1,721,308 research outputs found
Exploratory factor analysis of the Mini instrument for the observer rating according to ICF of Activities and Participation in Psychological disorders (Mini-ICF-APP) in patients with severe mental illness
No full textObjectives
After publication of the WHO International Classification of
Functioning, Disability and Health (ICF), the Mini-ICF-APP (Mini
instrument for the observer rating according to ICF of Activities
and Participation in Psychological disorders) was derived and
validated in three languages to assess limitations in activities or
capacities and restrictions in participation in patients with mental
illness. Although the Mini-ICF-APP has been demonstrated
to have sound psychometric properties, factor analytic studies
of this instrument have not been conducted, and the total score
is generally used. We aimed at examining the structure of this
instrument, in order to identify possible factors, which would
allow a more sensitive measurement of an individual’s specific
limitations.
Methods
Patients with schizophrenia or bipolar disorder attending a
community mental health center were recruited consecutively
over an index period and underwent standardised assessment,
including the 13-item Mini-ICF-APP 24-item and
Personal and Social Performance scale and the Brief Psychiatric
Rating Scale (BPRS-24). Factor analysis with maximum
likelihood estimation and oblique rotation was performed on
Mini-ICF-APP items.
Results
A three-factor solution provided the best goodness of fit indices.
Factors were interpreted as proficiency, relational capacity and
autonomy. Factor scores were significantly higher in patients with
schizophrenia than in those with bipolar disorder. The ‘proficiency’
factor exhibited the strongest associations with BPRS, CGI-S
and total PSP. Moreover, correlations between Mini-ICF-APP factors
and PSP dimensions were in the expected direction, indicating
good convergent and discriminant validity of the instrument;in
fact, the highest correlations were found between the corresponding
factors/dimensions of the two instruments (proficiency with
PSP socially useful activities, relational capacity with PSP personal
and social relationships, autonomy with PSP self-care) and the
lowest correlations were observed with PSP dimension ‘disturbing
and aggressive behaviour, that is not assessed in the Mini-ICF-APP.
Conclusions
The factors extracted are clearly interpretable and have convergent/
discriminant validity. Our findings may have clinical implications,
as the distribution of factors distinguishes the two patient
groups, which may require different interventions to achieve an
optimal therapeutic response
Construct validity and psychosocial correlates of the Italian version of the 21-item Medical Interview Satisfaction Scale in primary care
Full text linkBackground Satisfaction with the medical interview has been rarely explored in primary care outside the UK, despite evidence suggesting that a trustful doctor-patient relationship is a key ingredient to facilitate treatment adherence and relief from illness-related distress. Aims The aims of this study are to analyse the construct validity of the Italian version of the Medical Interview Satisfaction Scale (MISS-21) and its correlations with two outcome measures, the Inventory of Depressive Symptomatology - Self-Report and World Health Organization Quality Of Life Brief Version, in patients with mild-to-moderate depression, recruited in primary care practices. Method The factor structure underlying the MISS-21 was investigated with principal component analysis, and the internal consistency of the factors was evaluated with Cronbach's alpha. Network analysis was used to investigate the interrelationships among items. The importance of individual items in the network structure was determined with centrality analyses. Correlations of MISS-21 scores with changes in depression and quality of life were analysed with Spearman's correlation coefficient. Results The MISS-21 proved to have a robust four-dimensional factor structure. Cronbach's alpha for the factors ranged from 0.77 to 0.93, suggesting good to excellent internal consistency. The four factors identified were positively correlated with improvement in depressive symptoms and three quality-of-life domains. Conclusions The MISS-21 has sound psychometric properties, and comprises four factors related to clinical outcomes, which makes it suitable for clinical and research applications. The central items in the network should be considered as possible targets for quality improvement interventions in primary care
Gender-specific decline and seasonality of births in operationally defined schizophrenics in South-Verona
No full textThe Reasons for Unfinished Nursing Care during the COVID-19 Pandemic: An Integrative Review.
