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PubMed1997

[The development of a scale of life quality for diseases with visual impairment].

OBJECTIVE: To describe the development of a scale of life (QOL) quality which measures the quality of life of Chinese patients with visual impairment. METHODS: 20 items were chosen to form a scale. 57 cataractous patients with visual impairment and 60 glaucomatous patients with visual impairment and visual field loss at different levels simultaneously were measured by the scale to evaluate the validity, reliability and responsiveness of the scale. RESULTS: The scale consists of 20 items which cover four domains of QOL. The criterion related to the validity of the scale: r = 0.6865 (P = 0.000). The test-retest reliability of the scale: r = 0.8959 (P = 0.000). Coronback's alpha was 0.9358. The variance ratio (VR) of intra-individual variance to inter-individual variance was 0.0551 for overall scores. This correlation coefficient of split-half method was 0.9553. The responsiveness: t-test, t = 5.95 (P = 0.000). The effect size statistic was 1.533. CONCLUSION: The results also demonstrate that the scale has a satisfactory validity, reliability and responsiveness. It is suggested that the scale can be applied in clinical trails.

Cataract↗

PubMed1996

Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG)

This paper describes the development of an evaluative outcome measure for patients with upper extremity musculoskeletal conditions. The goal is to produce a brief, self-administered measure of symptoms and functional status, with a focus on physical function, to be used by clinicians in daily practice and as a research tool. This is a joint initiative of the American Academy of Orthopedic Surgeons (AAOS), the Council of Musculoskeletal Specialty Societies (COMSS), and the Institute for Work and Health (Toronto, Ontario). Our approach is consistent with previously described strategies for scale development. In Stage 1, Item Generation, a group of methodologists and clinical experts reviewed 13 outcome measurement scales currently in use and generated a list of 821 items. In Stage 2a, Initial Item Reduction, these 821 items were reduced to 78 items using various strategies including removal of items which were generic, repetitive, not reflective of disability, or not relevant to the upper extremity or to one of the targeted concepts of symptoms and functional status. Items not highly endorsed in a survey of content experts were also eliminated. Stage 2b, Further Item Reduction, will be based on results of field testing in which patients complete the 78-item questionnaire. This field testing, which is currently underway in 20 centers in the United States, Canada, and Australia, will generate the final format and content of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Future work includes plans for validity and reliability testing.

Activities of Daily Living↗

PubMed2003

[Persistent skin reaction and Raynaud phenomenon after a sting by Echiichthys draco (great weever fish)].

A 54-year-old recreational angler was stung in his right forefinger by Echiichthys draco. Within a few seconds he developed severe swelling with extreme pain sensation at the sting site, accompanied by dizziness and chill. Even under morphine therapy the pain symptoms were only slightly reduced. During the subsequent weeks, an erythema with marginate medium-sized scaling developed at the sting site and the patient experienced a approximately 50% reduced bending capacity of the forefinger and permanent numbness in this region. After 4 months, Raynaud phenomenon developed limited to the right forefinger. Great weever fishes (Echiichthys spp.) are the most venomous fishes in European waters. In humans, life-threatening sting reactions occur only in exceptional cases. As a commercial antiserum is not available, the therapy is mainly empiric (General measures of first aid and emergency medicine, the wound should be thoroughly washed). Patients should be informed that reduced motion ability, swelling or Raynaud's phenomenon can persist for several months.

Adrenal Cortex Hormones↗

PubMed1988

Assessment of methods for measuring social support.

