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PubMed2005

Development of scales to screen for eight common psychiatric disorders.

The present study was designed to create a group of scales from the items on the Symptom Checklist 90 (SCL-90) to identify common psychiatric diagnoses. Subjects were 1457 adult psychiatric outpatients who completed the Symptom Checklist-90 and a structured diagnostic interview at the time of their initial evaluation. A combination of rational and empirical test construction methods was used to create the SCL-90 Diagnostic Scales, item sets that identify eight common psychiatric conditions: major depression, bipolar disorder, schizophrenia, antisocial personality disorder, somatization disorder, obsessive-compulsive disorder, panic disorder, and agoraphobia. These specially constructed scales were found to possess good internal reliability. These scales were also shown to differentiate patients positive for each of the eight psychiatric disorders from other psychiatric patients who did not have that disorder. Sensitivities and specificities are reported for each item set. In addition to their utility at the time of initial assessment as an aid in identifying diagnosis, the SCL-90 Diagnostic Scales may have other potential uses, such as in monitoring the symptom course of the patient's disorder or disorders over time.

Ambulatory Care↗
PubMed2006

A retrospective controlled study into memory complaints reported by depressed patients after treatment with electroconvulsive therapy and pharmacotherapy or pharmacotherapy only.

Few studies have been conducted comparing complaints of memory problems using objective and subjective memory scales in depressed patients who received electroconvulsive therapy (ECT) + pharmacotherapy or treatment with pharmacotherapy only. Patients who suffer from depression according to the Diagnostic and Statistical Manual of Mental Disorder (Fourth Edition) criteria and who were admitted within the past 5 years before this study in a general psychiatric hospital were screened for inclusion. Objective retrograde amnesia was assessed using the Autobiographical Memory Interview and the Amsterdam Media Questionnaire (AMQ). Subjective retrograde amnesia was assessed using the Squire Subjective Memory Questionnaire and the ECT Retrograde Amnesia and Perception Scale (ERAPS), a newly developed scale. Twenty of the 84 patients who received ECT + pharmacotherapy and 30 of the 196 patients who received pharmacotherapy only participated in the study. Patients' ERAPS memory scores were compared with proxies' ERAPS memory scores of the patients to assess the reliability of memory complaints. The ECT + pharmacotherapy group was found to suffer more from memory problems using the AMQ 1990 test. There was also a difference for the proxy's ERAPS memory score, reflecting the conviction of proxies from the ECT + pharmacotherapy patients that these patients suffer more memory problems due to the illness, treatment with pharmacotherapy, or ECT. The differences could not be explained by the influence of determinants for retrograde amnesia. ECT + pharmacotherapy patients did not attribute their memory problems mainly to ECT but put equal "blame" on the depressive illness, treatment with pharmacotherapy, and ECT. The analyses suggest that the AMQ 1990s test is (more) sensitive in registering retrograde amnesia than the other scales used in the study.

Amnesia, Retrograde↗
PubMed1994

Measuring feeding difficulty in patients with dementia: developing a scale.

Feeding difficulty in elderly people with dementia is well documented and the need for research in this area of nursing care has been raised by several authors. One hundred and twelve elderly people with dementia were entered into a study of feeding difficulty. Data were gathered by means of a questionnaire administered to the nurses caring for the patients. The aspects of feeding difficulty which were investigated were based on reports of relevant behaviour in the literature and included refusal to eat, turning the head away, refusing to open the mouth, spitting, allowing food to drop out of the mouth and not swallowing. It was possible to arrange these different aspects of feeding difficulty under three headings: (a) refusal to eat, (b) spitting, and (c) inability to swallow, and to analyse the pattern of accumulation of these feeding difficulties by means of Guttman scale analysis. According to this analysis, the feeding difficulties investigated form a cumulative and unidimensional pattern. The implications of this pattern and the possibilities for further research are discussed.

