Italian validation of the Wagnild and Young Resilience Scale: a perspective to rheumatic diseases.

OBJECTIVES: Studying the characteristics of resilience may help to explain how, in the face of a chronic disease, people are able to cope in productive and effective ways. The Wagnild and Young Resilience Scale (RS) is an appropriate instrument to study resilience and has already been translated from the original English version into several languages. The aim of this study was to validate the Italian version of the RS, a 25-item scale ranging from 25 to 175 where higher scores indicate stronger resilience. METHODS: The Minimal Translation Criteria were followed to translate the scale which was then filled out by 1090 students to assess the reliability, stability, internal consistency and concurrent validity. RESULTS: Time stability was assessed in a sample of 117 students (M age=20.18 yr, SD 1.25) by test-retest correlation (r=0.78). RS reliability was evaluated in a second sample of 973 students (M age=16.95 yr, SD 1.50) with RS mean of 126.6 (SD 17.4). Concurrent validity was assessed by correlation with General Health Questionnaire (r=-0.51), Ego-Resilience Scale (r=0.63) and Beck Depression Inventory (r=-0.45). Internal consistency was evaluated by Cronbach alpha (α=0.84). Principal component analysis was performed on 24 out of the 25 items and resulted in six components. CONCLUSIONS: Our data indicated that the 24-item Italian version of the RS scale can be considered a useful instrument to measure resilience and can be used by healthcare staff to help patients cope effectively with stressful situations such as rheumatic and other chronic diseases.

A longitudinal study of cognitive abilities and achievement status of children with myelomeningocele and their relationship with clinical types.

Cognitive abilities and achievement status of 178 children with myelomeningocele (MMC) were examined with neuropsychological techniques. These children as a whole scored below the population average. Children with MMC and shunted hydrocephalus performed worse than the arrested (unshunted) and non-hydrocephalic children. The greater deficit occurred on the Performance IQ. 80.7% of the subjects attended normal school while, 19.3% received remedial instruction. The results of our study are consistent with a large body of literature indicating that children with shunted hydrocephalus demonstrate poorer development of non-verbal relative to verbal cognitive abilities.

[From informed to shared: the developing process of consent]. / Il processo evolutivo del consenso: da informato a condiviso.

Based on the respect of the four well known ethical principles "autonomy, non-maleficence, beneficence and justice", of clinical cognitive psychology, social psychology and bioethics, and in the light of moral values, we wish to comment the clinical problems involving informed consent for diagnostic procedures, treatment and research in pediatrics. Studies of the issues in attitudes and shared consent in the clinical management involving children, their parents and the therapeutic team are still limited. Our suggestion is to manage the process of informed consent as a negotiated "shared consent" originated from the cognitive social representation theory, and taking into consideration the evolutive characteristics of the cognitive processes in children and adolescents, the ego defence mechanisms, the coping behaviour activated in the relationship among the pediatric patient, his/her family and the physicians. Many parents told us that the informed consent process is helpful though often confusing. Satisfaction was not related to ethnicity or education level. They found discussions more helpful than the consent documents. The more difficult process concerned their understanding of the concept of randomisation and the request of their consent to this procedure. The model we suggest has also the aim to give adequate and honest informations to children and adolescents through a continuous dialogue with the physician, until this become a routine part of their life in hospital care, to avoid confusion, to satisfy any request and curiosity, to be honest and helpful with any answer. We strongly believe that medical students, and in particular pediatricians, must be trained on "communication" and that they need to acquire, in addition to their medical capability, a good knowledge on this topic, including ethics and relational aspects. In our opinion, pediatricians must become expert also in the following topics: "Problem-related Learning", "The Family System Health Model", "The Theory of Social Representations", "Gadamerian Hermeneutics", and "The Communicative Skills".

The Impact-on-Family Scale: a test of invariance across culture.

OBJECTIVE: To test the cultural invariance of the Impact-on-Family Scale in order to make cross-cultural comparisons. METHODS: The Italian version of the scale was administered to mothers of children with chronic illnesses. Factorial invariance was examined to investigate whether the four factors found with the original United States (U.S.) scale could be replicated. RESULTS: The results clearly demonstrate the replicability of the first three factors, Financial Burden, Familial/Social Impact, and Personal Strain. In addition, internal consistency and the homogeneity of the items of the corresponding scales are satisfactory. However, the fourth factor, Mastery, could not be replicated, and the reliability of the corresponding scale is poor. Italian mothers scored significantly lower on the Financial Burden and on the Familial/Social Impact dimension, compared to the American sample. CONCLUSIONS: Three of the four factors of the Impact-on-Family Scale are useful for cross-cultural comparisons between U.S. and Italian samples.