Development of the Clinician Assessment of Financial Incapability (CAFI)
Development of the Clinician Assessment of Financial Incapability (CAFI)
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DOI：
10.1016/j.psychres.2014.01.021
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发表时间：
2014-03-30
影响因子：
11.3
通讯作者：
Rosen, Marc I.
中科院分区：
文献类型：
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作者：
Black, Anne C.;McMahon, Thomas J.;Rosen, Marc I.
社会保障管理局(SSA)为因精神疾病而致残的成年人提供财政支持，以满足他们的基本需要。对于被确定为没有能力管理其资金的受益人，授权进行代表性受款人分配：然而，研究表明，目前确定能力的特别服务协议方法导致特殊的受款人分配，往往会低估需要受款人的受益人。在两个阶段中，我们利用78名心理健康临床医生治疗134名患者受益者的数据，描述了一种新的评估方法的发展，即临床医生财务能力评估(CAFI)。描述了条目的生成、子量表的构建和效度的初步评估。我们还描述了同时开发能力的标准衡量标准，即对所有数据的全面审查。专家确定了四个子量表，映射到四个无能标准；因素分析为该项目结构提供了支持。通过对所有数据的回顾，近一半的患者被确定为无能力。CAFI和SSA方法对73%的病例进行了正确分类，但CAFI的错误更平均地分布在假阴性和假阳性之间。文中考虑了分类误差的影响，并列举了CAFI方法相对于SSA方法的优点。简要描述了未来仪器修订的计划。(C)2014爱思唯尔爱尔兰有限公司。保留所有权利。
The Social Security Administration (SSA) provides financial support to adults disabled by psychiatric conditions to provide for their basic needs. For beneficiaries identified as incapable of managing their funds, representative payee assignment is mandated: However, studies indicate that the current SSA method of determining capability leads to idiosyncratic payee assignment, with a tendency to under-identify beneficiaries needing payees. Over two phases with data from 78 mental health clinicians treating 134 patient-beneficiaries, we describe the development of a new assessment, the Clinician Assessment of Financial Incapability (CAFI). Item generation, subscale construction, and preliminary assessments of validity are described. We also describe the simultaneous development of a criterion measure of capability, a comprehensive review of all data. Experts identified four subscales mapping to four criteria of incapability; factor analysis provided support for this item structure. Close to one-half of patients were determined to be incapable by review of all data. CAFI and SSA methods correctly classified 73% of cases, but errors with CAFI were more evenly distributed between false negatives and false positives. The implications of classification error are considered, and advantages of CAFI over the SSA method are enumerated. Plans for future instrument revision are briefly described. (C) 2014 Elsevier Ireland Ltd. All rights reserved.