Date Presented 3/30/2017
The Kohlman Evaluation of Living Skills (KELS) has been used for years to assess basic living skills in various realms of adult rehabilitation. This poster describes the process and results of updating this important assessment tool and introduces the fourth edition of the KELS (Thomson, 2016).
Primary Author and Speaker: Regula Robnett
Additional Authors and Speakers: Linda Kohlman Thomson
PURPOSE: In biopsychosocial rehabilitation settings, occupational therapists are often key team players in answering safety questions regarding discharge for their patients or clients. Determining clients’ level of basic living skills is an important component of a therapeutic evaluation. It is crucial for clinicians to be able to answer questions about discharge safety through valid and reliable means (Doucet & Gutman, 2013). The KELS is one tool that has been widely used for this purpose. It was originally designed in 1978 (Kohlman McGourty, 1978) and last updated in 1992 (Kohlman Thomson, 1992).
DESIGN: The research design for this project involved mixed-methods psychometric analyses. Initially, a “Talk About” session (n = 40) was held at the 2011 AOTA Annual Conference & Expo. Through a discussion, global feedback about assessing living skills was sought. This was followed up with an in-depth online survey asking respondents for feedback about each section of the KELS test. Using a snowball recruiting method resulting in a sample of convenience, 411 respondents from 47 states answered the detailed survey in 2012–2013. Their feedback was incorporated into the updated version of the KELS. While initially many more showed interest, 50 clinicians agreed to use the draft KELS fourth edition to assess their clients at least 10 times over a 6-mo period and then send the research team deidentified client data. For various reasons (e.g., retirement, pregnancy, and sometimes unknown), the final number of participants included 34 therapists from 18 different states who sent in 211 KELS test forms and the follow-up feedback surveys. The follow-up surveys involved both quantitative and qualitative questions, and the results, considered expert feedback, were used for assessing an aspect of content validity of the draft of the KELS fourth edition.
RESULTS: The results based on the initial survey indicated that each segment of the third edition of the KELS was still valued and valid but that a few sections needed significant updating (e.g., phone use, income information, photos). Most sections needed at least minor modifications. More than 2,000 detailed comments were carefully considered for the updated test. The most significant changes were made to the bill paying segment (optional online banking) and the safety photos. Demographic data included the primary settings in which the KELS fourth edition draft was used and the mean years of experience in occupational therapy (19; range = 1–38 yr). The average number of KELS administered was 6 (range = 1–29). Eight photos were used during the beta testing, and the four found to have the highest discrimination indexes were retained for the final version (Thomson, 2016).
Content validity analysis uncovered several themes from the therapists’ feedback in the follow-up surveys (related primarily to ease of administration and scoring). The majority stated that the results of the testing were “helpful” or “very helpful” for discharge planning. Beta testing participants provided feedback on individual sections.
CONCLUSION: Overall, the response to the new edition was positive, with comments often indicating the respondents’ appreciation of and enthusiasm for the new edition. The significance of the current project is to provide the profession of occupational therapy an up-to-date, reliable, valid, and user-friendly tool for assessing basic living skills. The KELS fourth edition is now available through the American Occupational Therapy Association. Continued research on the tool is warranted.
References
Doucet, B. M., & Gutman, S. A. (2013). Quantifying function: The rest of the measurement story. American Journal of Occupational Therapy, 67, 7–9. https://doi.org/10.5014/2013.007096
Kohlman McGourty, L. (1978). The Kohlman Evaluation of Living Skills. Seattle, WA: KELS Research.
Kohlman Thomson, L. (1992). The Kohlman Evaluation of Living Skills (3rd ed.). Bethesda, MD: American Occupational Therapy Association.
Thomson, L. K. (2016). The Kohlman Evaluation of Living Skills. Bethesda, MD: American Occupational Therapy Association.
