Abstract
BackgroundPhysical health among people with severe mental illness (SMI) is a global concern. However, many people with SMI do not receive regular comprehensive health checks. There is currently no validated physical health check instrument systematically used in Finnish mental health services. Therefore, this study aims to validate and establish the potential clinical utility of the translated Health Improvement Profile (HIP) tool for Finnish patients with SMI and compare differences in physical health risk items across genders.MethodsThe content validity of the two-way translated Finnish HIP (HIP-F) was evaluated by five nurses and four patients with SMI using cognitive debriefing (to assess the clarity and relevance of each item and the recommended actions of the HIP tool). The potential clinical utility was assessed using a pilot test involving 47 patients. The prevalence of red-flagged (risk) items in the whole sample, across female and male participants, and the frequencies of any type of missing item response were calculated and analysed using descriptive statistics. A chi-square test was used to determine differences in frequencies of red-flagged items across genders.ResultsBased on the cognitive debriefing, the HIP-F was found to have moderate content validity regarding the clarity and relevance of the items and recommended actions (the average scale level content validity index, S-CVI/Ave, 0.74). In the pilot test, some missing item responses were identified, but in the sample, nurses identified 399 areas of health and health behaviour risks (mean 8.6 per patient) using the HIP-F. The most frequently red-flagged items were body mass index (BMI) and waist circumference (83.0%), smoking status (48.9%) and lipid levels (46.8%). Female patients had a higher frequency of red-flagged items than males in BMI (92.6% vs. 70.0%, p = 0.04) and waist circumference (96.3% vs. 65.0%, p = 0.01).ConclusionsThe results demonstrate that the Finnish HIP has moderate content validity and preliminary clinical utility for evaluating the physical health and health behaviours of people with SMI. The HIP-F findings help to sign-post evidence-based interventions for identified areas of concern. Additional nurse training may be necessary to realise the potential clinical utility of the tool in Finland.
Highlights
Physical health among people with severe mental illness (SMI) is a global concern
We found that the percentage of participants with an unhealthy body mass index (BMI) value (80.0%) was much higher in Finland than that which was reported in Thailand (44.0%) [19], but the value in Finland was somewhat similar to that in
The results demonstrate that the Finnish Health Improvement Profile (HIP) has moderate content validity and preliminary clinical utility for evaluating the physical health and health behaviours of people with SMI in Finland
Summary
Physical health among people with severe mental illness (SMI) is a global concern. many people with SMI do not receive regular comprehensive health checks. This study aims to validate and establish the potential clinical utility of the translated Health Improvement Profile (HIP) tool for Finnish patients with SMI and compare differences in physical health risk items across genders. A number of guidelines have emphasised the importance of monitoring physical health [8,9,10], and different instruments are used to assess physical health status among people with SMI. These instruments have focused on patient satisfaction level (SAS-SMI) [11], quality of life (i.e. EQ-5D) [12], WHOQOL-Brief [13], 15D [14], SF-12 [15]) or functioning (GAF) [16]. The PHC does not provide clear recommendations for interventions or lifestyle advice, and its clinical utility may be limited [17]
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