Aged↗
PubMed1996

The National Hospital Seizure Severity Scale: a further development of the Chalfont Seizure Severity Scale.

Seizure severity scales have recently been identified as an important additional outcome measure in trials of new antiepileptic drugs (AEDs). The National Hospital Seizure Severity Scale (NHS3) is presented as a refined version of the Chalfont Seizure Severity Scale. The principal advantages of the new version are that it is quicker and simpler to apply, the limits of reliability are now clearly defined, and construct validity for the scale is available. The scale is administered by a health professional during an interview with a patient and a witness to the seizures. It contains seven seizure-related factors and generates a score from 1 to 27. An intraclass correlation coefficient of 0.90 was obtained during interobserver and test-retest reliability assessment, suggesting that the scale is sufficiently reliable for group studies. Scores for an individual patient should be interpreted with caution in light of the limits of agreement obtained. Validation experiments indicate that NHS3 measures seizure severity in a manner compatible with the subjective impression of people with epilepsy. We suggest that the NHS3 is a valid, easily applicable measure of seizure severity that is acceptably reliable for use in trials of novel AEDs.

Adult↗
PubMed1998

Neurobehavioral development in Joubert syndrome.

Research on children with Joubert syndrome has focused on brain structural abnormalities and associated clinical symptoms. The degree of developmental delay has not been objectively reported. We investigated the neurobehavioral development of children with Joubert syndrome through neurobehavioral assessment in the largest sample to date. Thirty-two parents of children with Joubert syndrome completed the Child Development Inventory and magnetic resonance imaging (MRI) data was gathered on 17 of these children. Results indicate that 94% were severely impaired according to the Child Development Inventory, with age being positively correlated with degree of neurobehavioral impairment. The average developmental age of our sample was 19 months (63% below chronological age). Severity of illness as measured by the General Development scale of the Child Development Inventory and severity of illness as measured by MRI (overall severity rating) did not yield consistent data regarding severity of the midbrain and cerebellar malformations. Similarly, markers of abnormal cerebral development such as cortical atrophy and delayed myelination were independent of severity of illness ratings on the Child Development Inventory. The degree of developmental delay in Joubert syndrome and the severity of gross central nervous system malformations appear independent.

Adolescent↗
PubMed2004

The Trunk Impairment Scale: a new tool to measure motor impairment of the trunk after stroke.

OBJECTIVE: To examine the clinimetric characteristics of the Trunk Impairment Scale (TIS). This newly developed scale evaluates motor impairment of the trunk after stroke. The TIS scores, on a range from 0 to 23, static and dynamic sitting balance as well as trunk co-ordination. It also aims to score the quality of trunk movement and to be a guide for treatment. DESIGN: Two physiotherapists observed each patient simultaneously, but scored independently. Each patient was re-examined by one of the therapists. SUBJECTS: Twenty-eight patients in a rehabilitation setting. RESULTS: Kappa and weighted kappa values for item per item reliability ranged for all but two, from 0.62 to 1. All percentages of agreement exceeded 81%. Intraclass correlations (ICC) for the summed scores of the different subscales were between 0.85 and 0.99. Test-retest and interobserver reliability for the TIS total score (ICC) was 0.96 and 0.99, respectively. The 95% limits of agreement for the test-retest and interexaminer measurement error were -2.90, 3.68 and -1.84, 1.84, respectively. Cronbach alpha coefficients for internal consistency ranged from 0.65 to 0.89. Content validity was defined. Spearman rank correlations with the Barthel Index (r = 0.86) and the Trunk Control Test (r = 0.83) was used to examine construct and concurrent validity, respectively. CONCLUSIONS: Analysis of different clinimetric parameters support the use of the TIS in both clinical use and future stroke research. Guidelines for treatment and level of quality of trunk activity can be derived from the assessment.

Abdomen↗
PubMed1986

Development of scales to measure treatment attitudes in psychiatry.

