Use of the SF-12 questionnaire to assess physical and mental health status in patients with psoriasis.

Health-related quality of life (HRQoL) in psoriasis patients is generally measured using disease- or dermatology-specific questionnaires. Our objective was to use the generic 12-item Short Form Health Survey (SF-12) instrument to measure the physical and mental impact of psoriasis and to compare scores with those already published for different diseases. An observational study was conducted among mild-to-severe psoriasis outpatients. Health status was assessed by the SF-12, which includes a physical (PCS) and a mental (MCS) scale. The 12-item General Health Questionnaire (GHQ-12) was used to assess the possible presence of depression or anxiety, and the Skindex-17 to measure dermatology-specific HRQoL. Statistical analyses were performed to estimate the association between physical and mental health status and demographic and clinical characteristics. The study population included 1592 patients. Psoriasis PCS scores were similar to the general population and to non-severe diseases such as allergies, dermatitis, or back pain, while MCS mean scores were very similar to that of depression, and lower than those of all the other chronic conditions. Poor physical health was associated with female sex, older age, lower educational level, joint involvement, ≥2 comorbidities, moderate to very severe clinical status, GHQ-12 score ≥4, and moderate to severe Skindex-17 psychosocial scores. Poor mental health was associated with younger age (<30 years), GHQ ≥ 4, and severe Skindex-17 psychosocial scores. In conclusion, a general health measure, such as the SF-12, appears to be able to capture, in psoriasis patients, the burden of the disease both from a physical and a mental point of view.

A comparison between two educational methods in the rehabilitation of the microstomia in systemic sclerosis: a randomized controlled trial.

OBJECTIVE: To test the effectiveness of an educational intervention including "face to face" training, compared to a standard information program, to reduce microstomia in women with systemic sclerosis. DESIGN: Single-blind, two-arm, randomized controlled study with a 12-month follow-up period. SETTING: Hospital wards of a large Italian dermatological reference center. SUBJECTS: Female inpatients with diagnosis of systemic sclerosis. INTERVENTIONS: For both groups an information brochure and an audio-visual DVD were developed specifically for the study. The control group was assigned to educational materials alone (i.e. brochures and DVD), while the experimental group, in addition to the same educational materials, received specific "face-to-face" interventions, repeated at each follow-up visit. MAIN MEASURES: Primary outcome was measurement of the opening of the mouth. Secondary outcomes was the self-reported mouth disability. RESULTS: The intention-to-treat analysis included 63 patients. Compared to the baseline measurement, we observed an increase of the mouth opening of 0.31 cm (95% confidence interval: 0.13-0.49), P = 0.003; in the control group, the increase was 0.13 cm (95% confidence interval: 0.01-0.25), P = 0.06. The difference in improvement between the two groups was not statistically significant (P = 0.10); however, it reached statistical significance in the per-protocol analysis (39 patients, P = 0.02). CONCLUSION: Face-to-face nursing rehabilitation training seems to improve microstomia to a greater extent, when compared to a standard intervention based only on written and audio-visual materials.

Measuring disability of women with systemic sclerosis: validation of the italian version of the systemic sclerosis questionnaire.

BACKGROUND: The aim of this study was to validate the Italian version of Systemic Sclerosis Questionnaire (SySQ) and to evaluate its psychometric characteristics on a sample of inpatient and outpatient women with systemic sclerosis (SSc). METHODS: Internal and external validity of the Italian version of SySQ were analyzed. Internal validity included: 1) construct validity by means of factor analysis; 2) internal consistency for each category of SySQ through Cronbach's alpha; and 3) reproducibility over time with test-retest using both Pearson's correlation and Intraclass Correlation Coefficient. External validity included: 1) concurrent validity, i.e. correlation with Skindex-17; and 2) discriminant validity, through comparison of scores for different groups of patients. RESULTS: We obtained data on 115 patients with SSc: 68 had the limited clinical form (lSSc) and 47 had the diffuse clinical form (dSSc). The structure of SySQ was confirmed by factor analysis. The questionnaire showed optimal internal consistency for all SySQ categories (Cronbach's alpha >0.84) and very good reproducibility over time (0.79-0.93, P<0.001). Regarding external validity, SySQ showed good correlation with Skindex-17 (P<0.01) and a satisfactory power of discrimination between groups affected by different clinical conditions. CONCLUSIONS: The study confirmed that the SySQ maintains good psychometric properties also in a language different from the original. It is a disease-specific tool that can be routinely used in clinical practice for the evaluation of the level of disability in patients with SSc.

