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PubMed1989

Development and validation of an instrument to measure patient satisfaction with pharmacy services.

A research program was undertaken to develop and validate a multidimensional measure of patient satisfaction with pharmacy services. A self-administered questionnaire consisting of 44 Likert-type attitudinal items was adapted from the Patient Satisfaction Questionnaire developed by Ware et al. In an iterative scale development process, the adapted questionnaire and its revisions were evaluated in three successive studies conducted on convenience samples (n = 30, 313, 489) of individuals in attendance at family practice clinics in a southwestern city. Methods used to construct multi-item scales measuring separate dimensions of service included principal components factor analysis and item analyses. Acquiescent response set (ARS), the tendency to agree with statements of opinion regardless of content, was measured by the method of matched pairs of items. A partial correlation matrix which controlled for ARS was used as the data in a principal components factor analysis in an effort to reduce the biasing effect of ARS on factor analytic outcomes. Dimensions of satisfaction identified were Explanation, Consideration, Technical Competence, Financial Aspects, Accessibility, Drug Efficacy, OTC (over-the-counter) Product Availability, and Quality of the Drug Product. Questionnaire revision is suggested to confirm the validity of the latter two dimensions Future research should examine the relationship between separate dimensions of satisfaction and other patient attitudes and behaviors, and the convergence between this instrument and other measures of patient satisfaction with pharmacy services.

Adolescent↗

PubMed1988

Identification, expression, and localization of beta keratin gene products during development of avian scutate scales.

Epidermal-dermal interactions influence morphogenesis and expression of the beta keratin gene family during development of scales in the embryonic chick. The underlying mechanisms by which these interactions control beta keratin expression are not understood. However, the present study of beta keratin gene expression during avian epidermal differentiation contributes new information with which to investigate the role of tissue interactions in this process. Using beta keratin-specific synthetic oligonucleotide probe, beta keratin mRNA was hybrid-selected from total poly A+ RNA of scutate scales. Seven beta keratin polypeptides were translated in vitro and could be identified by their positions in two-dimensional gels among the detergent-insoluble extracts of scutate scale epidermis. In vivo phosphorylation studies suggested that an additional three beta keratin polypeptides were present as phosphoproteins. The temporal appearance of beta keratin mRNA and the corresponding polypeptides was followed during scutate scale development. Polyclonal antiserum made against two of the beta keratin polypeptides was used for immunohistochemical and immunogold electron-microscopic analysis of beta keratin tissue distribution. Immunological reactivity was observed specifically along the outer scale surface in epidermal cells above the stratum germinativum. Immunogold beads were localized on 3-nm filament bundles. In situ hybridization with a beta keratin-specific RNA probe demonstrated that mRNA accumulated in the same regional manner as the polypeptides. This selective expression of beta keratin genes in specific regions of the developing scutate scale suggests that epidermal-dermal interactions provide not only for morphological events, but also for control of complex patterns of histogenesis and biochemical differentiation.

Animals↗

PubMed1987

Validity of self-report measures of girls' pubertal status.

To understand the meaning of somatic changes to the adolescent and their possible effects on behavior, developmentalists have begun to examine maturational timing and status in detail. Efforts have been hampered by the necessity of obtaining somatic growth data by physician examination. In the present study, 3 self-report methods for rating secondary sexual characteristic growth were compared to physician ratings; the accuracy of self-reported height and weight also was assessed. Specifically, 151 11-, 12-, and 13-year-old girls rated their breast and pubic hair development using schematics of the 5 Tanner stages and filled out the Pubertal Development Scale (PDS); their mothers also rated their daughters' development using the Tanner stage schematics. The correlation with physician Tanner ratings was .82 for self-ratings, .85 for ratings by the mother, and between .61 and .67 for self-reports on the PDS. The correlations for self- and actual reports of weight and height were .98 and .75, respectively. The usefulness of the PDS, Tanner ratings, and self-reported height and weight as adequate estimates of pubertal development is discussed.

Adolescent↗

PubMed1986

Lofexidine in alcohol withdrawal states.

Twenty-eight patients admitted to hospital for alcohol withdrawal were treated with lofexidine, an alpha adrenergic agonist of the imidazole type, in an open trial. Twenty-three patients completed the regime. Symptoms were measured on a scale developed for the study: the Alcohol Withdrawal Rating Scale (AWRS). Scores on this scale fell steeply over three days, more slowly over the subsequent four--the period of the trial. Results are compatible with the hypothesis that alcohol withdrawal states are characterised by increased adrenergic activity.

Attention↗

PubMed1991

Psychosocial and physiological correlates of male gender role stress among employed adults.