We used multiple regression analysis to modify and shorten two scales for measuring practitioners' attitudes to psychotherapy and drug therapy. The resulting scales have been combined in a 21-item questionnaire (Treatment Attitudes in Psychiatry Scales (TAPS] which is brief and easy to use, and should have wide application in psychiatry. The results of a concurrent validation of the scales, using two large groups of consultant psychiatrists who were members of either the Biological Psychiatry or Psychotherapy Section of the Royal College of Psychiatrists, show the extent to which their attitudes to psychotherapy or drug therapy tend to overlap. Polarisation of attitudes was more evident in the results from the Biological Psychiatry Section. A method is described by which scores obtained with the TAPS can readily be compared with those obtained by the criterion groups.

Attitude of Health Personnel↗
PubMed1999

Segmenting healthcare terminology users: a strategic approach to large scale evolutionary development.

Healthcare terminologies have become larger and more complex, aiming to support a diverse range of functions across the whole spectrum of healthcare activity. Prioritization of development, implementation and evaluation can be achieved by regarding the "terminology" as an integrated system of content-based and functional components. Matching these components to target segments within the healthcare community, supports a strategic approach to evolutionary development and provides essential product differentiation to enable terminology providers and systems suppliers to focus on end-user requirements.

Delivery of Health Care↗
PubMed1992

The Adolescent Life Change Event Scale: its development and use.

A variety of instruments have been used by researchers from several disciplines to assess life change events in adolescents. Most instruments have not been tested for validity and reliability, and have been used in one-time studies, with limited effort to synthesize all studies using the particular instrument. Because of the number of requests, over more than a decade, to use the Adolescent Life Change Event Questionnaire, the authors have attempted to review all known studies using this instrument as a preliminary step toward further testing of the questionnaire for validity and reliability. Twenty-five studies, involving a total of 4,024 adolescent subjects from nine states, were reviewed. Findings included gender and age differences in number of events experienced and the perceived stressfulness, and a relationship between events experienced and suicidal ideation. Recommendations are made regarding future development and use of the instrument.

Adolescent↗
PubMed1984

Attitude change and a prison health care experience.

Nursing in a prison setting has recently emerged as a field of concern. One of the issues in staff working with prisoners is attitudes and attitude change. Since the most favorable site for attitude formation and/or change is a student's educational experience, the present study was undertaken to explore if nursing students who have a clinical experience with prisoners will demonstrate a change toward more favorable attitudes toward prisoners. The research design was a pre-test, post-test control group design. The instrument was a Likert scale, adapted from previously developed scales dealing with attitudes toward prisoners, the mentally ill, and drug addicts. An important control was contained in the instrument, in that not only were there statements dealing with prisoners, but also dealing with the mentally ill and addicts, with whom none of the students would have student clinical experience. The results revealed that there was no significant difference in attitudes toward prisoners, drug addicts, and the mentally ill on the pre-test for either experimental or control group. However, on the post-test, there was a significantly lower (more positive) score on the scale for prisoners for the experimental group, who had a prison clinical experience. This finding suggests that attitudes can be favorably altered by a relevant student clinical experience.

Attitude↗
PubMedDate not supplied

Developing a scale to measure denial levels of clients with actual or potential myocardial infarctions.

OBJECTIVE: To refine and test the Robinson Self-Appraisal Inventory-Form D (RSAI-Form D), a self-administered scale designed to measure denial in coronary clients. DESIGN: Exploratory research. SETTING: Two midwestern medical centers. SAMPLE: The sample was composed of 130 patients 75 years of age and younger with actual or potential myocardial infarction. MEASURES: Two instruments, the Demographic Data Form and the RSAI-Form D, were completed by the participants. RESULTS: Cronbach's coefficient alpha, factor analysis, t test, and stepwise multiple regression were used in the data analysis. A coefficient alpha for the 20-item scale was 0.80 for both Day 2 and Day 4. Day 2 and Day 4 oblique rotations revealed that items loaded on four factors but did not load on the same factors for both days: therefore, factors were identified for each day. There was a significant decrease in RSAI-Form D scores from the second to fourth hospitalized day (t = 5.83, p = 0.001). Two predictors, number of prior hospitalizations of chest pain, and whether or not the individual had sustained a myocardial infarction this admission (identified by stepwise multiple regression) explained 9.4% of the variance in the change in RSAI-Form D scores from Day 2 to Day 4 (F[2, 127] = 6.55, p = 0.001). CONCLUSIONS: Findings of the study did provide preliminary evidence that the RSAI-Form D is a reliable and valid inventory. Four aspects of denial were extracted, thus providing supportive evidence to the nurse that the use of single specific or global criteria does not provide sufficient data for assessing denial.

