myths and current realities.Community Mental Health Journal, 22:249–263.

    Google Scholar 

  • Anthony, W.A. & Liberman, R.P. (1986). The practice of psychiatric rehabilitation: historical, conceptual and research base.Schizophrenia Bulletin, 12:542–559.

    Google Scholar 

  • Bachrach, L.L. (1987). Measuring program outcomes in Tucson.Hospital and Community Psychiatry, 38:1151–1152.

    Google Scholar 

  • Barker, S., Barron, N., McFarland, B.H., Bigelow, D.A., & Carnahan, T. (1994). A community ability scale for chronically mentally ill consumers: part II. applications.Community Mental Health Journal, 30:459–472.

    Google Scholar 

  • Barker, S., Barron, N., McFarland, B.H., and Bigelow, D.A. (1993). User's manual for the Multnomah Community Ability Scale. Network Behavioral Healthcare, Inc., Portland, Oregon.

    Google Scholar 

  • Bartko, J.J. (1991). Measurement and reliability: statistical thinking considerations.Schizophrenia Bulletin, 17:483–489.

    Google Scholar 

  • Bean, G.J., Champney, T.F., Garret, J., & Townsend, W. (1988). An assessment of the reliability and validity of the functioning scales used in the 508 certification process. InNew Research in Mental Health (1986–1987), Ohio Department of Mental Health Office of Program Evaluation and Research, Columbus. 168–175.

    Google Scholar 

  • Berren, M.R. (1984) Statewide outcome evaluation: an introduction to the special issue.Community Mental Health Journal, 20:4–13.

    Google Scholar 

  • Brekke, J.S. (1992). An examination of the relationships among three outcome scales in schizophrenia.Journal of Nervous and Mental Disease 180:162–167.

    Google Scholar 

  • Carmines, E.G. & Zeller, R.A. (1979).Reliability and Validity Assessment, Sage Publications, Inc., Newbury Park, California.

    Google Scholar 

  • Ciarlo, J.A. (1992). Indirect needs assessment for mental health services planning.Evaluation and Program Planning, 15 (special issue).

  • Cook, J.A. (1992). Outcome assessment in psychiatric rehabilitation services for persons with severe and persistent mental illness. Manuscript. Thresholds National Research and Training Center on Rehabilitation and Mental Illness, Chicago, Illinois.

    Google Scholar 

  • Corcoran, K. and Fischer, F. (1987).Measurements for Clinical Practice Free Press, New York.

    Google Scholar 

  • Diamond, H. & Biegel, A. (1984). Introduction to the special issue on statewide outcome evaluation.Community Mental Health Journal 20:3.

    Google Scholar 

  • Drummond, M.F. (1987). Resource allocation decisions in health care: a role for quality of life assessments?Journal of Chronic Disease, 40:605–616.

    Google Scholar 

  • Dworkin, R.J., Friedman, L.C., Telschow, R.L., et al (1990). The longitudinal use of the global assessment scale in multiple-rater, situations.Community Mental Health Journal 26:335–344.

    Google Scholar 

  • Ellis, R.H., Wilson, N.Z., & Foster, F.M. (1984). Statewide treatment outcome assessment in Colorado: The Colorado Client Assessment Record (CCAR).Community Mental Health Journal 20:72–89.

    Google Scholar 

  • Fleiss, J.L. (1981).Statistical Methods for Rates and Proportions (second edition). John Wiley and Sons, New York.

    Google Scholar 

  • Freiman, M.P. (1990). Hospital financial performance under the prospective payment system by type of admission: psychiatric versus medical/surgical.Health Services Research 25:785–808.

    Google Scholar 

  • Frey, W.D. (1984). Functional assessment in the 1980's: A conceptual enigma, a technical challenge. In A.S. Halpern & M.J. Fuhrer (Eds.),Functional Assessment in Rehabilitation,. Paul Brookes, Baltimore. 11–43.

    Google Scholar 

  • Furman, W.J. & Schneider, D.P. (1980). A comparison of the level of care predictions of six longterm-care patient assessment systems.American Journal of Public Health 70:1152–1161.

    Google Scholar 

  • Goodman, S.H., Sewell, D.R., Cooley, E.L. & Leavitt, N. (1993). Assessing levels of adaptive functioning: the role functioning scale.Community Mental Health Journal 29:119–131.

    Google Scholar 

  • Green, R.S. & Gracely, E.J. (1987). Selecting a rating scale for evaluating services to the chronically mentally ill.Community Mental Health Journal 23:91–102.

    Google Scholar 

  • Honigfeld, G., Gillis, R.D. & Klett, J.C. (1966). NOSIE-30: A treatment sensitive ward behavior scale.Psychological Reports 19:180–182.

    Google Scholar 

  • Horn, S.D., Chambers, A.F., Sharkey, P.D. & Horn, R.A. (1989). Psychiatric severity of illness: a case mix study.Medical Care 27:69–84.

    Google Scholar 

  • Hoyle, R.H., Nietzel, M.T., Guthrie, P.R., Baker-Prewitt, J.L., and Heine, R. (1992). The Disability Rating Form: a brief schedule for rating disability associated with severe mental illness.Psychosocial Rehabilitation Journal 16:77–93.

