| Objective: The present study was conducted to develop and application Inpatient Psychological Experience Questionnaire-1(IPEQ-1: screening anxiety,depression and suicidality)and Inpatient Psychological Experience Questionnaire-2(IPEQ-2: screening paranoid personality disorder,emotionally unstable personality disorder and histrionic personality disorder).Results of this study may help for the pre-detection of psychological incidence among non-psychiatric inpatients.Nurses can determine psychological nursing services for inpatients according to this study results that can promote the development of harmonious nurse-patient relationship.Methods: 1.Development and evaluation of IPEQ-1 and IPEQ-2 First,the original item pool of IPEQs were generated according to International Statistical Classification of Diseases and Related Health Problems 10 th Revision,and which were through literature review,expert consultation and review of the established relevant tools.Two original questionnaires had 40 and 32 items,respectively.Second,following the two-turn selection and evaluation by 20 senior experts,we developed two pre-questionnaires(including 37 and 30 items,respectively).Third,1,210 inpatients were signed into three groups(160,450 and 600 samples,respectively)for IPEQs item selection and evaluation.The survey data of item selection were analyzed by employing both classical test theory(CTT)and item response theory(IRT).The survey data of item evaluation were analyzed by employing Cronbach's alpha coefficient,test-retest reliability analysis,criterion-related validity and construct validity.12 questions were selected for both IPEQ-1 and IPEQ-2 final version.2.Application of IPEQ-1 and IPEQ-2 Totally 1080 non-psychiatric inpatients in general hospital with the way of stratified random sampling were investigated by IPEQ-1 and IPEQ-2.The emotional distress incidence and personality disorder incidence of inpatiets were analyzed.Results: 1.The results of development and evaluation of IPEQ-1 IPEQ-1 included 12 items,which consisted of anxiety(4 items),depression(4 items)and suicidality(4 items).A five-point Likert strategy(0 for “Never”,1 for “Occasionally”,2 for “Some of the time”,3 for “Most of the time”,4 for “Nearly all the time”)was applied.A total score range was 0~48,indicating degree of severity of emotional distress.Normal subjects were suggested P25(cut-off score of 12)for IPEQ-1 cut-off by the percentile of the questionnaire total score.The following cutoff scores have been suggested for IPEQ-1: ?11=normal,12~16=mild,17~21=moderate,?22=severe.The total Cronbach's alpha coefficient of IPEQ-1 was 0.91 and Cronbach's alpha coefficient of three factors were 0.85,0.86 and 0.83,respectively,which indicated better internal consistency.The test-retest reliability coefficient of the total questionnaire was 0.95 and the coefficient of three factors were 0.94,0.91 and 0.86,respectively,which indicated strong stability.The correlation coefficients between IPEQ-1 and commonly used psychological-assessment tools were significant(P<0.01),which indicated good criterion-related validity.Factor loadings for each of the 12 items were above 0.50(P<0.05)and the values of model fits were met the acceptance criteria,which indicated good construct validity.The completion rate for IPEQ-1 was 91.17% and the average completion time was 3.19±3.09 min,which indicated that the application of IPEQ-1 was feasible.2.The results of development and evaluation of IPEQ-2 IPEQ-2 included 12 items,which consisted of paranoid personality disorder(4 items),emotionally unstable personality disorder(4 items)and histrionic personality disorder(4 items).Yes or no strategy(1 for “yes”,0 for “no”)was applied,and total score range was0~12.Higher scores indicated an increased likelihood of having a certain or several personality disorder.The score range of each personality disorder was 0~4,which showed the likelihood of having a certain personality disorder.According to ICD-10,the cutoff score of 3 or greater was for screening of each personality disorder.IPEQ-2 showed satisfied internal consistency with total Cronbach's alpha coefficient of 0.78 and three factors' Cronbach's alpha coefficient of 0.60,0.64 and 0.63,respectively.The test-retest reliability coefficient of the total questionnaire was 0.87 and the coefficient of three factors were 0.81,0.79 and 0.82,respectively,which indicated good stability.The correlation coefficients between IPEQ-2 and PDQ-4+ were