A rapidly expanding literature documents the effects of social support on physical and psychological well-being. Although definitions vary, most include both tangible components (e.g., financial assistance and physical aid) and intangible components (e.g., encouragement and guidance). Social support has been implicated in the mediation of stressful life events, recovery from illness, and increased program adherence. There are many inconsistent findings in the literature, however, and it is difficult to resolve discrepancies because measures of social support vary widely from study to study. To guide in the selection of measurement methods for research and applied work, 23 techniques for assessing social support are reviewed and evaluated. Criteria for favorable evaluation included reliability coefficients greater than .8 and documentation of validity. Correlations between various social support and criterion measures are simulated in order to demonstrate the consequences of choosing a measure with low reliability. Scale developers reported reliability data for 19 of the reviewed measures. Internal consistency coefficients ranged from .31 to .98. Test-retest coefficients ranged from .22 to .96. At least some validity documentation was available for 13 of the scales. Discriminant validity evidence, however, is almost universally absent. Despite psychometric weaknesses and variability among the scales, researchers have several instruments available to them.

Adaptation, Psychological↗

PubMed2006

Use of the faces pain scale to evaluate pain of a pediatric patient with pauciarticular juvenile rheumatoid arthritis.

The Faces Pain Scale developed by Wong and Baker is a common assessment tool that uses cartoon-like faces to assess self reported pain in children. The purpose of this case report is to explore the appropriateness of the Faces Pain Scale as an outcome measure for a young child with pauciarticular juvenile rheumatoid arthritis. The patient was a four-year-old boy who had undergone a synovectomy on his right knee secondary to pauciarticular JRA. Each session the patient was asked to rate his pain using the Faces Pain Scale. The patient gainedfull knee range of motion and his functional mobility improved compared to initial visit. His subjective pain rating remained constant at "no hurt" throughout three weeks of visits. His functional mobility did not match his subjective rating of pain via the Faces Pain Scale. Further research is needed to determine the relationship of pain, stiffness, and function in children with rheumatic diseases.

Arthritis, Juvenile↗

PubMed1994

Treatment effects in Trichuris dysentery syndrome.

Heavy infection with the geohelminth Trichuris trichiura causes the Trichuris dysentery syndrome (TDS). Growth retardation and anaemia are characteristic of TDS and both are associated with poor development. We have examined the growth and developmental responses to treatment in 19 children aged 27-84 months with TDS. Developmental levels (DQ) were measured with the Griffiths mental development scales. Compared with a control group matched for age, gender and neighbourhood, the TDS children initially had serious deficits in DQ (24 points, p < 0.001). After a year of anthelmintic treatment, the TDS children showed improvement in locomotor development (p < 0.001) compared with the controls. The TDS children also had initial deficits in height-for-age, weight-for-height, mid-upper arm circumference and haemoglobin levels. They caught up rapidly in indices of wasting (weight-for-height and mid-upper arm circumference) and showed steady improvement in height-for-age and haemoglobin levels. Catch-up in height was comparable to that of children recovering from coeliac disease. The importance of continuing prevention after initial treatment is highlighted.

Case-Control Studies↗

PubMed2006

A test of knowledge about prostate cancer screening. Online pilot evaluation among Southern California Physicians.

BACKGROUND: Although the benefits of prostate cancer screening are uncertain and guidelines recommend that physicians share the screening decision with their patients, most U.S. men over age 50 are routinely screened, often without counseling. OBJECTIVE: To develop an instrument for assessing physicians' knowledge related to the U.S. Preventive Services Task Force recommendations on prostate cancer screening. PARTICIPANTS: Seventy internists, family physicians, and general practitioners in the Los Angeles area who deliver primary care to adult men. MEASUREMENTS: We assessed knowledge related to prostate cancer screening (natural history, test characteristics, treatment effects, and guideline recommendations), beliefs about the net benefits of screening, and prostate cancer screening practices for men in different age groups, using an online survey. We constructed a knowledge scale having 15 multiple-choice items. RESULTS: Participants' mean knowledge score was 7.4 (range 3 to 12) of 15 (Cronbach's alpha=0.71). Higher knowledge scores were associated with less belief in a mortality benefit from prostate-specific antigen (PSA) testing (r=-.49, P<.001). Participants could be categorized as low, age-selective, and high users of routine PSA screening. High users had lower knowledge scores than age-selective or low users, and they believed much more in mortality benefits from PSA screening. CONCLUSIONS: Based on its internal consistency and its correlations with measures of physicians' net beliefs and self-reported practices, the knowledge scale developed in this study holds promise for measuring the effects of professional education on prostate cancer screening. The scale deserves further evaluation in broader populations.

