Monaldi Archives for Chest Disease (Dec 2015)
Presentation of the Psycho-Cardiological Schedule and convergence levels analyses among the psycho-cardiological screening and the psychological assessment
Abstract
In Cardiovascular Rehabilitation the increasing inpatients complexity suggests the necessity to develop screening methods which allow to identify those patients that require a psychological intervention. Material and methods: A Psycho-Cardiological Schedule (PCS) was developed with the aim of detecting the critical situation indicators or the presence of psychological, social and cognitive problems. The PCS, compiled by a nurse or cardiologist in collaboration with a psychologist, allows to assess the need for a deeper psychological examination, clinical and/or with tests. Aim of the present study is to identify the convergence levels among the observational and anamnestic data of the PCS collected by a nurse and the clinical and/or test data of the psychological deeper assessment. Results: Among the 87 patients recruited in January- February 2010, 28 (aged 53.5±12.6, M=20, F=8) fulfilled the criteria for a deeper psychological examination: age <50, manifestation of psychological/behavioural problems, neuropsychological disorders, low adherence to prescriptions, inadequate disease knowledge/representation. From data comparisons emerged convergence levels with 100% concordance as to smoke habits and problems in social-family support. High convergence levels also resulted as to emotional and/or behavioural problems (92.8%) and inadequate adherence to prescriptions (89.3%). Lower levels of concordance (82.1%) emerged when considering disease knowledge/ representation, issues specifically linked to cognition and subjective illness experience, not directly detectable from behaviour. Conclusions: our data confirm the synergic efficacy of the two evaluations: the Psycho-Cardiological Schedule reliably identifies the problematic macro-categories, mainly if they are characterized by behavioural indicators, which facilitate the detection. The psychological approach appears more suitable for better specifing macro-categories characteristics and for detecting critical aspects not overt but not less important, providing therefore advice for a therapeutic psychological management.
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