Characteristics of eating disorders in a university hospital-based Spanish population

The use and misuse of the SCOFF screening measure over two decades: a systematic literature review

PURPOSE

The SCOFF questionnaire was designed as a simple, memorable screening tool to raise suspicion that a person might have an eating disorder. It is over 20 years since the creation of the SCOFF, during which time it has been widely used. Considering this, we wish to review the use of the SCOFF in peer-reviewed scientific journals, and to assess whether it is being used appropriately in the manner in which it was originally devised and tested.

METHODS

The Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines were followed, and all search strategies and methods were determined before the onset of the study. PubMed and Wiley Online Library were searched using the terms SCOFF and eating. Two reviewers were involved in the reviewing process. Criteria for appropriate use of the SCOFF were formalised with the tool's original authors.

RESULTS

180 articles were included in the final review. 48 articles had used the SCOFF appropriately, 117 articles inappropriately and 15 articles had been mixed in the appropriateness of their use.

CONCLUSION

This systematic review highlights the inappropriate use of the SCOFF in diverse languages and settings. When used correctly the SCOFF has made a significant contribution to the understanding of eating disorders and its simplicity has been applauded and led to widespread use. However in over two-thirds of studies, the use of the SCOFF was inappropriate and the paper highlights how and in what way it was misused, Guidelines for the appropriate use of the SCOFF are stated. Future validation and avenues of research are suggested.

LEVEL OF EVIDENCE

Level I.

Association between the Potential Influence of a Lifestyle Intervention in Older Individuals with Excess Weight and Metabolic Syndrome on Untreated Household Cohabitants and Their Family Support: The PREDIMED-Plus Study

This cross-sectional study aims to evaluate the association between the PREDIMED-Plus study lifestyle intervention and (i) adherence to the Mediterranean diet (MedDiet) and (ii) physical activity of cohabiting study participants, and to define the related social characteristics of the household members. Participants were a subsample of 541 cohabitants of the PREDIMED-Plus study. Adherence to the MedDiet, physical activity, anthropometric measurements, family function, and social support were assessed. Multiple linear regressions were applied to the data. Partners of the PREDIMED-Plus participants had higher adherence to the MedDiet compared to their sons/daughters (9.0 vs. 6.9 points). In comparison to partners with low adherence to the MedDiet, partners with high adherence were older, practiced more physical activity, ate more frequently with the PREDIMED-Plus participants, and had better family function (adaptability item). Compared to physically active partners, very active ones were older, more likely to be women, and had lower BMI and higher adherence to the MedDiet. In addition, they ate more frequently with the PREDIMED-Plus participants and had better family function. Using multiple lineal regressions, an increase in the adherence to the MedDiet of the PREDIMED-Plus participant, and better family function, were positively associated with their partner's adherence to the MedDiet. The PREDIMED-Plus intervention showed a positive association with adherence to the MedDiet of the study participants' partners. In addition, this association was influenced by the social characteristics of the household members.

Family functioning in the context of an adult family member with illness: A concept analysis

AIM

To describe and explain how the concept of family functioning has been used in the targeted sample of health literature on adult family members with illness.

BACKGROUND

Understanding the influence of illness on family functioning is central to the provision of patient- and family-centred care. There is lack of consistency in utilising family functioning which creates confusion about the concept and can interfere with theory development in nursing science. A clear conceptual definition of attributes of family functioning based on concept analysis could act as a guide in the development of instruments to assess family functioning, the design of family-based interventions and their application in clinical practice.

DESIGN

Concept analysis.

DATA SOURCES

Academic Search Premier, ProQuest Research Library, Family & Society Studies Worldwide, PsycINFO, SocINDEX, PubMed and CINAHL databases were searched within the last 20 years (1997-Dec. 2016) using the terms "family function*" and "patient." Studies of paediatric patients and non-English articles were excluded.

METHOD

Rodgers' evolutionary perspective.

RESULTS

The findings suggest that family functioning in the context of illness is defined as family members' ability to maintain cohesive relationships with one another, fulfil family roles, cope with family problems, adjust to new family routines and procedures and effectively communicate with each other.

CONCLUSION

Further research is needed to inform nurses' practice when assessing families or providing patient- and family-centred interventions to support family functioning across different sociocultural and political contexts, and further identification and evaluation of antecedents and consequences regarding family functioning from a nursing perspective.

RELEVANCE TO CLINICAL PRACTICE

Having a comprehensive understanding of the attributes, antecedents and consequences of ineffective family functioning can facilitate healthcare providers' ability to identify strengths and potential targets to improve family functioning among their clients.

Validation of the Finnish version of the SCOFF questionnaire among young adults aged 20 to 35 years

BACKGROUND

We tested the validity of the SCOFF, a five-question screening instrument for eating disorders, in a general population sample.

METHODS

A random sample of 1863 Finnish young adults was approached with a questionnaire that contained several screens for mental health interview, including the SCOFF. The questionnaire was returned by 1316 persons. All screen positives and a random sample of screen negatives were invited to SCID interview. Altogether 541 subjects participated in the SCID interview and had filled in the SCOFF questionnaire. We investigated the validity of the SCOFF in detecting current eating disorders by calculating sensitivity, specificity, and positive and negative predictive values (PPV and NPV) for different cut-off scores. We also performed a ROC analysis based on these 541 persons, of whom nine had current eating disorder.

RESULTS

The threshold of two positive answers presented the best ability to detect eating disorders, with a sensitivity of 77.8%, a specificity of 87.6%, a PPV of 9.7%, and a NPV of 99.6%. None of the subjects with current eating disorder scored zero points in the SCOFF.

CONCLUSION

Due to its low PPV, there are limitations in using the SCOFF as a screening instrument in unselected population samples. However, it might be used for ruling out the possibility of eating disorders.

[Factors underlying psycho-social problems]

OBJECTIVE

To investigate personal and family variables involved in the appearance of psychosocial problems (PSP) and the role of stressful life events (SLE) and Social Network and Support in its genesis; and to construct a profile of a PSP patient.

DESIGN

Transversal, descriptive study.

SETTING

Almanjayar Health Centre, Granada, Spain.

PARTICIPANTS

Three hundred fourteen patients over 18 selected by systematic sampling in on-demand consultation.

MAIN MEASUREMENTS

Every patient had an interview, filling in the GHQ-28 (with scores>or=8 considered indicative of PSP), the family Apgar test (Family Function study), the Holmes-Rahe Social Readjustment Scale (SLE in the last year), the DUKE-UNC questionnaire (Social Support), and Social Network (number of people). The Structure and Stage of the Family Life Cycle, social-economic and cultural level, work and income were also determined. A descriptive analysis of each variable and its association with the GHQ-28 through the chi2 test were also conducted. To find what categories were associated independently with high scores on the GHQ, a multivariate analysis was carried out.

RESULTS

Categories of age (between 30 and 59 years old), gender (being a woman) and social-economic level (unskilled workers) entail greatest risk of PSP. Similarly, single-parent families, perception of family dysfunction, high levels of stress (OR=3.02; 95% CI, 1.76-5.18), and low social support affect PSP.

CONCLUSIONS

The profile of a PSP patient in our setting is of a middle-aged woman forming part of a single-parent and/or dysfunctional family, who has suffered major SLEs and has insufficient social support.