Adult↗

PubMed2004

The PedsQL in pediatric cancer pain: a prospective longitudinal analysis of pain and emotional distress.

The objective of this prospective study was to investigate the cross-sectional and longitudinal associations between pain and emotional distress in children and adolescents with cancer as measured by the Pediatric Quality of Life Inventory (PedsQL) Emotional Functioning and Pain Scales. The PedsQL 1.0 Generic Core Scales are multidimensional scales developed as the generic core measure to be integrated with the PedsQL Disease-Specific Modules. The PedsQL 1.0 Cancer Module was designed to measure pediatric cancer-specific health-related quality of life. The PedsQL Generic Core Scales, Emotional Functioning Scale and Cancer Module Pain Scale, were administered to 69 children and 59 adolescents and their parents at Time 1 and Time 2, which was 6 months on average after Time 1. Prospective hierarchical multiple regression analyses supported a longitudinal predictive model with Time 1 pain predicting Time 2 pain and Time 1 emotional distress predicting Time 2 emotional distress, respectively. Time 1 emotional distress did not predict Time 2 pain, and Time 1 pain did not predict Time 2 emotional distress. The results demonstrate that pediatric cancer pain and emotional distress, although associated cross-sectionally, are differentially predictive in prospective longitudinal analyses. These results suggest that both pain and emotional distress should be targeted for treatment interventions concurrently to enhance long-term health-related quality of life of the pediatric patient with cancer.

Adolescent↗

PubMedDate not supplied

Cross-cultural differences in developmental rates: a comparison between British and Brazilian children.

The Griffiths Mental Development Scales were administered to a population-based sample of 305 4-year-old children from a Brazilian city. Their performance was compared to that of 285 British children of the same age who participated in the standardization phase of this instrument. Although the mean general quotients were very similar for both groups, British children performed better than Brazilians in the fine motor and practical reasoning scales. Brazilians, on the other hand, proved to be more advanced in gross motor and speech scales. The possibility of these differences being explained in terms of cultural environment is discussed.

Brazil↗

PubMed1991

Psychomotor and mental development from birth to age of four years; sex differences and their relation to home environment. Children in a new Stockholm suburb. Results from a longitudinal prospective study starting at the beginning of pregnancy.

Five hundred and thirty-two pregnant women were interviewed about their psychosocial health at the beginning of pregnancy. According to various factors including alcoholism, mental disease and criminality among the women and their husbands the families were divided in three groups of different degrees according to psychosocial stress. The pregnancies, deliveries and the 497 live-born children in these families have been investigated with prospective methods. Data concerning the psychological development and psychiatric health of the child were attained by interviewing the mother and evaluating the child during visits to home (age 1 and 4). The physical health and development of the children has been followed by prospective data achieved from the child welfare centers. At one year of age 452 of the children (226 boys, 226 girls) and at four-five years of age 412 of the children (202 boys, 210 girls) were evaluated by the Griffith's Development Scales. Findings from these evaluations can now be related to a number of factors concerning the psychosocial situation, pediatric riskfactors etc. With the prospective, longitudinal methods used in this project interesting results concerning sex differences related to the mental development have been found. At one year of age girls had higher scores than boys on the Griffiths-subscale measuring hearing-and-speech abilities. At four years of age several significant differences between the sexes were found. Girls had more "even" Griffiths-profiles and scored higher than boys in several Griffiths-subscales. The greatest differences at four years of age were found concerning personal-social function and eye-hand-coordination. Boys seem to be specially vulnerable to the psychosocial situation in their homes as the Griffiths-results at four years of age are lower among boys from homes with psychosocial stress compared to other boys. It should be very interesting to follow and study what these sex differences mean concerning future development, the occurrence of psychopathology school difficulties.

Child Development↗

PubMed2003

The PedsQL in type 1 and type 2 diabetes: reliability and validity of the Pediatric Quality of Life Inventory Generic Core Scales and type 1 Diabetes Module.

