RESUMO
Background: The COVID-19 pandemic has caused major disruptions in all aspects of daily functioning, from school and work to interactions with friends and family. The Functioning Assessment Short Test (FAST) is an interviewer-administered scale validated in the psychiatric sample with no previous study assessing its validity and reliability in a digital format. Thus, we aimed to analyse the psychometric properties of the digital version of the FAST and understand the implications of COVID-19 and restrictive measures on functioning. Methods: Data were collected using an online survey. The psychometric properties of the digital FAST were assessed by confirmatory factor analysis, Cronbach's alpha, and discriminant functional by cluster analysis in a community sample. Results: Out of the total sample, 2,543 (84.1%) were female, and the mean (SD) age was 34.28 (12.46) years. The digital FAST retained the six factors structure observed in the original version, with Cronbach's alpha above 0.9. In addition, we showed evidence of discriminant validity by differentiating three clusters of psychosocial functioning. Clinical and demographic differences between groups explained, in part, the heterogeneity of functioning, thus providing support for the construct validity of the instrument. Conclusion: The digital FAST is a simple and easy-to-understand instrument that provides a multidimensional assessment of functioning without the need for an interviewer. Furthermore, our findings may help to better understand the psychosocial implications of the pandemic and the importance of planning specific interventions to rehabilitee the affected group.
RESUMO
Introdução: A internação psiquiátrica é um recurso terapêutico utilizado para a estabilização dos sintomas, contenção de riscos, elucidação diagnóstica e planejamento terapêutico. O psicodiagnóstico permite acesso a questões emocionais e cognitivas do indivíduo. Objetiva-se apresentar um panorama referente à realização de psicodiagnósticos em leitos da especialidade da Psiquiatria Infância e Adolescência de um hospital geral nos anos 2015, 2016 e 2017. Métodos: Trata-se de um estudo transversal, em que foram obtidas informações a partir do prontuário eletrônico de pacientes internados em leitos da especialidade. Os dados analisados foram sexo, idade, naturalidade, realização de psicodiagnóstico, motivo e tempo de internação. Resultados: Durante o triênio estudado, houve realização de psicodiagnóstico em 65,1% das internações. Entretanto, constatou-se diminuição estatisticamente significativamente (p = 0,006) no número de psicodiagnósticos em relação ao número de internações: 82% em 2015; 63% em 2016; e 53% em 2017. Conclusão: Esta diminuição no número de psicodiagnósticos realizados durante a internação indica que houve uma mudança nesse processo, onde se passou de um período em que a grande maioria das crianças e adolescentes (82%) realizava a avaliação, para um panorama onde metade dos pacientes (53%) realiza o psicodiagnóstico. Esse resultado sugere que estratégias de psicoeducação, voltadas para equipes assistentes, tendo por objetivo otimizar custo-efetividade e qualidade da assistência, levaram esses profissionais a refletirem sobre relevância, riscos e benefícios da realização do psicodiagnóstico durante a internação psiquiátrica de crianças e adolescentes. (AU)
Introduction: Inpatient psychiatry is a therapeutic resource for symptom stabilization, risk management, diagnostic clarification and/or treatment planning. Psychological assessment provides information on emotional and cognitive functioning. This study aims to provide an overview of psychological assessment in a child and adolescent inpatient psychiatric unit at a general hospital in southern Brazil in 2015, 2016 and 2017. Methods: This cross-sectional retrospective study obtained information from electronic medical records of patients admitted to the hospital psychiatric unit. Data for analysis were sex, age, place of birth, psychological assessment, reason and length of stay. Results: In those three years, psychological assessments were requested in 65.1% of all unit admissions. However, there was a statistically significant decrease (p = 0.006) in the number of psychological assessments in relation to the number of admissions: 82% in 2015; 63% in 2016; and 53% in 2017. Conclusion: The decrease in the number of psychological assessments performed in the inpatient unit indicates that there was some changes in the process, as first most children and adolescents (82%) underwent the assessment and then the rate reduced to half of all patients (53%). This can be explained by the implementation of strategies to educate the health care team about psychological assessment, with the purpose of improving costeffectiveness and quality of care. This led to greater reflection on relevance, risks and benefits of psychological assessment in a child and adolescent inpatient psychiatric unit. (AU)