[Psychological wellbeing and risk of anxiety/depression in nursing students measured with the General Health Questionnaire-12 ]. / Il benessere psicologico degli studenti del corso di laurea in infermieristica misurato con il General Health Questionnaire-12.

UNLABELLED: Psychological wellbeing and risk of anxiety/depression in nursing students, measured with the General Health Questionnaire-12. Introduction. Psychological wellbeing facilitates the learning performance while emotional problems such as anxiety/depression limit it and may impact on future professional practice. OBJECTIVES: To assess the prevalence of anxiety/depression in nursing students in Rome, at the beginning of the annual course. METHODS: An observational study was conducted administering the 12 items General Health Questionnaire (GHQ-12) to 601 students at the beginning of the annual course. Students were labeled at risk for anxiety and depression with GHQ-12 scores >5. A logistic regression model was used to identify factors associated to anxiety and depression. RESULTS: Thirty-four per cent (39% of the females) of the students were at risk for anxiety/depression. The risk was higher for female students (OR=2.9; 95%CI 1.6-5.2; p<0.001), in those unsatisfied with the academic results (OR 2.3; 95%CI 1.4-3.9; p=0.002) and with their general health status (OR=0.4; 95%CI 0.3-0.7; p≤0.001). CONCLUSIONS: The risk for anxiety and depression is high among nursing students, especially for females. A screening since the first year would help to identify subject at risk that could benefit from specific interventions.

Family burden in epidermolysis bullosa is high independent of disease type/subtype.

Epidermolysis bullosa is a rare, inherited group of disorders characterized by blistering of the skin following friction or mechanical trauma. The aim of this study was to assess the family burden of epidermolysis bullosa in children aged 0-7 years. A postal survey was conducted. The perceived severity of the disease was evaluated by the caregivers, using the Patient Global Assessment 5-point scale. The caregiver received the Family Strain Questionnaire and the 12-item General Health Questionnaire to assess the probable presence of depression/anxiety. A single-item analysis was also performed for questions related to the burden of disease. Forty-two families were invited to participate. Data from 28 young patients and their caregivers were analysed (response rate 66.7%). The family burden increased with increasing caregiver's perceived disease severity, with increasing patient's body surface involved, and if parents had depression/anxiety, reaching statistical significance in several Family Strain Questionnaire scales. The family burden due to epidermolysis bullosa is very high independent of disease type/subtype.

[The needs of mothers of children affected by skin diseases]. / I bisogni delle mamme di bambini affetti da malattie dermatologiche.

AIM: The needs assessment of mothers with children affected by dermatitis is as crucial as technical interventions. The child's disease may modify mothers' priorities of needs. Aim of the study is to identify priority of needs in mothers of children admitted to a dermatological hospital (IDI-IRCSS) in Rome. Data were collected between May and June 2007. The Needs Assessment Questionnaire and the Patient Global Assessment (PGA) were distributed to 160 mothers to assess the perceived severity of the disease. RESULTS: The main needs were to receive more information about diagnosis (59%), more care after discharge (48%), more information about treatments (36%) a better symptoms control (36%) and to receive informational material (33%). Mothers who perceived very severe the illness of their children expressed an higher need to receive more care after discharge (63%) and a better symptoms control (56%) compared to those with lower severity scores. The need of information about diagnosis is the first priority irrespective of the perceived severity of the illness. CONCLUSIONS: Information and education are crucial to involve mothers in the caring process. Nurses can improve critical areas of dermatological care through identification of needs.