OBJECTIVE: The Pediatric Quality of Life Inventory (PedsQL) is a modular instrument designed to measure health-related quality of life (HRQOL) in children and adolescents aged 2-18 years. The PedsQL 4.0 Generic Core Scales are child self-report and parent proxy-report scales developed as the generic core measure to be integrated with the PedsQL disease-specific modules. The PedsQL 3.0 Type 1 Diabetes Module was designed to measure diabetes-specific HRQOL. RESEARCH DESIGN AND METHODS: The PedsQL Generic Core Scales and Diabetes Module were administered to 300 pediatric patients with type 1 or type 2 diabetes and 308 parents. RESULTS: Internal consistency reliability for the PedsQL Generic Core Total Scale score (alpha = 0.88 child, 0.89 parent-report) and most Diabetes Module scales (average alpha = 0.71 child, 0.77 parent-report) was acceptable for group comparisons. The PedsQL 4.0 distinguished between healthy children and children with diabetes. The Diabetes Module demonstrated intercorrelations with dimensions of generic and diabetes-specific HRQOL. CONCLUSIONS: The results demonstrate the reliability and validity of the PedsQL in diabetes. The PedsQL may be used as an outcome measure for diabetes clinical trials and research.

Adolescent↗

PubMed1997

Static and dynamic balance responses in persons with bilateral knee osteoarthritis.

Research has documented decreased strength and proprioception in people with arthritis. Both are components of balance, but reliable studies documenting balance deficits have not been done. This study tested standing balance in an adult population with osteoarthritis. The osteoarthritic group (N = 11) and the age-matched control group (N = 10) were tested on the Balance System. Each underwent two trials of six testing conditions [two visual conditions (eyes open, eyes closed) under each of three platform conditions (stable, angular rotation, and linear translation)] and completed a functional assessment scale. Individuals with knee osteoarthritis demonstrated significantly more postural sway than the control group across conditions (p < 0.02). The functional assessment scale developed to discriminate between the two groups demonstrated internal consistency (Cronbach's coefficient alpha = 0.83), and scores were significantly different between the two groups (p < 0.0001). Results suggest the importance of balance training in this population. The functional assessment scale may be a useful tool to document functional levels in knee osteoarthritis.

Accidental Falls↗

PubMed1998

Development and psychometric properties of the Washington Primary Care Interest Inventory.

PURPOSE: To describe the development of the Washington Primary Care Interest Inventory (WPCII), which was designed to assess attitudes toward what constitutes appropriate psychosocial concerns for visiting a family physician, and to demonstrate the relationship between these attitudes and specialty selection in matriculating medical students. METHOD: Five entering classes of medical students (1990 to 1995, without 1992) at the University of Washington were administered the WPCII during orientation. Reliability, factor, and predictive validity analyses were performed to measure the utility of the WPCII. RESULTS: Factor analysis revealed three interpretable factors to underlie the WPCII: stressors, physical complaints, and familial complaints. Scales developed from these factors correlated with students' early career preferences and showed significant differences across students who were selected under different interviewing formats. Differences between the sexes were found for both specific items and scales. CONCLUSION: The WPCII is a reliable and valid measure of attitudes toward the appropriateness of family physicians' treating psychosocial complaints. These attitudes have implications for the selection of medical students, curriculum development, assessment, and health education research.

Career Choice↗

PubMed1978

A study of work behaviour in a psychiatric rehabilitation unit.

A rating scale developed by Griffiths (1973) was used to assess four separate areas of the work behaviour of patients in a psychiatric rehabilitation unit. Assessments were made at an early and a late stage of rehabilitation. The ability of ratings on this scale to predict resettlement was confirmed in a prospective study. The scale was also used to provide information about four separate areas of work behaviour. Social relationships provided the strongest predictor of resettlement in employment, response to supervision and enthusiasm predicted only in psychotic patients; task competence failed to predict. Changes in work behaviour during rehabilitation, and the relationships between self-reported attitudes and work behaviour were also examined.

