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Using the Levels of Cognitive Functioning Assessment Scale with Patients with Traumatic Brain Injury in an Acute Care Setting


  • Jeanne Flannery DSN RN CRRN ARNP CNRN

    Corresponding authorSearch for more papers by this author
    • Jeanne Flannery is an associate professor at Florida State University School of Nursing in Tallahassee, FL.

10874 Luna Point Road, Tallahassee, FL 32312


The Levels of Cognitive Functioning Assessment Scale (LOCFAS) is a behavioral checklist that includes behaviors commonly seen in patients during the earliest stages of recovery from traumatic brain injury (TBI). The LOCFAS and the Disability Rating Scale were used four times each week to evaluate 28 patients who had had TBI; this was done throughout their acute care hospitalization. The Glasgow Coma Scale, Stover-Zeiger Scale, and Expanded Glasgow Outcome Scale also were used to evaluate patients at their initial assessment and at the time of their discharge. Concurrent validity (r > .85), both at the initial assessment and discharge, and predictive validity (r > .70) were high. The daily stability and interrater reliability (r = .99) of the LOCFAS also were good.