Abstract
ObjectiveTo describe the development of the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia (ASPIDD), a multidimensional scale to evaluate awareness of disease in dementia.MethodThe development of this scale was conducted in four steps. In step one, questions were drawn up after a review of the literature. The second step involved the suggestions offered by a neurologist regarding the skills considered important for the scale. The third step involved the re-writing and review of the domains and questions in the scale followed by a semantic evaluation performed by two independent psychiatrists. Step four consisted of the preliminary study aimed at evaluating the applicability of the ASPIDD.ResultsIn the semantic evaluation only minor changes were proposed. The preliminary sample had 52 patients, comprising 23 CDR 1 (male=9; female=14) and 29 CDR2 (male=13; female=16).Mean age of patients was 69.7±5.51(CDR1) and 73.6±9.4 (CDR2), and age at onset was 66.4±5.7 years (CDR1) and 68.3±9.3 year (CDR2).Mean schooling was 9.0±4.3 years (CDR1) and 8.8±4.4 years (CDR2). Mean MMSE was 21.0±3.3(CDR1) and 17.6±3.5(CDR2).Mean Cornell was 4.8±2.3(CDR1) and 4.2±1.9 (CDR2). The patient and caregiver dyads were aware of problems, mainly of those related to social, family and affective relations. The higher rates of discrepant responses were found on the awareness of cognitive deficits and changes in ADL.ConclusionThe ASPIDD is a multidimensional instrument to assess awareness of disease among AD patients.
Highlights
To describe the development of the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia (ASPIDD), a multidimensional scale to evaluate awareness of disease in dementia
This study aimed to describe the development process of the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia (ASPIDD), a multidimensional scale designed to cover cognitive deficits and functional, emotional and social impairment involved in the awareness of disease in dementia
Question 1 was withdrawn from the scale because both psychiatrists felt that the original phrase directly asked about the health of the patient, whereas our objective was to gather general data on the awareness of perceived changes by the patient
Summary
Objective: To describe the development of the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia (ASPIDD), a multidimensional scale to evaluate awareness of disease in dementia. A terceira etapa envolveu a correção e revisão dos domínios e questões da escala seguida de uma avaliação semântica feita por dois psiquiatras independentes. Awareness of disease is a complex concept with many different definitions It may be considered as the recognition of changes caused by the deficits related to the disease process[1,2,3] and covers the ability to recognize a specific deficit, the emotional response to the difficulties, and the ability to understand the impact of the impairment to activities of daily living (ADL)[3,4,5]. Several studies have focused on the various factors involved in lack of awareness in dementia, namely the presence of cognitive deficits, the site(s) of the lesion, presence and severity of depressive symptoms, severity of the disease, and the existence of psychological mechanisms of adaptation[1,6,7,8]. Among the several methods used in an attempt to operationalize this concept[9], approaches generally fit under (1) derivation of a discrepancy score based on the difference in impairments reported by the patient and an informant[10,11]; (2) judgment based on clinical observation[12], and (3) comparison of patient reports or predictions of his/her functioning with objective measures[2]
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