PubMed · 14616589
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Ian Smith. 2003. Doing more with less.. https://doi.org/10.1046/j.1365-2044.2003.03520.x
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BACKGROUND: There is a lack of a simplified instrument for use in busy clinical settings to measure and differentiate anxiety levels of children. OBJECTIVES: To develop a short form of the Chinese version of the State Anxiety Scale for Children (CSAS-C) and test psychometric properties of the new form. DESIGN: The study was divided into two phases with phase one aimed at developing a short form of the CSAS-C, while phase two aimed at testing psychometric properties of the new form. A test-retest, within-subjects design was employed. Children (7-12 years of age) admitted for surgery in a day surgery unit during two consecutive years' summer holiday were invited to participate in the study. In phase one, selected participants (N=112) were asked to respond to the CSAS-C. In phase two, selected participants (N=82) were asked to respond to the short form of the CSAS-C. RESULTS: Using exploratory factor analysis, a subset of 10 items, which was highly correlated with scores obtained from the full form (r=0.92) and, which had acceptable internal consistency (r=0.83) was developed. The psychometric properties of this short form have been empirically tested, showing adequate internal consistency reliability, good concurrent validity, and excellent construct validity. CONCLUSION: This study addresses a gap in the literature by developing a 10-item short form of the CSAS-C. Results indicate that this short form is an appropriate and objective assessment tool for measuring anxiety levels of Chinese children in a busy clinical setting where time constraints make unfeasible the use of the full form.
This study sought to establish the practice patterns of a diverse group of academic physicians, in the management of periprocedural anticoagulation for patients with mechanical heart valves, to study adherence to American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Physicians (n = 140) were surveyed to assess strategies for the periprocedural anticoagulation of patients with bileaflet mechanical heart valves undergoing 2 common outpatient procedures. Six patient scenarios with graded risk profiles were presented for each valve location (mitral and aortic). In >90% of high-risk patient scenarios, for which the ACC/AHA guidelines recommend periprocedural anticoagulation, anticoagulation was recommended, with minimal differences between physician specialties. However, periprocedural anticoagulation was also recommended in >70% of non-high-risk scenarios, for which the ACC/AHA guidelines recommend no periprocedural anticoagulation. Noncardiologists recommended anticoagulation more often in non-high-risk patients (p <0.01), especially for patients with aortic valve prostheses. Thus, academic physicians appropriately recommend periprocedural anticoagulation for high-risk patients with mechanical heart valves who undergo elective procedures. However, these data specifically suggest variability in practice for non-high-risk patients that are discordant with current ACC/AHA guidelines, with differences by treating specialty especially notable in this risk subset.