Barra laterale dell'articolo

Scarica
Abbonamento o quota di accesso PDF (EUR 5)
Statistica
Leggi contatore : 1952 Scarica : 30

Contenuto dell'articolo principale

Abstract

Introduzione: il senso di dignití  è un sentimento multifattoriale influenzato anche dal contesto delle relazioni assistenziali. Il PDI è uno strumento che consente di indagare tale costrutto, ma le sue caratteristiche psicometriche non sono state sufficientemente indagate in popolazioni diverse da quella dei pazienti oncologici in fine vita. L'obiettivo di questo studio è di esaminare le caratteristiche psicometriche del PDI in un gruppo di pazienti cronici in situazioni cliniche non terminali e di verificare l'invarianza dello strumento rispetto alle caratteristiche individuali dei pazienti.

Metodi: è stato condotto uno studio multicentrico e sono stati presi in considerazione 421 pazienti in regime ambulatoriale o di ricovero strutture di area specialistica medica, chirurgica ed oncologica. Lo studio sulla validití  del PDI in questa popolazione è stato realizzato mediante i modelli di equazioni strutturali (SEM), l'attendibilití  è stata valutata mediante l'Alpha di Cronbach, mentre l'invarianza è stata studiata mediante analisi multigruppo.

Risultati: i risultati sembrano confermare la monodimensionalití  della struttura teorica ed una ottima attendibilití . Seppure con interventi finalizzati all'ottimizzazione del modello, gli indici di fit evidenziano un buon adattamento dei dati al modello di riferimento. Lo strumento è invariante rispetto alle caratteristiche individuali (sesso ed etí ), ma non sembra essere appropriato per tutti i pazienti cronici.

Discussione: seppure con alcune cautele riguardanti lo stato di avanzamento della patologia, il PDI-IT sembra essere uno strumento valido, attendibile, utile a misurare il senso di dignití  anche in popolazioni di pazienti cronici. Sviluppi futuri della ricerca potrebbero prevedere lo sviluppo di versione ridotta dello strumento. Parole chiave: cronicití ; Patient Dignity Inventory; invarianza. abstract

Is the Patient Dignity Inventory suitable even for not end of life patients? Factorial structure and invariance in chronic patients

 

ABSTRACT

Introduction: the sense of dignity is a multifactorial feeling influenced also by the healthcare context. PDI-IT is a tool that measures this construct, but its psychometric characteristics have not been adequately investigated in patients which are not experiencing and End-Of-Life condition. The aim of this study is to examine the psychometric characteristics of PDI-IT in a group of non-terminal chronic patients and to verify the instrument's invariance with respect to the individual characteristics of patients.

Methods: a multicentric study was conducted on 421 patients undergoing ambulatory care or hospitalized in specialized medical, surgical and oncological areas. The study of the PDI-IT validity in this population was achieved by structural equation (SEM) models; reliability was assessed by Cronbach's Alpha, whereas invariance was studied through multigroup analysis.

Results: findings show an excellent reliability and confirm the monodimensionality of the theoretical structure. After the model optimization interventions, fit indices point out a good data fitting on the reference model. The instrument is invariant with respect to individual characteristics (sex and age) but does not appear to be appropriate for all chronic patients.

Discussion: although with some cautions about the state of progression of the disease, PDI-IT seems to be a valid and reliable tool, useful in measuring the sense of dignity even in populations of chronic patients. Future research should address the development of a short form of the tool. Keywords: chronicity; Patient Dignity Inventory; invariance.

Dettagli dell'articolo

Come citare
Ferretti, F., Pozza, A., Pallassini, M., Righi, L., Marini, F., Adami, S., & Coluccia, A. (2018). Il Patient Dignity Inventory è utilizzabile anche in pazienti che non sono in fine vita? Struttura fattoriale e invarianza in pazienti con patologie croniche. PROFESSIONI INFERMIERISTICHE, 71(2). Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/497
Scarica citazione
Endnote/Zotero/Mendeley (RIS)
BibTeX

