ALTERNATIVE ASSESSMENTS OF FUNCTIONAL STATUS OF AIDS PAT

The purpose of this proposal is to develop and field test two complementary approaches to the measurement of functional status in persons with AIDS. The first approach involves adaptation of nomothetic activities of daily living (ADL) and instrumental activities of daily living (IADL) methods developed for techniques used to assess individuals' goal directed activity. Each approach is intended to address specific assessment problems in service delivery and evaluation. The specific aims of this study are: (1) to develop a nomothetic behavioral assessment measure, that: a) can be completed by both care recipients and providers, b) addresses difficulties relevant to PWAs, c) describes both basic and higher-order aspects of functioning, and d) identifies needed resources. (2) to develop an idiographic interview that: a) emphasizes current concerns and goals of AIDS patients, b) describes goal attainment activities, and c) describes performance of these activities. (3) to evaluate the psychometric properties of measures. (4) to test specific hypotheses related to the construct validity of these measures, and (5) to provide an empirical base for making methodological decisions which bear on a wide variety of assessment applications. The proposed project will be carried out in two phases. The measurement development phase will involve focus group sessions and individual interviews with people with AIDS care partners, and health care providers to ensure that measures are relevant and clear to these constituencies. The field test phase will involve empirical research on 225 residents in three facilities. This field test will provide detailed information on psychometric properties of measures, as well as construct validity demonstrated by relationships with treatment and service usage, history of illness, concurrent measures of health and well-being, and predictions of health outcomes and subsequent use of services.