The assessment of real-life functioning presents complex challenges from variability in the operational definition of functional outcome to problems in identifying optimum information sources. In this context, there are still few satisfactorily reliable instruments for the assessment of functional outcomes that are practical in terms of time involved, and most real-life functional outcome scales seem to be largely redundant with each other when utilised simultaneously. The Validation of Everyday Real-World Outcomes (VALERO) Study selected six functional outcome scales from a much larger group of candidate scales as most suitable for current use. The Specific Levels of Functioning (SLOF) Scale was one of these and was considered to be a hybrid scale rating multiple functional domain. This scale has been translated into Italian by our group, and the translation is presented herein.
In the context of the multicentre study of the Italian Network for Research on Psychoses, the SLOF was translated in Italian by two psychiatrists and then back-translated. A formal assessment of semantic equivalence, debriefing of conventional sample and final review by experts were carried out. The operational equivalence was taken into account, which preserves the original features.
The Italian version of the SLOF is a 43-item multidimensional behavioural survey comprising six subscales: (1) physical functioning, (2) personal care skills, (3) interpersonal relationships, (4) social acceptability, (5) activities of community living and (6) work skills. It is administered in person to the caseworker or caregiver of a schizophrenic patient or a patient-administered scale completed with verbal instructions from the examiner to rate its own performance. The scale does not include items relevant to psychiatric symptomatology or cognitive dysfunctions, but assesses the patient’s current functioning and observable behaviour, as opposed to inferred mental or emotional states, and focuses on a person’s skills, assets, and abilities rather than deficits that once served as the central paradigm guiding assessment and intervention for persons with disabilities.
Ratings on individual items of the SLOF may be used to capture the current state of overall functioning while showing specific areas of therapeutic and rehabilitative need. Moreover, the SLOF has direct applications in research on patient outcomes and evaluation of programmes.