A preliminary study of Patient Dignity Inventory validation among patients hospitalized in an acute psychiatric ward

Abstract

PurposeTo investigate the perception of dignity among patients hospitalized in a psychiatric setting using the Patient Dignity Inventory (PDI), which had been first validated in oncologic field among terminally ill patients.Patients and methodsAfter having modified two items, we administered the Italian version of PDI to all patients hospitalized in a public psychiatric ward (Service of Psychiatric Diagnosis and Treatment of a northern Italian town), who provided their consent and completed it at discharge, from October 21, 2015 to May 31, 2016. We excluded minors and patients with moderate/severe dementia, with poor knowledge of Italian language, who completed PDI in previous hospitalizations and/or were hospitalized for <72 hours. We collected the demographic and clinical variables of our sample (n=135). We statistically analyzed PDI scores, performing Cronbach’s alpha coefficient and principal factor analysis, followed by orthogonal and oblique rotation. We concomitantly administered to our sample other scales (Hamilton Rating Scales for Depression and Anxiety, Global Assessment of Functioning and Health of the Nation Outcome Scales) to analyze the PDI concurrent validity.ResultsWith a response rate of 93%, we obtained a mean PDI score of 48.27 (±19.59 SD) with excellent internal consistency (Cronbach’s alpha coefficient =0.93). The factorial analysis showed the following three factors with eigenvalue >1 (Kaiser’s criterion), which explained >80% of total variance with good internal consistency: 1) “Loss of self-identity and social role”, 2) “Anxiety and uncertainty for future” and 3) “Loss of personal autonomy”. The PDI and the three-factor scores were statistically significantly positively correlated with the Hamilton Scales for Depression and Anxiety but not with other scale scores.ConclusionOur preliminary research suggests that PDI can be a reliable tool to assess patients’ dignity perception in a psychiatric setting, until now little investigated, helping professionals to improve quality of care and patients to accept treatments.

The Patient Dignity Inventory: Just another evaluation tool? Experiences with advanced cancer patients

“…In another context, Di Lorenzo et al (2017) performed a validation study with the PDI among patients hospitalized in an acute psychiatric ward. They reported that application of the PDI was appreciated well by patients, probably because it was seen as a sign of professional interest in their problems, a consideration also noted in our study.…”

Psychometric properties of the Patient Dignity Inventory in an acute psychiatric ward: an extension study of the preliminary validation

“…We administered the Italian version of the PDI, initially validated in an oncology setting 28 and successively modified for a psychiatric context in our preliminary validation study. 36 The two slightly amended items were the following: No. 3: “physically distressing symptoms” was changed to “experiencing physically distressing symptoms (such as pain, shortness of breath, nausea) for example, adverse drug effects”.…”

“…The PDI content and face validity were assessed before the administration of the questionnaire as reported in the preliminary research. 36 The content validity was discussed among the researchers and the face validity was initially assessed by the first 20 patients of our sample in order to evaluate their capacity to understand and answer the questionnaire. We investigated the internal consistency of the PDI to assess the structural validity and explored its dimensions by factor analysis.…”

“…The preliminary validation study in an acute psychiatric ward highlighted three factors supported by all but two items of the PDI, which represented the main domains of dignity, excellent internal consistency and statistically significant positive correlation with the Hamilton Scales for both Depression and Anxiety. 36 …”

Translating the Patient Dignity Inventory

“…The PDI has been shown to be useful and valued in oncology settings (Chochinov et al, 2012); however, it is not limited to aiding specific diagnoses (Albers et al, 2012) and, as such, is relevant for noncancerous populations, including patients in psychiatric settings, the frail older people, and the general population (Albers et al, 2011;Chochinov et al, 2016;Di Lorenzo et al, 2017). As a screening tool, the PDI has been shown to be beneficial, ensuring that issues causing dignity-related distress can be identified in a holistic way (Chochinov et al, 2012).…”