Denial, Psychological↗
PubMed2005

The Taylor Hyperpigmentation Scale: a new visual assessment tool for the evaluation of skin color and pigmentation.

The Taylor Hyperpigmentation Scale is a new visual scale developed to provide an inexpensive and convenient method to assess skin color and monitor the improvement of hyperpigmentation following therapy. The tool consists of 15 uniquely colored plastic cards spanning the full range of skin hues and is applicable to individuals with Fitzpatrick skin types I to VI. Each card contains 10 bands of increasingly darker gradations of skin hue that represent progressive levels of hyperpigmentation. This article describes the ongoing development of the Taylor Hyperpigmentation Scale and reports the results of a recent validation study of the use of this newly developed chart in individuals with skin of color. In the study, skin color and an area of hyperpigmentation in 30 subjects of white, African American, Asian, or Hispanic ancestry (approximately 5 from each of the 6 skin types) were evaluated by 10 investigators. The results of the study revealed significant variation among intraindividual and interindividual ratings by investigators of skin hue (P < .0001) and hyperpigmentation (P = .0008); however, most investigators rated the scale as useful and easy to use, and 60% stated they would use it in clinical practice to document the response of hyperpigmentation to therapeutic agents. A heuristic evaluation of the results of this study provided insight into essential considerations for the continued effort to develop a useful and simple scale for assessing skin color and pigmentation.

Adult↗
PubMed1986

A measurement scale for the parental underinvestment concept.

"The concept of parental underinvestment was used by Scrimshaw (1978) to explain infant and childhood mortality where a biological explanation was lacking. This report describes an underinvestment scale developed and tested in the Philippines. No previous scale had been developed to test the underinvestment concept. Reliability and validity of the scale are reported along with recommendations for improvement of the scale and an expansion of the parental underinvestment concept to explain outcomes other than mortality."

Adolescent↗
PubMed1984

Development of indicator scales for the Comprehensive Assessment and Referral Evaluation (CARE) interview schedule.

The objective of this research was to develop indicator scales for major health and social problems of individuals aged 65 or over who live in the community. A semistructured interview technique, the Comprehensive Assessment and Referral Evaluation (CARE), was used in two large surveys in London and New York City. Twenty-two indicator scales were developed by using items that met certain clinical and statistical criteria. These indicator scales are intended for use in developing a general taxonomy of the problems of older individuals, for clinical assessment and referral of such individuals, and for use in geriatric epidemiological research. The scales were developed to be comprehensive with regard to the CARE, to be relatively independent of one another, and to have satisfactory content, clinical, and face validities, and interrater and internal consistency reliabilities.

Activities of Daily Living↗
PubMed1978

The development of the Telic Dominance Scale.

The development of a 42-item measure of a number of personality features derived from the theory of psychological reversals is reported. These personality features are (a) the extent to which a person is serious-minded, (b) the extent to which a person plans ahead and organizes himself in the pursuit of goals, and (c) the extent to which a person seeks to avoid arousal. These features together are seen to constitute a personality trait which is described as telic dominance. Data concerning the test-retest reliability, criterion-related and construct validity of the Telic Dominance Scale are presented, together with the scale and scoring key.

Journal Article↗