The traditional approach to the measurement of change presents important drawbacks (no information at individual level, ordinal scores, variance of the measurement instrument across time points), which Rasch models overcome. The article aims to illustrate the features of the measurement of change with Rasch models. To illustrate the measurement of change using Rasch models, the quantitative data of a longitudinal study of heart-surgery patients (N = 98) were used. The scale “Perception of Positive Change” was used as an example of measurement instrument. All patients underwent cardiac rehabilitation, individual psychological intervention, and educational intervention. Nineteen patients also attended progressive muscle relaxation group trainings. The scale was administered before and after the interventions. Three Rasch approaches were used. Two separate analyses were run on the data from the two time points to test the invariance of the instrument. An analysis was run on the stacked data from both time points to measure change in a common frame of reference. Results of the latter analysis were compared with those of an analysis that removed the influence of local dependency on patient measures. Statistics t, χ2 and F were used for comparing the patient and item measures estimated in the Rasch analyses (a-priori α = .05). Infit, Outfit, R and item Strata were used for investigating Rasch model fit, reliability, and validity of the instrument. Data of all 98 patients were included in the analyses. The instrument was reliable, valid, and substantively unidimensional (Infit, Outfit < 2 for all items, R = .84, item Strata range = 3.93-6.07). Changes in the functioning of the instrument occurred across the two time, which prevented the use of the two separate analyses to unambiguously measure change. Local dependency had a negligible effect on patient measures (p ≥ .8674). Thirteen patients improved, whereas 3 worsened. The patients who attended the relaxation group trainings did not report greater improvement than those who did not (p = .1007). Rasch models represent a valid framework for the measurement of change and a useful complement to traditional approaches.

In research and clinical contexts, it is important to briefly evaluate perceived Psychological and Social Support (PSS) to plan psychological interventions and allocate efforts and resources. However, an appropriate brief assessment tool for PSS was lacking. This study aimed at developing a brief and accurate scale to specifically measure PSS in clinical and emergency contexts, with specific, relevant, targeted, and irredundant items. Experienced clinicians developed the perceived Psycho-Social Support Scale (PSSS) and administered it to a clinical sample (N = 112) seeking psychological help during the COVID-19 emergency. A Confirmatory Factor Analysis examined the PSSS internal structure, and a Multiple Indicator and Multiple Causes model investigated its association with the number of sessions and emotional symptoms. The PSSS showed good psychometric properties and the Confirmatory Factor Analysis provided acceptable fit indexes for a unidimensional structure. The Multiple Indicators and Multiple Causes revealed that more sessions and emotional symptoms were associated with lower PSSS scores. The PSSS is a reliable brief tool to measure PS and could be useful to individualize treatments (i.e., number of sessions) to efficiently allocate efforts and resources in clinical contexts and emergencies (e.g., earthquake, COVID-19 pandemic).

Rehabilitative and preventive cardiology (CRP) is configured as intervention prevention to “gain health” through a process of multifactorial care that reduces disability and the risk of subsequent cardiovascular events. It makes use of an interdisciplinary team in which every professional needs to have multiple intervention paths because of the different levels of clinical and functional complexity of cardiac patients who currently have access to the rehabilitation. The document refers to the use of interventions by nurses, physiotherapists, dietitians and psychologists that are part of the rehabilitation team of CRP. Interventions of which have been documented, on scientific bases and clinical practice, empirical effectiveness and organizational efficiency. The methodological approach of this paper is a first attempt to define, through the model of consensus, the minimum standards for a CRP evidence based characterized by clearly defined criteria that can be used by operators of CRP. The document describes the activities to be carried out in each of the phases included in the pathways of care by nurses, physiotherapists, dietitians and psychologists. The routes identified were divided, according to the type of patients who have access to the CRP and to the phases of care, including the initial assessment, intervention, evaluation and final reporting, in high medium and low complexity. Examples of models of reporting, used by the operators of the team according to the principles of good clinical practice, are provided. This is made to allow traceability of operations, encourage communication inside the working group and within the patient and the caregiver. Also to give any possible indication for the post-rehabilitation.

The present Italian health planning demands the use of tools, care and treatments useful for the National Health Service, but with empirical effectiveness scientifically sustained. Aim of the present paper is to verify the validity, the reliability and the responsiveness of the factor “Perception of positive change” (named Schedule C) in cardiovascular rehabilitation. Method. The reliability of the Schedule C of the CBA VE has been examined comparing the mean scores obtained from each item at the entry and just before the discharge through the t-Student for paired sample. To assess the concurrent validity we used the AD Short Scale to measure anxiety and depression. 100 patients who underwent cardiac surgery were enrolled during hospitalization for a Cardiac Rehabilitation Programme. Cronbach’s alpha was used to assess internal consistency of each item. Results. Each item of the Schedule C demonstrated good internal consistency (Cronbach Alpha >.88) and elevated correlations item-total for each item. The strong correlation of anxiety and depression scores with the Schedule C points out appropriate concurrent validation. Conclusions. We believe that the Schedule C of the CBA VE is endowed with suitable metric validity and then useful as outcome evaluation in cardiovascular rehabilitation settings.