Monitoring of the pathway of rehabilitation (MPR)

Objective

The challenge of monitoring the pathways of individuals with mental disorders in residential facilities (RFs) persists in the Italian residential system. Despite available instruments for assessing patients’ functioning in general settings, specialized tools for evaluating the functional autonomy of individuals in RFs are lacking internationally. To address this gap, the Verona Department of Mental Health developed the Monitoring of the Pathway of Rehabilitation (MPR). The main aim of this paper is to describe this tool which comprehensively evaluates functional autonomy, tailors monitoring, and programs rehabilitation goals within residential pathways, and address the critical need for accurate intervention documentation.

Methods

Focus groups were conducted with mental health professionals from RFs to identify the need for a common assessment tool meeting Ministry of Health accreditation requirements. Experts collaborated to develop the initial draft of the MPR, ensuring its relevance and practicality. The MPR underwent modifications based on stakeholder feedback, utilizing an active research-participation model. A formal study examined the MPR’s psychometric properties.

Results

The MPR consists of 40 items grouped into ten basic skills, each rated on a 4-point Likert scale (0 to 3). It categorizes individuals into one of five stages of autonomy (poor to excellent). Both staff (MPR-S) and service users (MPR-U) complete the MPR, ensuring a holistic assessment. Residential interventions are based on goals identified through the MPR informed by the scores from both staff and patient assessments. The types of residential interventions provided in RFs are documented using the Activity and Intervention Log Form, which collects daily data on 59 interventions/activities.

Conclusions

The MPR appears to be a valuable tool for assessing functional autonomy in the context of RFs, suitable for both research purposes and routine clinical activities.