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When used in a sample of patients with different states of depression the MDI has an adequate internal and external validity.

The profile of the four WHOQOL-BREF domains is a more adequate expression of quality of life than the total score of all 26 items. Although none of the subscales are statistically sufficient measures of their domains, the profile scores seem to be adequate approximations to the optimal score.

To improve quality care, the nurse managers should implement processes that strengthen continuity across the care spectrum and among all disciplines.

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