Exploring gender impact on collaborative care planning: insights from a community mental health service study in Italy

Introduction: Personal recovery is associated with socio-demographic and clinical factors, and gender seems to influence the recovery process. This study aimed to investigate: i) differences in the recovery goals of men and women users of a community mental health service in Italy; ii) any differences by gender in recovery over six months using the Mental Health Recovery Star (MHRS). Methods: Service users and staff completed the MHRS together at recruitment and six months later to agree the recovery goals they wished to focus on. Socio-demographic and clinical characteristics and ratings of symptoms (BPRS), needs (CAN), functioning (FPS), and functional autonomy (MPR) were collected at recruitment and six months follow-up. Comparisons between men and women were made using t-tests. Results: Ten women and 15 men completed the MHRS with 19 mental health professionals. Other than gender, men and women had similar socio-demographic, and clinical characteristics at recruitment. Women tended to choose recovery goals that focused on relationships whereas men tended to focus on work related goals. At follow-up, both men and women showed improvement in their recovery (MHRS) and women were less likely to focus on relationship related goals, perhaps because some had found romantic partners. There were also gains for both men and women in engagement with work related activities. Ratings of functional autonomy (MPR) improved for both men and women, and men also showed improvement in symptoms (BPRS) and functioning (FPS). Conclusions: Our findings suggest that collaborative care planning tools such as the MHRS can assist in identifying individualized recovery goals for men and women with severe mental health problems as part of their rehabilitation

Proprietà psicometriche della Scheda di Monitoraggio del Percorso Riabilitativo (MPR). [Psychometric properties of the Monitoring of the Path of Rehabilitation (MPR) Form.]

Scopo. Il corretto inserimento degli individui con disturbi mentali nelle strutture residenziali psichiatriche (SRP) e il monitoraggio del loro percorso nelle stesse risulta una criticità non compiutamente risolta del sistema italiano. Per ovviare a tale criticità si utilizzano alcuni strumenti validati che per lo più valutano il funzionamento/disabilità del paziente in setting aspecifico, mentre nella platea internazionale non sono stati predisposti strumenti che valutino l’autonomia funzionale dei pazienti psichiatrici ospiti in SRP. Il Dipartimento di Salute Mentale di Verona ha creato la Scheda di Monitoraggio del Percorso Riabilitativo (MPR) con l’obiettivo di valutare l’autonomia funzionale dei pazienti per inserirli e monitorarli adeguatamente nei loro percorsi residenziali. L’obiettivo di questo studio è testare le principali proprietà psicometriche della Scheda MPR. Metodi. Lo studio delle proprietà psicometriche della Scheda MPR è stato articolato in tre passaggi: una valutazione condotta a distanza di più di 15 giorni da due valutatori indipendenti su 18 casi clinici per indagare la riproducibilità dello strumento (test-retest); un test dei 18 casi clinici da parte dei due valutatori per misurare la concordanza tra valutatori (inter-rater); una misurazione della validità concorrente utilizzando la Scala di Funzionamento Personale e Sociale. Otto professionisti hanno compilato un questionario di gradimento inerente all’accettabilità della Scheda MPR. Le analisi di inter-rater e di test-retest sono state condotte utilizzando coefficienti di correlazione intraclasse. La validità concorrente è stata studiata tramite il coefficiente di correlazione tau-b rank di Kendall e l’accettabilità tramite un’analisi delle frequenze. Risultati. L’affidabilità inter-rater e test-retest sono risultate buone, così come la validità concorrente e l’accettabilità. Conclusioni. I dati presentati in questo articolo dimostrano che è possibile misurare l’autonomia funzionale dei pazienti ospiti nelle SRP italiane utilizzando la Scheda MPR.Purpose: The correct placement of people with mental disorders in psychiatric residential facilities (PRF) and the monitoring of their progress in these facilities is a critical issue that has not been fully settled in the Italian system. To overcome this problem, some validated instruments are used, which mostly assess the patient's functioning/disability, while no instruments have been set up to assess functional autonomy in patients with a psychiatric disorder residents in RFs. The Verona Department of Mental Health has created the Monitoring of the Path of Rehabilitation (MPR) Form with the aim of assessing the functional autonomy of patients to admit and monitor them adequately in their residential pathways. The aim of this study is to test the main psychometric properties of the MPR Form. Methods: The study of the psychometric properties of the MPR Form consisted of three steps: an evaluation conducted more than 15 days apart by two independent evaluators on 18 clinical cases to investigate the test-retest reliability; a test of the 18 clinical cases by the two evaluators to measure the inter-rater rieliability; a measure of convergent validity using the Personal and Social Functioning Scale. Eight professionals completed a satisfaction questionnaire regarding the acceptability of the MPR Form. Inter-rater and test-retest analyses were conducted using intraclass correlation coefficients. Convergent validity was investigated using Kendall's tau-b rank correlation coefficient and acceptability using a frequency analysis. Results: Inter-rater and test-retest reliability were good, as well for concurrent validity and acceptability. Conclusions: The data presented in this article demonstrate that it is possible to measure the functional autonomy of patients in Italian SRPs using the MPR Form