Development and validation of a contextual measure of functioning for people living with severe mental disorders in rural Africa.
Development and validation of a contextual measure of functioning for people living with severe mental disorders in rural Africa.
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DOI：
10.1186/s12888-016-1022-3
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发表时间：
2016-09-07
期刊：
影响因子：
4.4
通讯作者：
Hanlon C
中科院分区：
文献类型：
--
作者：
Habtamu K;Alem A;Medhin G;Fekadu A;Prince M;Hanlon C
大多数严重精神障碍（SMD）患者的功能指标都是在西方社会开发的。这些量表中的许多问题都受文化限制，无法反映性别对任务的区分，而且难以适应其他情况。本研究的目的是制定一项措施的功能与SMD的人，这是上下文适合非洲农村环境。通过对现有比额表的审查、定性研究、自由清单和成堆分类工作以及专家共识，建立了一个项目库。认知访谈指导初始项目缩减和细化。由此产生的规模与SMD（n = 200）和他们的照顾者（n = 200）的人进行了试点测试，以告知进一步的项目减少的基础上的心理测量特性。最终的Butajira功能量表（BFS）包括33个男女通用的项目，另外8个项目仅适用于妇女，涵盖以下领域：自我照顾、工作、家庭和社区参与。心理测量特性的最终BFS进行了检查，在一个基于设施的样本150人SMD和他们的照顾者（n = 150），纵向随访n = 84。SMD患者的BFS具有良好的内部一致性（Cronbach α = 0.99），可接受的收敛效度（与世界卫生组织残疾评估量表[WHODAS-2.0]的r = 0.88，与简明精神病评定量表[BPRS-E]的r = 0.32），并且对治疗后的变化敏感（效应量=0.50）。添加特定于女性的项目并没有改善心理测量特性。照顾者的版本有类似的心理测量特性，但更高的平均值为每个项目和更好的反应变化。探索性因素分析的BFS提供了证据的结构效度，有四个基本的维度。我们已经制定了一个措施，在农村，低收入国家设置与SMD的人的功能与可接受的心理测量特性。BFS易于管理，对治疗后的变化敏感，具有内容效度、结构效度和收敛效度。该战略包括现有措施的领域，但更强调社会和职业领域，这反映了环境中的优先事项。本文的在线版本（doi：10.1186/s12888-016-1022-3）包含补充材料，可供授权用户使用。
Most measures of functioning in people with severe mental disorders (SMD) have been developed in Western societies. Many of the questions in these scales are culture-bound, fail to capture differentiation of tasks by gender and are difficult to adapt to other contexts. The aim of this study was to develop a measure of functioning for people with SMD which is contextually appropriate for a rural African setting. A review of existing scales, a qualitative study, free listing and pile sorting exercises, and expert consensus were used to establish a pool of items. Cognitive interviewing guided initial item reduction and refinement. The resulting scale was pilot-tested in people with SMD (n = 200) and their caregivers (n = 200) to inform further item reduction based on psychometric properties. The final Butajira Functioning Scale (BFS) comprised 33 items that were common to both men and women, and an additional eight items for women only, covering the following domains: self-care, work, and family and community participation. Psychometric properties of the finalized BFS were examined in a facility-based sample of 150 people with SMD and their caregivers (n = 150), with longitudinal follow-up of n = 84. The BFS in people with SMD had excellent internal consistency (Cronbach’s α = 0.99), acceptable convergent validity (r = 0.88 with the World Health Organization Disability Assessment Schedule [WHODAS-2.0] and r = 0.32 with the Brief Psychiatric Rating Scale [BPRS-E]) and was sensitive to change following treatment (effect size =0.50). Addition of the items specific to women did not improve the psychometric properties. The caregiver version had similar psychometric properties but higher mean values for each item and better responsiveness to change. Exploratory factor analysis of the BFS provided evidence of construct validity, with four underlying dimensions. We have developed a measure of functioning for people with SMD in a rural, low income country setting with acceptable psychometric properties. The BFS is easy to administer, sensitive to changes following treatment and has content, construct and convergent validity. The BFS includes domains from existing measures, but has more emphasis on social and occupational domains, which reflects priorities in the setting. The online version of this article (doi:10.1186/s12888-016-1022-3) contains supplementary material, which is available to authorized users.
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影响因子：
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