Full text linkBackground: The concept of unfinished nursing care (UNC) describes nursing interventions required by patients and families that nurses postpone or omit. UNC reasons have been documented; however, no studies have summarised the underlying factors triggering the UNC during the pandemic. Therefore, the aim was to synthesise the available studies exploring factors affecting UNC during a pandemic. Methods: We conducted an integrative review following Whittemore and Knafl's framework according to the Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the Scopus databases were searched for primary studies that collected data from 1 January 2020 to 1 May 2023. Both qualitative and quantitative studies assessing the reasons for UNC were eligible and evaluated in their quality using the Critical Appraisal Skills Programme and the Mixed Methods Appraisal Tool. Results: Four studies were included-three qualitative and one cross-sectional. The reasons for UNC have been documented at the following levels: (a) system (e.g., new healthcare system priorities); (b) unit (e.g., ineffective work processes); (c) nurse management (e.g., inadequate nurse manager's leadership); (d) nurse (e.g., nurses' attitudes, competences, performances); and (e) patient (increased demand for care). Conclusion: The reasons for UNC during the COVID-19 pandemic are different to those documented in the pre-pandemic times and reflect a pre-existing frailty of the National Health Service towards nursing care
Multivariate analysis of outcome of mental health care using graphical chain models. The South-Verona Outcome Project 1
No full textBackground. Short-term outcome of mental health care was assessed in a multidimensional perspective using graphical chain models, a new multivariate method that analyses the relationship between variables conditionally, i.e. taking into account the effect of antecedent and intervening variables. Methods. GAF, BPRS, DAS (at baseline and after 6 months), LQL and VSSS (at follow-up only) were administered to 194 patients attending the South-Verona community-based mental health service. Direct costs in the interval were also calculated. Graphical chain models were used to analyse: (1) the associations between predictors (psychopathology, disability, functioning, assessed at baseline); (2) the effects of predictors on costs; and (3) the effect of predictors and costs on outcomes (psychopathology, disability, functioning, quality of life and service satisfaction) as well as their correlation. Results. Psychopathology, disability and functioning scores at baseline predicted the corresponding scores at 6-month follow-up, with greater improvement in the more severely ill. Higher psychopathology and poorer functioning at baseline predicted higher costs and, in turn, costs predicted poorer functioning at follow-up. Outcome indicators polarized in two groups: psychopathology, disability and functioning, which were highly correlated; and the dyad service satisfaction and quality of life. Service satisfaction was highly related to quality of life and was predicted by low disability and high dysfunctioning. No predictors for quality of life were found. Conclusions. Graphical chain models were demonstrated to be a useful methodology to analyse process and outcome data. The results of the present study help in formulating specific hypotheses for future studies on outcome
Multidimensional Assessment of Outcome in Psychiatry: the use of Graphical Displays. The South Verona Project 2
No full textINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARC
Validity and reliability of the italian version of life,enjoyment and satisfaction questionnaire
No full textPrevalence and correlates of mental disorders among adolescente in Italy: the PrISMA study.
No full textA review of self-report and interview-based instruments to assess mania and hypomania symptoms [Una rassegna degli strumenti autovalutativi ed eterovalutativi per valutare i sintomi maniacali e ipomaniacali]
Full text linkObjective: The aim of this paper is to provide an overview of the self-report and interview-based instruments to assess mania/hypomania symptoms and related features, with a focus on 7 selected instruments in widespread use to illustrate their psychometric properties, comparative performance and pros and cons. Methods: A systematic search strategy was devised and queried on Medline from 1973 to 2012 using the terms mania, hypomania, instrument, scale, questionnaire, interview, validity, reliability, psychometric properties and adults, elderly, aged. To be included, a study had to be published in a peer-reviewed journal or book in English or Italian. Results: Of the 17 self-report instruments identified, two (the Mood Disorder Questionnaire (MDQ) and the Hypomania Checklist-32 (HCL-32), received the most research attention. Although the psychometric properties of these instruments are good, their use as screening instruments to detect hypomania in the community or in patients with depression is partially limited by their low positive predictive value, related to the low prevalence of this condition. Nonetheless, they can be efficiently used to rule out the presence of hypomania. The Altman Self-Rating Mania Scale is increasingly being used to monitor mania symptoms over time by phone or email in patients diagnosed with bipolar disorder because it consists of only 5 items. When the aim is early detection of manic/hypomanic symptoms that a patient may have experienced during their lifetime, the 33-item subset of the MOODS-SR seems promising because it includes the key psychopathology dimensions that better discriminate bipolar from unipolar disorder. Of the interview-based instruments, the Young Mania Rating Scale and the Bech-Rafaelsen Mania Scale are the most widely used outcome measures in clinical trials. Although they were developed more than 30 years ago, they continue to be the gold standard for research purposes. The two instruments have a similar coverage, although the YMRS is preferred over the BR-MAS because it includes an item on insight. Conclusions: Although no instrument can replace the need for accurate clinical diagnosis based on patient history, we argue that the increasing use of self-report instruments to screen bipolar disorder in patients presenting with depression or to monitor mania/hypomania symptoms over time may contribute to increasing the use of routine standardized assessment. Measurement-based care as the standard of care has the potential to transform psychiatric practice, move psychiatry into the mainstream of medicine, and ultimately improve the quality of care for patients with psychiatric illness
Prevalence and correlates of mental disorders among adolescents in Italy: the PRISMA study
No full textBACKGROUND: While in the last 5 years several studies have been conducted in
Italy on the prevalence of mental disorders in adults, to date no epidemiological
study has been targeted on mental disorders in adolescents.
METHOD: A two-phase study was conducted on 3,418 participants using the child
behavior checklist/6-18 (CBCL) and the development and well-being assessment
(DAWBA), a structured interview with verbatim reports reviewed by clinicians.
RESULTS: The prevalence of CBCL caseness and DSM-IV disorders was 9.8% (CI
8.8-10.8%) and 8.2% (CI 4.2-12.3%), respectively. DSM-IV Emotional disorders were
more frequently observed (6.5% CI 2.2-10.8%) than externalizing disorders (1.2%
CI 0.2-2.3%). In girls, prevalence estimates increased significantly with age;
furthermore, living with a single parent, low level of maternal education, and
low family income were associated with a higher likelihood of suffering from
emotional or behavioral problems.
CONCLUSIONS: Approximately one in ten adolescents has psychological problems.
Teachers and clinicians should focus on boys and girls living with a single
parent and/or in disadvantaged socioeconomic conditions
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