Una proposta di valutazione psicosociale e neuropsicologica dei pazienti cronici immigrati e italiani a confronto

[Autom. eng. transl.] Introduction and objectives: New pathways have recently been established for the management of the care of patients with chronic disease, who live in conditions of fragility and whose health and psycho-social well-being are compromised due to cognitive and emotional deficits associated with the condition of chronicity . Particularly at risk are chronic patients with different cultural backgrounds now stable in Italy, who also face aspects of vulnerability related to the challenge of integration: linguistic-cultural barriers, socio-legal difficulties and low socio-economic status. The present study aims to define a new multidimensional approach that can evaluate the clinical, psychosocial and neuropsychological conditions of immigrant patients with chronic diseases in parallel and compare them with those of Italian patients. Materials and methods: The total sample of 80 patients with chronic pathology is made up of 55% immigrant patients and 45% Italian patients. The assessment tool created ad hoc to allow this multilevel assessment is composed of: 1) a series of psychosocial tests aimed at assessing patients' basic language skills (production and understanding), the patient's state of health, perceived social support and the degree of daily discrimination, as well as the socio-economic status and the possible presence of comorbid diseases; 2) a battery of tests for neuropsychological evaluation, aimed at investigating the overall cognitive functioning of patients, in particular for the evaluation of attention, short and long term memory, abstract non-verbal reasoning and fluency of linguistic production; 3) a semi-structured interview, characterized by open and closed-ended questions, to collect social and psychological data directly expressed by patients, including their own representation of the condition of the disease and their health. Results: From the results obtained from the psychosocial battery, it emerges that the sample of chronic immigrant patients is younger than the sample of Italian patients, it achieves lower performances in the assessment tests of basic linguistic skills, in the scales that investigate global mental health and in those related to social involvement, where, in detail, they report that they receive less family social support than Italian patients, while they instead obtain high scores in the responses related to emotional problems compared to Italian patients. With regard to the results of the neuropsychological evaluation, chronic immigrant patients are more vulnerable cognitively, in particular in the short-term auditory-verbal memory test and in the abstract non-verbal reasoning where they perform lower than the sample of Italian patients. From the analysis of the semi-structured interviews, differences also emerge with respect to the issues shared by the patients, including, for example, the experiences lived within the health services, which the chronic foreign sample describes better than the Italian sample. Discussion: These results describe how useful it is to include a multi-level assessment approach within the Italian National Health System, in order to better and suddenly understand the health and well-being needs of chronic immigrant patients, and therefore, to integrate new diagnostic and therapeutic perspectives, also from a preventive perspective. Bibliography Bibliografia De Luca, G., Ponzo, M., & Andrés, AR 2013. Health care utilization by immigrants in Italy. International Journal of Health Care Finance and Economics, 13 (1), 1–31. Di Napoli, A., Gatta, R., Rossi, A., Perez, M., Costanzo, G., Mirisola, C., & Petrelli, A. 2017. Perceived discrimination at work for being an immigrant: A study on self-perceived