Validation of the Finnish Health Improvement Profile (HIP) with patients with severe mental illness

Background Physical health among people with severe mental illness (SMI) is a global concern. However, many people with SMI do not receive regular comprehensive health checks. There is currently no validated physical health check instrument systematically used in Finnish mental health services. Therefore, this study aims to validate and establish the potential clinical utility of the translated Health Improvement Profile (HIP) tool for Finnish patients with SMI and compare differences in physical health risk items across genders. Methods The content validity of the two-way translated Finnish HIP (HIP-F) was evaluated by five nurses and four patients with SMI using cognitive debriefing (to assess the clarity and relevance of each item and the recommended actions of the HIP tool). The potential clinical utility was assessed using a pilot test involving 47 patients. The prevalence of red-flagged (risk) items in the whole sample, across female and male participants, and the frequencies of any type of missing item response were calculated and analysed using descriptive statistics. A chi-square test was used to determine differences in frequencies of red-flagged items across genders. Results Based on the cognitive debriefing, the HIP-F was found to have moderate content validity regarding the clarity and relevance of the items and recommended actions (the average scale level content validity index, S-CVI/Ave, 0.74). In the pilot test, some missing item responses were identified, but in the sample, nurses identified 399 areas of health and health behaviour risks (mean 8.6 per patient) using the HIP-F. The most frequently red-flagged items were body mass index (BMI) and waist circumference (83.0%), smoking status (48.9%) and lipid levels (46.8%). Female patients had a higher frequency of red-flagged items than males in BMI (92.6% vs. 70.0%, p = 0.04) and waist circumference (96.3% vs. 65.0%, p = 0.01). Conclusions The results demonstrate that the Finnish HIP has moderate content validity and preliminary clinical utility for evaluating the physical health and health behaviours of people with SMI. The HIP-F findings help to sign-post evidence-based interventions for identified areas of concern. Additional nurse training may be necessary to realise the potential clinical utility of the tool in Finland.Peer reviewe

Validation of the Finnish Health Improvement Profile (HIP) with patients with severe mental illness

Background Physical health among people with severe mental illness (SMI) is a global concern. However, many people with SMI do not receive regular comprehensive health checks. There is currently no validated physical health check instrument systematically used in Finnish mental health services. Therefore, this study aims to validate and establish the potential clinical utility of the translated Health Improvement Profile (HIP) tool for Finnish patients with SMI and compare differences in physical health risk items across genders. Methods The content validity of the two-way translated Finnish HIP (HIP-F) was evaluated by five nurses and four patients with SMI using cognitive debriefing (to assess the clarity and relevance of each item and the recommended actions of the HIP tool). The potential clinical utility was assessed using a pilot test involving 47 patients. The prevalence of red-flagged (risk) items in the whole sample, across female and male participants, and the frequencies of any type of missing item response were calculated and analysed using descriptive statistics. A chi-square test was used to determine differences in frequencies of red-flagged items across genders. Results Based on the cognitive debriefing, the HIP-F was found to have moderate content validity regarding the clarity and relevance of the items and recommended actions (the average scale level content validity index, S-CVI/Ave, 0.74). In the pilot test, some missing item responses were identified, but in the sample, nurses identified 399 areas of health and health behaviour risks (mean 8.6 per patient) using the HIP-F. The most frequently red-flagged items were body mass index (BMI) and waist circumference (83.0%), smoking status (48.9%) and lipid levels (46.8%). Female patients had a higher frequency of red-flagged items than males in BMI (92.6% vs. 70.0%, p = 0.04) and waist circumference (96.3% vs. 65.0%, p = 0.01). Conclusions The results demonstrate that the Finnish HIP has moderate content validity and preliminary clinical utility for evaluating the physical health and health behaviours of people with SMI. The HIP-F findings help to sign-post evidence-based interventions for identified areas of concern. Additional nurse training may be necessary to realise the potential clinical utility of the tool in Finland

Health Improvement Profile© (HIP)–mittarin validointi vakavaa mielenterveyshäiriötä sairastavilla potilailla

Vakavaa mielenterveyshäiriötä sairastavilla potilailla on usein merkittäviä elinikää lyhentäviä fyysisiä sairauksia. Psykiatrian palvelujärjestelmässä on tiedostettu tarve huomioida fyysistä terveydentilaa ja terveyskäyttäytymistä. Selkeät arviointimenetelmät ja -prosessit kuitenkin puuttuvat. Tutkimuksen tarkoituksena oli validoida Health Improvement Profile© (HIP)-mittari vakavaa mielenterveyshäiriötä sairastavilla potilailla. Tutkimuksella tuotettiin tietoa HIP-mittarin kysymysten selkeydestä ja tärkeydestä potilaiden ja hoitajien kokemana sekä HIP-mittarin käyttökelpoisuudesta potilaiden fyysisen terveydentilan arviointiin. Lisäksi tutkittiin millaiseksi HIP-mittari arvioi potilaiden fyysisen terveydentilan ja terveyskäyttäytymisen sekä eroavatko arviot eri sukupuolten välillä. Tutkimuspaikkana oli kolme psykiatrista poliklinikkaa. Tutkimusasetelmana oli kuvaileva survey- tutkimus. Kaksoiskäännöksen jälkeen mittarin näennäisvaliditeettia arvioitiin asiantuntija-arvioinnilla. Hoitajat (n=5) ja potilaat (n=4) arvioivat mittarin kysymysten selkeyttä ja tärkeyttä neliportaisella Likertin asteikolla. Asiantuntija-arvioinnin perusteella mittarin muuttujille ja koko mittarille laskettiin luotettavuusindeksi (CVI). Esitestauksessa hoitajat suorittivat potilaiden (n= 47) fyysisen terveydentilan ja terveyskäyttäytymisen arvioinnin suomenkielisellä HIP-mittarilla. Esitestauksen aineisto analysoitiin tilastollisin menetelmin. Hoitajat kuvasivat HIP-mittarin kysymyksiä kohtuullisen selkeiksi (I-CVI 0,68) ja tärkeiksi (I-CVI 0,76) koko mittarin luotettavuusindeksiksi (S-CVI-Ave) muodostuessa 0,74. HIP-mittari osoittautui käyttökelpoiseksi arvioimaan koko esitestausaineistossa yhteensä 399 terveysongelmaa. Esitestausaineistossa 83,0 %:lla esiintyi terveydelle haitallisia BMI-arvoja ja suurentunutta vyötärönympärysmittaa. Aineistosta 48,9 % tupakoi ja 46,8 %:lla oli koholla veren rasva-ainepitoisuudet. Naisilla esiintyi enemmän terveysongelmaa BMI-arvoissa (92,6 % vs. 70,0 %, p=0,04) ja vyötärönympärysmitassa (96,3 % vs. 65,0 %, p=0,01). Tutkimus osoitti, että HIP-mittari on käyttökelpoinen työväline psykiatrian palvelujärjestelmään potilaiden fyysisen terveydentilan ja terveyskäyttäytymisen arviointiin sekä terveyden edistämiseen suositeltujen toimintojen avulla