ABSTRACT
AIM: Stress conditions in patients with intellectual disabilities and psychiatric disorders are among all factors the most disabling in their quality of life. We aimed to develop a self-rating and third-person rating instrument verifying the effect of psychiatric and psychotherapeutic treatments in these patients. METHODS: First, we asked 150 caregivers of residential facility for patients with intellectual disabilities and psychiatric disorders to define 20 words, which describe stress conditions most accurately. Secondly, out of the list of collected words, two independent observers (neurologist, Germanist) defined subgroups, to which the words could be referred. Out of the most frequent subgroups, a questionnaire was developed in order to measure the expression of a target symptom. RESULTS: Out of 150 surveyed persons only 40 caregivers participated in the study with resulting 680 words defining stress condition in mentally disabled patients. Out of these, 31 words were excluded by observer A and 30 words by observer B, because according to their assessment, the words did not correctly cover the term 'stress condition'. Out of the remaining words, 13 subgroups were worked out. Exclusion of subgroups with less than 15 words in the development of the questionnaire resulted in following categories: (1) auto-aggression; (2) externalized aggression; (3) verbal aggression (4) isolation; (5) (motoric) restlessness; (6) autonomic changes; (7) emotional changes; (8) behavioral changes. For self- and third-person rating, a Likert scale was introduced, for self-rating, answers were visually supported with symbols. CONCLUSIONS: The development of an instrument to measure stress conditions in these patients is important for the improvement of therapies. Such an instrument for the measurement of psychological, social or medical therapy effects allows disentangling efficient strategies improving the patients' quality of life, as the assessment can be quickly integrated during a hospital intervention.