Adult↗

PubMed1983

Ward atmosphere as a factor in irregular discharge from an alcohol rehabilitation unit.

A 20-bed alcohol rehabilitation unit with a high patient retention rate had the experience of a sudden increase in irregular discharges. Administration of the Ward Atmosphere Scale developed by Rudolph Moos showed a drop in various therapeutic aspects of the ward environment that paralleled the increase in irregular discharges. These results were discussed with staff, and soon after the number of irregular discharges diminished. The Ward Atmosphere Scale was readministered and showed a move toward a more therapeutic atmosphere. The reasons for these fluctuations are discussed.

Alcoholism↗

PubMed2006

Evaluating clinical competence of distant nurse practitioner students.

Developing and evaluating core clinical competencies of nurse practitioner students at distant clinical sites requires dialog among the student, the clinical preceptor and University faculty. Students enter our program with diverse backgrounds, experience and interests. Here we demonstrate an innovative online Clinical Development Scale (CDS) that gathers self assessment data from each student, analyzes, organizes and prioritizes competencies to be accomplished in a clinical practicum, produces midterm and final evaluation summaries from data contributed by both student and preceptor and displays action plans developed by students, for meeting deficient competencies for preceptor and faculty approval.

Clinical Competence↗

PubMed2001

Report from the second international meeting of the Attention Deficit Hyperactivity Disorder Molecular Genetics Network.

Given evidence from twin, family, and adoption studies of genetic influence on attention deficit hyperactivity disorder (ADHD), a growing number of researchers have initiated molecular genetics studies to explore the influence of specific genes on this condition. In 1999, these investigators convened to discuss ways of sharing information and facilitating collaborations across research sites. Enthusiastic response to this first conference prompted an even larger group of investigators to come together this year. This recent meeting, held in London, began with a presentation of Hypescheme, an operational criteria checklist developed in an effort to promote the reliable communication of diagnostic and other relevant clinical information related to ADHD. The benefits and limitations of Hypescheme, as well as the continued challenges to collaboration, were discussed. A new ADHD-specific rating scale, developed to be of use in genetic analyses, was also presented. Focus then turned to collaborative projects proposed by investigators and practical suggestions regarding joint data analyses projects. Finally, new data from individual sites were presented. Because the mode of inheritance of ADHD is likely to be complex, efforts to collaborate and cross-validate findings remain an important priority for researchers studying the molecular genetics of this disorder.

Attention Deficit Disorder with Hyperactivity↗

PubMed1991

Nutritional supplementation, psychosocial stimulation, and mental development of stunted children: the Jamaican Study.

There is little unequivocal evidence that nutritional supplementation of undernourished children has a beneficial effect on their mental development. The effects of nutritional supplementation, with or without psychosocial stimulation, of growth-retarded (stunted) children aged 9-24 months were assessed in a study in Kingston, Jamaica. 129 children from poor neighbourhoods were randomly assigned to four groups--control, supplemented only, stimulated only, and supplemented plus stimulated. A group of matched non-stunted children (n = 32) was also included. The supplement comprised 1 kg milk-based formula per week for 2 years, and the stimulation weekly play sessions at home with a community health aide. The children's development (DQ) was assessed on the Griffiths mental development scales. Initially the stunted groups' DQs were lower than those of the non-stunted group, and those of the control group declined during the study, increasing their deficit. Stimulation and supplementation had significant independent beneficial effects on the children's development. Estimates of the supplementation effect ranged from 2.2 (95% confidence limits-1.4, 5.7) for the hand and eye subscale to 12.4 (5.4, 19.5) for the locomotor subscale and those for the stimulation effect from 6.4 (2.8, 10.0) for hand and eye to 10.3 (3.3, 17.3) for locomotor. The treatment effects were additive, and combined interventions were significantly more effective than either alone. These findings suggest that poor mental development in stunted children is at least partly attributable to undernutrition.

Female↗