Reliability and validity of a performance-based measure of skills for communicating with doctors for older people with serious mental illness

Abstract

Background: Older people with serious mental illnesses (SMI) have high rates of medical comorbidity and impaired social skills, including basic communication skills that are imperative for medical encounters.Aim: To examine two role-plays developed to evaluate communication in a health care visit.Method: A total of 152 people over age 50 with SMI were rated on two standardized medical visit role-plays.Results: This assessment had excellent inter-rater reliability and test-retest reliability. Performance was not related to gender or age, although participants with a mood disorder had better social skill performance than those with schizophrenia or schizoaffective disorder. Performance was strongly related to the Social Skills Performance Assessment (SSPA: Patterson et al., ), designed to assess basic communication skills in older people with SMI. Performance was also correlated with self-care skills, social functioning, number of medical visits within the past six months, and informant rating of the effect of physical condition on functioning.Conclusions: This assessment demonstrates acceptable psychometric properties, including reliability and convergent validity, and may be a useful tool to assess basic communication skills for discussing health care concerns.Declaration of interest: Participants in this study were participating in NIMH R01 MH62324: “Rehabilitation and Health Care for Elderly with SMI” (Bartels, PI).