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Yıl:2005; Cilt: 8; Sayı: 3>> Özet
TAM METİN
Klinik Psikiyatri Dergisi; 2005;8(3):117-122
Psikiyatri Servisinde Yatan Hastalar için Etkileşimsel Gözlem Ölçeği: Güvenirlik, Geçerlik ve Faktör Yapısını İnceleyen Bir Çalışma
Ş Mısırlı, E Bora, K Gültekin, S Elçi, G Gülen
Ege Üniv. Tıp Fakültesi Psikiyatri ABD, İzmir
Amaç: Psikiyatri servisinde yatan hastaların izleminde etkileşime dayalı standardize ölçeklerin kullanılması bir yandan hizmet kalitesini, bir yandan da hastalara ayrılan zamanı artırabilir. Bu çalışmada tüm maddelerinin etkileşimle doldurulmasıyla diğer standardize ölçeklerden ayrılan Psikiyatri Servisinde Yatan Hastalar İçin Etkileşimsel Gözlem Ölçeği'nin Türkçe geçerlik ve güvenirlik çalışması yapılmıştır. Yöntem: Otuz dört yatan hasta dört tane hemşire ekibi tarafından bir ay boyunca izlenmiştir. Ekibin bir üyesi hastayı günlük olarak izlerken, diğer üye haftanın belli günleri hastayı değerlendirmiştir. Toplam 717 adet ölçek doldurulmuştur. Hastalar bir psikiyatri hekimince haftada bir BPRS (Kısa Psikiyatrik Değerlendirme Ölçeği) ile değerlendirilmiştir. Bulgular: Ölçeğin görüşmeciler arası güvenirliğini değerlendiren sınıf içi korelasyon katsayısı 0.84 olarak bulunmuştur. Ölçek toplam puanının BPRS puanıyla korelasyonu 0.55'dir. Ölçeğin alkol bağımlılığı olan hastalar dışında öngörücü geçerliliğe sahip olduğu gösterilmiştir (Kesim noktası=3, Duyarlılık= % 73.7, Özgüllük= %73.9). Bu kesim noktasında pozitif öngörme gücü %64.6 olarak bulunurken negatif öngörme gücü %80.8 olarak hesaplanmıştır. Ölçeğin Türkçe formunun sosyal ilgi, psikotizm ve irritabilite/psikomotor ajitasyon olarak adlandırılan üç faktöre sahip olduğu gösterilmiştir. Sonuç: Psikiyatri Servisinde Yatan Hastalar İçin Etkileşimsel Gözlem Ölçeği'nin affektif ve psikotik hastalığı olan bireylerin psikiyatri servisinde yatışları sırasında tedavilerinin izlenmesi ve tedaviye yanıtlarının değerlendirilmesinde kullanılabilecek güvenilir bir ölçek olduğu söylenebilir.



The Reliability, Validity and Factor Structure of Interactive Observation Scale of Psychiatric Inpatients
Objective: The utilization of interactive observation scales can be beneficial for the psychiatric care by improving the quality of care and also by increasing the staff-patient interaction time in psychiatric inpatient settings. In this study, the interrater reliability and validity of Interactive Observation Scale of Psychiatric Inpatients was investigated. Method: Thirty-four psychiatric inpatient were observed by four teams of nursing staff. While one member of the team observed the patients daily, the other member assessed the patient two or three times a week. A total of 717 scales were obtained. The patients were evaluated by BPRS weekly by a psychiatry resident. The study sample consisted of 9 manic patients with bipolar disorder, 10 M. depression (or bipolar depression), 7 patients with schizophrenia and schizoaffective disorder and 8 patients with alcohol dependence. Results: The interclass correlation coefficient of the scale for the interrater reliability of the scale was 0.84. The correlation of the total score of the scale with BPRS was 0.55. The scale had predictive validity for the patients except for the patients with alcohol dependence (Cut off score=3, Sensitivity= % 73.7, Specificity= % 73.9). The positive predictive value of the scale was % 64.6 and the negative predictive value was % 80.8. The Turkish version of the scale consisted of there factors; Social interest, irritability/psychomotor agitation and psychotism. Conclussion: The Turkish form of the Interactive Observation Scale of Psychiatric Inpatients is a reliable scale to observe the treatment responses of affective and psychotic inpatients.



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