Riferimenti

  • Albers, G., Pasman, H.R.W., Deliens, L., de Vet, H.C.W. & Onwuteaka-Philipsen, B.D. (2013) Does health status affect perceptions of factors influencing dignity at the end of life? Journal of Pain and Symptom Management, 45(6), 1030-1038.
  • Albers, G., Pasman, H.R.W., Rurup, M.L., de Vet H.C.W. & Onwuteaka-Philipsen B.D. (2011) Analysis of the construct of dignity and content validity of the patient dignity inventory. Health and Quality of Life Outcomes, 9, 45.
  • Aoun, S.M., Chochinov, H.M. & Kristjanson, LJ. (2015) Dignity therapy for people with motor neuron disease and their family caregivers: a feasibility study. Journal of Palliative Medicine, 18(1), 31-7.
  • Baillie, L. (2008) Patient dignity in an acute hospital setting: A case study. International Journal of Nursing Studies, 46, 23-37.
  • Bentler, P.M. (1990) Comparative Fit Indexes in Structural Models. Psychological Bulletin, 107(2), 238-246.
  • Bentler, P.M. & Bonett, D.C. (1980) Significance Tests and Goodness of Fit in the Analysis of Covariance Structures. Psychological Bulletin, 88(3), 588-606.
  • Bentler, P.M. & Chou, C.P. (1987) Practical issues in structural modelling. Sociological Methods Research, 16(1), 78-117.
  • Byrne, B.M. (2000) Structural equation modelling with AMOS. Mahwah NJ: Lawrence Erlbaum.
  • Bollen, K.A. (1989) Structural Equations with Latent Variables. New York: John Wiley & Sons.
  • Borhani, F., Abbaszadeh, A. & Moosavi, S. (2014) Status of human dignity of adult patients admitted to hospitals of Tehran. Journal of Medical Ethics and History of Medicine, 7, 20.
  • Cassel, E.J. (1982) The nature of suffering and the goals of medicine. The New England Journal of Medicine, 306, 639-45.
  • Chochinov, H.M., Hack, T., McClement, S., Kristjanson, L. & Harlos, M. (2002a) Dignity in the terminally ill: a developing empirical model. Social Science & Medicine, 54, 433–43.
  • Chochinov, H.M., Hack, T., Hassard, T., Kristjanson, L.J., McClement, S. & Harlos M. (2002b) Dignity in the terminally ill: a cross-sectional, cohort study. Lancet, 360, 2026-30.
  • Chochinov, H.M. (2004) Dignity and the eye of the beholder. Journal of Clinical Oncology, 22, 1336-40.
  • Chochinov, H.M. (2007) Dignity and the essence of medicine: the A, B, C and D of dignity conserving care. British Medical Journal, 335(7612), 184-7.
  • Chochinov, H.M., Hassard, T., McClement, S. & Hack, T. et al. (2008) The Patient Dignity Inventory: a novel way of measuring dignity-related distress in palliative care. Journal of Pain and Symptom Management, 36, 559-571.
  • Chochinov, H.M., Johnston, W., McClement, S.E., Hack, T.F., Dufault, B., Enns, M., Thompson, G., Harlos, M., Damant, R.W., Ramsey, C.D., Davison, S., Zacharias, J., Milke, D., Strang, D., Campbell-Enns, H.J. & Kredentser, M.S. (2016) Dignity and Distress towards the End of Life across Four Non-Cancer Populations. PLoS One, 11(1), e0147607.
  • Di Lorenzo, R., Cabri, G., Carretti, E., Galli, G., Giambalvo, N., Rioli, G. (2017) A preliminary study of Patient Dignity Inventory validation among patients hospitalized in an acute psychiatric ward. Neuropsychiatric Disease & Treatment, 13, 177-190.
  • Grassi, L., Costantini, A., Caruso, R., Brunetti, S., Marchetti, P. (2017) Dignity and Psychosocial-Related Variables in Advanced and Non advanced Cancer Patients by Using the Patient Dignity Inventory-Italian Version. Journal of Pain and Symptom Management, 53(2), 279-287.
  • Gueldner, S.H. (2012) Preserving dignity and sense of worth in older adults. Journal of Gerontological Nursing, 38(7), 55-6.
