Versione italiana della defence mechanisms rating scales for clinicians: Uno strumento per la valutazione dei meccanismi di difesa del medico in oncologia

Introduction. Facing distress situations arising from the interaction with the patient in oncology, eg breaking bad news, clinicians also, such as patients, protect themselves using unconscious defense mechanisms. Clinicians' psychic defenses topic is related to the clinicians training on communication with patients and to clinicians' individual characteristics issues. For clinicians the defensive functioning can be adaptive when mature defenses are activated or maladaptive if the defensive mode is immature, with implications on medical care effectiveness. It is therefore important to identify, assess and intervene on clinicians' defense mechanisms. The Defense Mechanisms Rating Scales for Clinicians (DMRS-C) is a tool developed as an addendum to the DMRS (originally created by Perry), for the assessment of clinician defenses. It is an assessment tool based on the observer, which can be applied to audio or video recordings, interviews transcripts or medical - psychotherapy sessions. This tool is currently available in French language only. Aim. The aim of this work is to translate and adapt DMRS-C in Italian. Method. The DMRS-C has been translated into Italian and back-translated into French in order to verify the correspondence with the original language. Psychometric properties of the scale has been investigated, in terms of face validity and reliability among judges, by calculating the intraclass coefficients Correlation, based on videotaped interviews of oncology visits from the Milan San Paolo Hospital video recordings Archive. Results. The assessment tool has had positive findings for the purposes of intra-judges reliability (ICC=4.73; sd mean=80,33) and face validity. Conclusions. The consistency of the italian version with the original makes it suitable to highlight the frequency and variety of clinician defenses. This is the first study on medical oncologists defenses in real interviews. This tool will be useful to the fields of training and research on defenses in clinical care settings treating severe conditions such as oncology.