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Yıl:2009; Cilt: 19; Sayı: 2>> Özet
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Klinik Psikofarmakoloji Bülteni; 2009;19(2):93-100
Bireysel ve sosyal performans ölçeği'nin Türkçe sürümünün geçerlilik ve güvenilirlik çalışması
Ö Aydemir, A Üçok, AE Danacı, T Canpolat, G Karadayı, B Emiroğlu, F Sarıöz
Celal Bayar Üniversitesi, Tıp Fakültesi, Psikiyatri Anabilim Dalı, Manisa-Türkiye
Amaç: Ağır ruhsal bozukluklarda sosyal işlevsellik çok önemlidir ve kısa değerlendirme araçlarına gereksinim vardır. Ağır ruhsal bozukluğu olan hastalar belirti yönünden iyileşseler bile, hastaların birçoğu başlangıçtaki sosyal işlevsellik düzeylerine dönmeyi başaramazlar. Bireysel ve Sosyal Performans Ölçeği, şizofreni gibi ağır ruhsal bozukluğu olan hastalarda kısa sürede sosyal işlevselliği ölçmeye yarayan bir değerlendirme aracıdır. Bu çalışmada, Bireysel ve Sosyal Performans Ölçeği'nin Türkçe sürümünün geçerlilik ve güvenilirlik çalışmasının yapılması amaçlanmıştır. Yöntem: Bu çalışma iki üniversite hastanesinin psikiyatri anabilim dalında yürütülmüştür. Şizofreni veya bipolar bozukluk tanısı konmuş yatan veya ayaktan hastalar çalışmaya alınmıştır. Çalışmanın dışlama ölçütü; hastalarda madde kullanım bozuklukları da dahil herhangi bir psikiyatri bozukluk veya bedensel hastalık ek tanısı bulunmasıdır. Birlikte geçerlilik için, Bireysel ve Sosyal Performans Ölçeğinin (PSP) yanı sıra, Klinik Global izlenim (KGİ), DSM-IV İşlevselliği Genel Değerlendirilmesi (İGD), Yaşamdan Hoşnutluk ve Doyum Ölçeği (Q-LES-Q) ve şizofreni hastaları için Pozitif ve Negatif Sendrom Ölçeği (PANSS) kullanılmıştır. Ayırt edici geçerlilik için ise, belirtilerinde tam düzelme olan ve olmayan hastaların PSP puan ortalamaları karşılaştırılmıştır. Bulgular: Araştırma şizofreni tanısını konan 105 (%77.8) ve bipolar bozukluk tanısı konan 30 (%22.2), toplam 135 hasta ile yürütülmüştür. Hastaların yaş ortalaması 34.1±10.7 olarak elde edilmiştir ve 75�i (%55.6) erkektir. Hastaların aldıkları toplam eğitim süresi 11.8±3.3 olarak belirlenmiştir. Hastaların hastalık süresi 10.4±7.5 yıldır. Ölçeğin güvenilirlik analizlerinde ölçeğin Cronbach alfa iç tutarlılık katsayısı 0.8327 olarak hesaplanmıştır. Madde-toplam puan korelasyon katsayıları 0.4920-0.7462 arasında bulunmuştur ve istatistiksel olarak anlamlıdır (p<0.0001). PSP ölçeğinin sınıf içi korelasyon katsayıları 0.8324 olarak elde edilmiştir. PSP ölçeğinin 30 şizofreni hastası üzerinde yapılan görüşmeciler- arası güvenilirlik katsayısı 0.973 (p<0.0001) olarak elde edilmiştir. PSP ölçeği, KGİ ile (r=-0.854, p<0.0001) çok iyi, İGD ile (r=0.748, p<0.0001) iyi, Q-LES-Q ile (r=0.734, p<0.0001) iyi ve şizofreni hastaları için PANSS ile (r=-0.664, p<0.0001) iyi düzeyde korelasyon göstermektedir ve tüm korelasyon katsayıları istatistiksel olarak anlamlıdır. Belirtili dönemde olup olmamalarına göre gruplandırılmış hastalar PSP ölçek puanları yönünden karşılaştırıldıklarında iki grup arasında istatistiksel olarak anlamlı farklılık saptanmıştır(54.8±14.8 vs. 72.6±9.8, t=7.434, p<0.0001). Sonuç: Bu bulgularla Bireysel ve Sosyal Performans Ölçeği� nin Türkçe sürümünün geçerli ve güvenilir olduğu ortaya konmuştur. Aynı zamanda ölçek değişimi ölçmeye de duyarlıdır. PSP hem gündelik psikiyatri uygulamada hem de ilaç araştırmalarında kullanıma uygundur.
The validation of Turkish version of personal and social performance scale (PSP)
Objective: Functioning in severe mental disorders is very
important and brief functioning rating instruments are
needed. Even though patients with severe psychiatric
disorders achieve symptomatic recovery, most of them
cannot return to their initial level of social functioning.
Personal and Social Performance Scale (PSP) is one of the
instruments which can be used in severe mental disorders
such as schizophrenia and takes a short time to complete.
Methods: The study was performed in departments of
psychiatry of two university hospitals. In- or out-patients
diagnosed with schizophrenia or bipolar disorders were
included in the study. The exclusion criteria were co-
morbidity of other psychiatric disorders including
substance use disorders or of physical diseases. For
concurrent validity, beside PSP, Clinical Global Impression
(CGI), Global Assessment of Functioning (GAF) of DSM-IV,
Quality of Life and Satisfaction Questionnaire (QLS-Q), and
Positive and Negative Syndrome Scale (PANSS) were used.
For discriminant validity, the mean scores of PSP in
patients with and without symptomatic remission were
compared.
Results: The study was carried out with a total of 135
patients, 105 (77.8%) patients diagnosed with
schizophrenia and 30 (22.2%) patients diagnosed with
bipolar disorder. The mean age of the patients was
34.1±10.7 and 75 (55.6%) of them were male. The duration
of illness was 10.4±7.5 [year]s. The mean score of PSP was
found to be 60.0±17.1. In the reliability analysis, the
Cronbach alpha coefficient was calculated to be 0.8327,
and item-total score correlations were found to be
between 0.4920-0.7462. Intraclass correlation coefficient
was calculated to be 0.8324. The inter-rater reliability of
PSP performed on 30 schizophrenic patients was found to
be 0.973 (p<0.0001). In the validity analyses, the total score
of PSP was significantly correlated with the total score of
Clinical Global Impression (CGI) (r=-0.854, p<0.0001),
Global Assessment of Functioning (GAF) (r=0.748,
p<0.0001), Quality of Life and Satisfaction Questionnaire
(QLS-Q) (r=0.734, p<0.0001), and Positive and Negative
Syndrome Scale (PANSS) (r=-0.664, p<0.0001). There was a
significant difference between the patients with and
without symptomatic remission (54.8±14.8 vs. 72.6±9.8,
t=7.434, p<0.0001).
Conclusion: The Turkish version of PSP was found to be
reliable and valid in severe mental disorders and was
sensitive to change. It can be used both in clinical trials and
routine clinical practice.

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