Assessing the demand for psychological care in chronic diseases: development and validation of a questionnaire based on the example of inflammatory bowel disease.
BACKGROUND
This study was designed to develop and validate the ADAPT (Assessment of the Demand for Additional Psychological Treatment), a questionnaire assessing the demand for disease-oriented counseling (DOC), integrated psychosomatic care (IPC), and psychotherapy (PT) in chronically ill patients on the example of inflammatory bowel diseases (IBDs).


METHODS
After its development, the ADAPT was distributed to 39 IBD patients along with the Hospital Anxiety and Depression scale (HAD), the Rating Form of IBD Patient Concerns (RFIPC), and a questionnaire on social support (SOZU-K22). For construct validity, 19 hypotheses were made on how DOC, IPC, and PT should correlate with HAD, RFIPC, SOZU-K22, and disease-related variables. To analyze interindividual responsiveness, patients were classified according to their bio-psycho-social state, and DOC, IPC, and PT scores were compared between these classes. The test-retest method with a 4-week time lapse was used to analyze reliability and intraindividual responsiveness. DOC, IPC, and PT scores between baseline and follow-up were compared separately for patients classified as "stable" or "changed" according to changes in HAD and disease activity.


RESULTS
Observed correlations were largely in agreement with the 19 hypotheses. DOC, IPC, and PT achieved significantly different scores between different patients. After 4 weeks, DOC, IPC, and PT revealed stable scores in patients with "stable" HAD and revealed significantly different scores in patients with "changed" HAD. Changed disease activity was not associated with significant changes of the ADAPT.


CONCLUSIONS
The ADAPT is the first questionnaire to assess subjective demand for additional psychological care in chronically ill patients. The first application of the ADAPT to 39 IBD patients suggests its validity, reliability, and responsiveness.
Department of Internal Medicine IV, Division of Gastroenterology and Hepatology, University of Vienna, Austria. wolfgang.miehsler@chello.at
Wolfgang
W
Miehsler
Martina
M
Weichselberger
Anna
A
Offerlbauer-Ernst
Clemens
C
Dejaco
Walter
W
Reinisch
Harald
H
Vogelsang
Klaus
K
Machold
Tanja
T
Stamm
Alfred
A
Gangl
Gabriele
G
Moser
D000328:Adult; D002908:Chronic Disease; D003376:Counseling; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D011594:Psychometrics; D011795:Surveys and Questionnaires