  • Hall, S., Chochinov, H., Harding, R., Murray, S., Richardson, A. & Higginson, I.J. (2009) A Phase II randomised controlled trial assessing the feasibility, acceptability and potential effectivenessof dignity therapy for older people in care homes: study protocol. BMC Geriatrics, 9, 9.
  • Harries, M. (2012) Dignity. Nursing Older People, 24(3), 12.
  • Hu, LT., & Bentler, P.M. (1999) Cut-off criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 56-83.
  • Johnston, B., Lawton, S., McCaw, C., Law, E., Murray, J., Gibb, J., Pringle, J., Munro, G. & Rodriguez, C. (2016) Living well with dementia: enhancing dignity and quality of life, using a novel intervention, Dignity Therapy. International Journal of Older People Nursing, 11(2), 107-20.
  • Jí¶reskog, K. & Sí¶rbom, D. (1996) LISREL 8: User's Reference Guide. Chicago: Scientific Software International Inc.
  • Jí¶reskog, K., Sí¶rbom, D., Du Toit, S. & Du Toit, M. (2000) LISREL 8: New Statistical Features. Lincolnwood: Scientific Software International.
  • Kline, P. (1994) An easy guide to factor analysis. Milton Park, Abingdon, 1994, Oxon OX14 4RN: Routledge.
  • Loehlin, J. (2004) Latent variable models: An introduction to factor, path and structural equation analysis. Mahwah NJ: Lawrence Erlbaum Associates Publishers.
  • Macklin, R. (2003) Dignity is a useless concept: it means no more than respect for persons or their autonomy. British Medical Journal, 327 (7429), 1419-1420.
  • Murata, H. (2003) Spiritual pain and its care in patients with terminal cancer: construction of a conceptual framework by philosophical approach. Palliative & Supportive Care, 1, 15-21.
  • Nunnally, J. & Bernstein, I. (1994). Psychometric theory. New York: McGraw-Hill.
  • Peate, I. (2012) Dignity and geriatrics. British journal of hospital medicine, 73(6), 354.
  • Remen, R.N. (2001) The power of words: how the labels we give patients can limit their lives. The Western Journal of Medicine, 175, 353-4.
  • Ripamonti, C.I., Buonaccorso, L., Maruelli, A., Bandieri, E., Pessi, M.A., Boldini, S., Primi, C., & Miccinesi, G. (2012) Patient dignity inventory (PDI) questionnaire: the validation study in Italian patients with solid and hematological cancers on active oncological treatments. Tumori, 98 (4), 491-500.
  • Rodrí­guez-Prat, A., Monteforte-Royo, C., Porta-Sales, J., Escribano, X. & Balaguer, A. (2016) Patient perspective of dignity, autonomy and control at the end of life: systematic review and meta-ethnography. PlosOne,11(3), e0151435.
  • Solomon, B.K., Wilson, K.G., Henderson, P.R., Poulin, P.A., Kowal, J. & McKim, D.A. (2016) Loss of dignity in severe Chronic Obstructive Pulmonary Disease. Journal of Pain and Symptom Management, 51(3), 529-537.
  • Steiger, J.H. (1990) Structural model evaluation and modification. Multivariate Behavioral Research, 25(2), 173-180.
  • Stevens, J. (1996) Applied multivariate statistics for the social sciences. Mahwah, NJ: Lawrence Erlbaum Publishers.
  • Van Gennip, I.E., Pasman, H.R.W., Oosterveld-Vlug, M.G., Willems, D.L. & Onwuteaka-Philipsen, B.D. (2015) Dynamics in the sense of dignity over the course of illness: a longirudinal study into the perspective of serious ill patients. International Journal of Nursing Studies, 52, 1694-1704.
  • Wilson, K.G., Curran, D. & McPherson C.J. (2005) A burden to others: a common source of distress for the terminally ill. Cognitive Behaviour Therapy, 34, 115-23.
  • Wheaton, B., Muthén, B., Alwin, D.F. & Summers, G.F. (1977) Assessing reliability and stability in panel models. In Heise DR (eds) Sociological Methodology. San Francisco: Jossey-Bass, pp. 84-136.
  • Webster, C. & Bryan, K. (2009) Older people's views of dignity and how it can be promoted in a hospital environment. Journal of Clinical Nursing, 18,1784-1792.