Medidas individualizadas de mudança: análise das propriedades psicométricas do PSYCHLOPS

Neste estudo apresentam-se dados referentes à fiabilidade, validade e sensibilidade para detetar mudança de uma medida individualizada de mudança (MIM), o PSYCHLOPS. Os dados foram recolhidos em quatro países, e dividem-se por seis amostras, totalizando 1053 participantes. Pretende-se aprofundar o conhecimento acerca das propriedades psicométricas e da sua adequabilidade, em MIM no geral, e no PSYCHLOPS, em particular. Após avaliar as propriedades psicométricas separadamente por amostra, procedeu-se à sua integração mediante métodos de meta-análise. O valor global de alfa de .82 indica uma boa consistência interna, mas a sua interpretação é dificultada pela não equivalência de itens. A correlação entre o PSYCHLOPS e o CORE-OM é de .63, e a correlação entre os scores de mudança das duas medidas é .67. Os dados suportam as hipóteses referentes à validade, mas suscitam dúvidas quanto à estrutura do PSYCHLOPS, e quanto à adequabilidade da avaliação psicométrica tradicional em MIM; Abstract: Various evidence regarding reliability, validity, and responsiveness of PSYCHLOPS, a patient-generated outcome measure (PGOM), are presented. Data comes from three countries, in a total of seven data sets comprising 1053 participants. The purpose of this study is to deepen the understanding of psychometric properties in PGOMs, and in PSYCHLOPS in particular. Following psychometric analysis by sample, meta-analysis procedures were used to calculate overall values. Overall mean internal consistency (alpha) was .82. Overall mean correlation between PSYCHLOPS and CORE-OM is r = .63, and overall mean correlation between change scores is r = .67. Overall mean internal consistency is good, but item non-equivalency makes interpretation difficult. Data support hypotheses regarding correlations, but cast doubt over PSYCHLOPS’ internal structure, and over suitability of classical psychometric evaluation in PGOM.

A relevância das medidas individualizadas : ouvimos o paciente mas captamos a história?

Individualized measures are relevant for the assessment of therapeutic results and allow patients to identify the aspects that they value the most in assessing their clinical improvement. PSYCHLOPS, as an individualized measure, invite the patient to create their own items. The items created by the patients were compared with the contents of standardized measures. A sample composed by 107 patients admitted for psychological treatment in Hospital Espírito Santo (Évora), and three institutions for drug misuse fill in the PSYCHLOPS and two standardized measures presented in a random order: CORE-OM and PHQ-9. 279 items were created in PSYCHLOPS and later recoded, by thematic analysis, in 51 subthemes. Work-related problems was the most common subtheme identified by patients as relevant to the clinical improvement assessment. From the 51 subthemes, 17 (33.3%) were not represented in CORE-OM and 43 (84.3%) were not represented in PHQ-9. The majority of our sample indicated at least one subtheme that was not represented in CORE-OM and PHQ-9. These results show us the importance of individualized measures in identifying the patients’ most value concerns, which may have implications in the therapeutic process.