significant(P<0.01),which indicated good criterion-related validity.Factor loadings for each of the 9 items were above 0.50 and all parameters were significant(P<0.05).The values of model fits were met the acceptance criteria,which indicated satisfactory construct validity.The completion rate for IPEQ-2 was 87.17% and the average completion time was 3.71±3.39 min,which indicated that the application of IPEQ-2 was feasible.3.The results of application of IPEQ-1 and IPEQ-2(1)The results of emotional distress incidence among the inpatients using IPEQ-1 1)The incidence of emotional distress among non-psychiatric inpatients was 23.81%,indicating that there were more inpatients with emotional distress in general hospital.2)According to the incidences of emotional distress in general hospital departments,the top five departments were hematology(44.12%),oncology(41.76%),neurology(38.24%),respiratory(30.43%),neurosurgery(30.38%),which indicated that the incidence of emotional distress in medical departments was higher than in surgery departments.3)The inpatients aged 60 or more were likely to have emotional distress(32.24%)(P<0.05).The inpatients who were divorced/separated/widowed were also likely to have emotional distress(55.10%)(P<0.05).(2)The results of personality disorder incidence among the inpatients using IPEQ-2 1)The incidence of non-psychiatric inpatients with one or more personality disorders was 25.29%,including paranoid personality disorder(10.89%),emotionally unstable personality disorder(11.87%),histrionic personality disorder(9.05%),paranoidpersonality disorder comorbid emotionally unstable personality disorder(1.95%),paranoid personality disorder comorbid histrionic personality disorder(2.63%),emotionally unstable personality disorder comorbid histrionic personality disorder(2.82%),paranoid personality disorder comorbid emotionally unstable personality disorder and histrionic personality disorder(0.88%).2)The top five departments with paranoid personality disorder incidence were oncology(15.18%),urology(12.50%),neurosurgery(11.61%),neurology(8.93%)and respiratory(8.04%).The top five departments with emotionally unstable personality disorder incidence were endocrinology(11.48%),neurosurgery(9.84%),neurology(9.02%),urology(9.02%)and cardiology(8.20%).The top five departments with histrionic personality disorder incidence were neurosurgery(17.20%),oncology(12.90%),neurology(10.75%),cardiology(9.68%)and endocrinology(8.60%).The results showed that the incidence of personality disorder in medical departments was higher than in surgery departments.3)The inpatients who were divorced/separated/widowed were likely to have paranoid personality disorder(24.49%)(P<0.05).(3)The results of correlation analysis between emotional distress and personality disorder among the inpatients 1)The incidences of emotional distress comorbid paranoid personality disorder,emotionally unstable personality disorder or histrionic personality disorder among non-psychiatric inpatients were 5.36%,5.56% and 3.22%,respectively.2)The total score of emotional distress was positively correlated with the score of each three personality disorders and the total score of personality disorder(P<0.01).Conclusions: 1.The IPEQ-1 and IPEQ-2 demonstrated good reliability and validity,suggesting their potential benefit as tools for emotional distress and personality disorder screening for non-psychiatric inpatients in general hospital.2.It was noticeable that high incidence of emotional distress was found among non-psychiatric inpatients in general hospital.The inpatients who were in medical department,aged 60 and more or divorced/separated/widowed were more likely to have emotional distress.3.It needed to pay attention to the incidence of non-psychiatric inpatients with one or more personality disorders was high and the comorbidity among three personality disorders was showed.The personality disorders' incidence of the inpatients in medical department was higher.The inpatients who were divorced/separated/ widowed were more likely to have paranoid personality disorder.4.Some non-psychiatric inpatients with emotional distress had comorbid paranoid personality disorder,emotionally unstable personality disorder or histrionic personality disorder.The inpatients' emotional distress was closely related to the three personality disorders.It can provide reference for nurses to make psychological nursing plan for the inpatients. |
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