    Google Scholar 

  • Kramer, H.B., Massey, O.T. & Pokorny, L.J. (1990). Development and validation of a level-of-care instrument for predicting residential placement.Hospital and Community Psychiatry 41:407–412.

    Google Scholar 

  • Kuhlman, T.L., Sincaban V.A. & Bernstein, M.J. (1990). Team use of the global assessment scale for inpatient planning and evaluation.Hospital and Community Psychiatry 41:416–419.

    Google Scholar 

  • Lemoine, R.L. & Carney, A. (1984). The Louisiana health client-outcome evaluation project: an initial progress report.Community Mental Health Journal 20:90–100.

    Google Scholar 

  • Lord, F.M. & Novick, M.R. (1968).Statistical Theories of Mental Test Scores. Addison-Wesley Publishing Company, Inc., Boston. 88–91, 261–353.

    Google Scholar 

  • Lulroff, D., Nuechterlein, K.H., & Ventura, J. (1986). Manual for expanded brief psychiatric rating scale (BPRS).Schizophrenia Bulletin 12:594–602.

    Google Scholar 

  • McPheeters, H.L. (1984). Statewide mental health outcome evaluation: a perspective of two southern states.Community Mental Health Journal, 20:44–55.

    Google Scholar 

  • Mulkern, V.M. & Manderscheid, R.W. (1989). Characteristics of community support program clients in 1980 and 1984.Hospital and Community Psychiatry 40:165–172.

    Google Scholar 

  • Nunnally, J.C. (1978).Psychometric Theory (Second Edition). McGraw-Hill, New York. 86–97. 214–233.

    Google Scholar 

  • Overall, J.E., & Gorham, D.R. (1962). The brief psychiatric rating scale.Psychological Reports 10:799–812.

    Google Scholar 

  • Owen, W.L. (1984). Analysis and aggregation of CMHC outcome data in a statewide evaluation system: a case report.Community Mental Health Journal, 20:27–43.

    Google Scholar 

  • Rosen, A., Hadzi-Pavlovic, D., & Parker, G. (1989). The Life Skills Profile: a measure assessing function and disability in schizophrenia.Schizophrenia Bulletin 15:325–337.

    Google Scholar 

  • Sisk, J.E. (1987). Discussion: Drummond's “Resource allocation decisions in health care: a role for quality of life assessment?”.Journal of Chronic Disease, 40:617–619.

    Google Scholar 

  • Snedecor, G.W. and Cochran, W.G. (1980).Statistical Methods (seventh edition). Iowa State University Press, Ames, Iowa.

    Google Scholar 

  • Spitzer, W.O. (1987). State of science 1986: quality of life and functional status as target variables for research.Journal of Chronic Disease, 40:465–471.

    Google Scholar 

  • Stahler, G.J. & Rappaport, H. (1986). Do therapists bias their ratings of patient, functioning under peer review?Community Mental Health Journal, 22:265–274.

    Google Scholar 

  • Susser, M. (1990). Disease, illness, sickness; impairment, disability and handicap.Psychological Medicine, 20:471–473.

    Google Scholar 

  • Ware, J.E., Jr. (1987). Standards for validating health measures: definition and content.Journal of Chronic Disease, 40:473–480.

    Google Scholar 

  • Weltzien, R.T. Jr., McIntyre, T.J., Ernst, J.A., Walsh, J.A. & Parker, J.K. (1986). Crossvalidation of some psychometric properties of the CSQ and its differential return rate as a function of token financial incentive.Community Mental Health Journal, 22:49–53.

    Google Scholar 

  • Wood, P.H. (1980). Appreciating the consequence of disease: the classification of impairments, disability and handicaps.The WHO Chronicle, 34:376–380.

    Google Scholar 

  • Wood, W.D. & Beardmore, D.F. (1986). Prospective payment for outpatient mental health services: evaluation of Diagnosis-Related Groups.Community Mental Health Journal, 22:286–291.

    Google Scholar 

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Authors and Affiliations

  1. Training Coordinator and Quality Assurance Manager, Network Behavioral Healthcare, Inc., 5415 S.E. Milwaukee Ave., 97202, Portland, Oregon

    Sela Barker M.S.W., L.C.S.W.

  2. Program Evaluation Specialist, Multnomah County Community and Family Services Division, Portland, Oregon

    Nancy Barron Ph.D.

  3. Oregon Health Sciences University, Portland, Oregon

    Bentson H. McFarland M.D., Ph.D. (Associate Professor of Psychiatry)

  4. Program Standards and Information Management, British Columbia Ministry of Health, Victoria, British Columbia

    Douglas A. Bigelow Ph.D. (Director)

Authors
  1. Sela Barker M.S.W., L.C.S.W.
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  2. Nancy Barron Ph.D.
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  3. Bentson H. McFarland M.D., Ph.D.
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  4. Douglas A. Bigelow Ph.D.
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Additional information

Supported in part by National Institute of Mental Health grants numbers P50 MH 43458 and R01 MH 44686.

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Barker, S., Barron, N., McFarland, B.H. et al. A community ability scale for chronically mentally Ill consumers: Part I. Reliability and validity. Community Ment Health J 30, 363–383 (1994). https://doi.org/10.1007/BF02207489

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