Department of Medicine, Psychiatry Unit, KEM Hospital, Pune and KEM Hospital Research Centre, Pune, Maharashtra, India.
Department of Psychiatry, Maharashtra Institute of Mental Health, Pune, Maharashtra, India.
Indian J Psychiatry. 2015 Jan-Mar;57(1):59-67. doi: 10.4103/0019-5545.148524.
Development of the cultural formulation interview (CFI) in DSM-5 required validation for cross-cultural and global use.
To assess the overall value (OV) of CFI in the domains of feasibility, acceptability, and utility from the vantage points of clinician-interviewers, patients and accompanying relatives.
We conducted cross-sectional semi-structured debriefing interviews in a psychiatric outpatient clinic of a general hospital.
We debriefed 36 patients, 12 relatives and eight interviewing clinicians following the audio-recorded CFI. We transformed their Likert scale responses into ordinal values - positive for agreement and negative for disagreement (range +2 to -2).
We compared mean ratings of patients, relatives and clinician-interviewers using nonparametric tests. Clinician-wise grouping of patients enabled assessment of clinician effects, inasmuch as patients were randomly interviewed by eight clinicians. We assessed the influence of the presence of relatives, clinical diagnosis and interview characteristics by comparing means. Patient and clinician background characteristics were also compared.
Patients, relatives and clinicians rated the CFI positively with few differences among them. Patients with serious mental disorders gave lower ratings. Rating of OV was lower for patients and clinicians when relatives were present. Clinician effects were minimal. Clinicians experienced with culturally diverse patients rated the CFI more positively. Narratives clarified the rationale for ratings.
Though developed for the American DSM-5, the CFI was valued by clinicians, patients and relatives in out-patient psychiatric assessment in urban Pune, India. Though relatives may add information and other value, their presence in the interview may impose additional demands on clinicians. Our findings contribute to cross-cultural evaluation of the CFI.
DSM-5 中文化构念访谈（CFI）的发展需要进行跨文化和全球验证。
从临床医生-访谈者、患者和陪同的亲属的角度评估 CFI 在可行性、可接受性和实用性方面的总体价值（OV）。
我们在一家综合医院的精神病门诊进行了横断面半结构式深度访谈。
在完成 CFI 的音频记录后，我们对 36 名患者、12 名亲属和 8 名访谈临床医生进行了深度访谈。我们将他们的李克特量表反应转化为有序值——同意为正，不同意为负（范围+2 到-2）。
我们使用非参数检验比较了患者、亲属和临床医生访谈者的平均评分。由于患者是由 8 名临床医生随机访谈的，因此可以根据临床医生进行分组，评估临床医生的影响。我们通过比较平均值来评估亲属的存在、临床诊断和访谈特征的影响。还比较了患者和临床医生的背景特征。
患者、亲属和临床医生对 CFI 的评价均为正面，彼此之间差异不大。患有严重精神障碍的患者给出的评分较低。当亲属在场时，患者和临床医生对 OV 的评价较低。临床医生的影响最小。有经验的与文化多元化患者接触的临床医生对 CFI 的评价更为积极。叙述阐明了评分的基本原理。
尽管 CFI 是为美国 DSM-5 开发的，但在印度浦那市的门诊精神病评估中，临床医生、患者和亲属都对其给予了高度评价。虽然亲属可能会提供更多的信息和其他价值，但他们在访谈中的存在可能会给临床医生带来额外的需求。我们的研究结果有助于对 CFI 进行跨文化评估。
