Reliability and validity of the interactive observation scale for psychiatric inpatients applied by nursing aides in daily ward practice

Abstract

The main characteristic of the nursing Interactive Observation Scale for Psychiatric Inpatients (IOSPI) is the necessity of interaction between raters and patients during assessment. The aim of this study was to evaluate the reliability and validity of the scale in the real world of daily ward practice and to determine whether the IOSPI can increase the interaction time between raters and patients and influence the raters opinion about mental illness. All inpatients of a general university hospital psychiatric ward were assessed daily over a period of two months by 9 nursing aides during the morning and afternoon shifts, with 273 pairs of daily observations. Once a week the patients were interviewed by a psychiatrist who filled in the Brief Psychiatric Rating Scale (BPRS). The IOSPI total score was found to show significant test-retest reliability (interclass correlation coefficient = 0.83) and significant correlation with the BPRS total score (r = 0.69), meeting the criteria of concurrent validity. The instrument can also discriminate between patients in need of further inpatient treatment from those about to be discharged (negative predictive value for discharge = 0.91). Using this scale, the interaction time between nursing aides and patients increased significantly (t = 2.93, P<0.05) and their opinion about the mental illness changed. The social restrictiveness factor of the opinion scale about mental illness showed a significant reduction (t = 4.27, P<0.01) and the interpersonal etiology factor tended to increase (t = 1.98, P = 0.08). The IOSPI was confirmed as a reliable and valid scale and as an efficient tool to stimulate the therapeutic attitudes of the nursing staff.

Documenting changes in communication behaviours using a Structured Observation System

“…In conjunction with criterion-referenced behaviours, speech and language therapists have also used rating scales as a method of evaluating behaviours and monitoring progress during the treatment process. In fact, many researchers have reported on the successful clinical use of rating scales in a variety of domains (see eg, Benaim et al, 2004;Drachman et al, 1992;Pedrao et al, 2001;Redmond, 2002;Reuben and Siu, 1990;Spiegel et al, 1991). Elliot and Busse (1993) indicated that rating scales usually represent a summary of recent and direct observations with a clinical population.…”