Previous research has identified male gender role stress (MGRS) as a construct that leads men, as a function of traditional socialization processes, to appraise certain situations in ways that produce psychosocial and physiological distress. Because the initial research was based on college undergraduates, the current study explored the relationship of MGRS to psychosocial and physiological risk factors for cardiovascular disease among employed adults. As predicted, men obtained significantly higher scores than women on a measure, the MGRS Scale, developed to assess this construct. Women with elevated MGRS Scale scores, however, experienced undesirable outcomes much the same as their male counterparts. Specifically, MGRS Scale scores were significantly associated with Type A behavior, hostility, personal loss, life dissatisfaction, and elevated systolic and diastolic blood pressure. The authors discuss possible environmental contributors to the development and maintenance of MGRS, including organizational factors associated with male-dominated work environments.

Adolescent↗

PubMed1992

Butorphanol tartrate (Stadol) relieves postanesthesia shaking more effectively than meperidine (Demerol) or morphine.

The cause of postanesthesia shaking (PS) is unknown. PS develops spontaneously and unpredictably in up to 67% of patients emerging from general anesthesia, and it continues for minutes to hours when not treated with medications or radiant heat lamps. The purposes of this study were to (1) examine whether butorphanol tartrate (Stadol; Anaquest, Madison, WI/Bristol-Meyers Squibb, Evansville, IN), meperidine (Demerol; Winthrop, NY, NY), and morphine are differentially effective in suppressing PS, (2) compare PS suppression by sex, and (3) determine time to PS development. PS, measured on a 0 to 3 visual scale, developed in 120 of 533 patients (23%). Medication treatment was initiated for 66 of 120 patients by PACU nurses following standard policies and procedures for intravenous doses of 1 mg butorphanol (n = 12), 15 to 30 mg meperidine (n = 18; n = 23), or 2 to 4 mg morphine (n = 13). Treatment effect was measured in units on a 0 to 2 visual scale. By t test, butorphanol is more effective within 2 minutes than meperidine for suppressing shaking alone (P less than .02) or shaking among patients also complaining of pain (P less than .02). Morphine does not relieve shaking. The chi 2 test indicates women suppress PS more rapidly than men (P less than .01), and PS develops within 5 minutes of PACU arrival (P less than .001). Findings suggest that butorphanol is an alternative PS treatment to meperidine, since it relieves shaking within 2 to 5 minutes without producing nausea, vomiting, or recurrence of shaking.

Adolescent↗

PubMed1992

The assessment of sexual function in cancer patients.

The sexual function of cancer patients may be compromised by their disease or treatment. This is infrequently assessed as an outcome variable and methodological differences between reported studies make comparison difficult. Where sexual function is being assessed as one dimension of a more comprehensive assessment of quality of life, a single item concerned with frequency of intercourse or satisfaction may be sufficient, but many studies require more detailed information. Methods developed for clinical assessment of sexual dysfunction are generally too long and detailed for this purpose. The best developed scales for cancer patients are embedded in lengthy and expensive questionnaires. A pool of items can be identified from which a scale could be derived to assess the relevant aspects of sexual experience. The development of an appropriate and psychometrically sound scale is now required to encourage greater consideration of the impact of disease and treatment on cancer patients' sexual function.

Adaptation, Psychological↗

PubMedDate not supplied

A self-report measure of violence risk, II.

A brief self-report scale designed to measure the risk of violence was developed. Scale scores were found to be significantly related to a history of violence, or violence as a reason for admission, in psychiatric inpatients. Internal reliability was found to be high. A group of psychiatric inpatients could be significantly discriminated from a normal group of individuals, both on total scale score as well as on each individual item. Sensitivity and specificity were also determined. The value of the scale is in its brevity, in its focus on overt behavior as well as feelings, and in the fact that it defines a profile of characteristics that have been found to be associated with violent behavior. It thus represents a useful tool for future research on human aggression.

Adult↗

PubMed1990

[A study on the relationships of discomfort, self-esteem, personality and life satisfaction in persons with rheumatoid arthritis].

The purpose of this study was to investigate the correlation of discomfort, self-esteem, personality and life-satisfaction in persons with rheumatoid arthritis and to provide basic data to help them attain a better quality of life. From Jan. 27 to Feb. 24, 1988, 53 patients, registered at a rheumatic clinic at one general hospital in Seoul, were accepted as subjects for this study. The instruments used for this study were a discomfort scale and life-satisfaction scale developed by the researcher, Rosenberg's Self-esteem Scale and Wallston and Wallston's Multidimensional Health Locus of Control (MEILC) Scale. The reliability of the scales were tested by Cronsbach's alpha. The collected data were analyzed by the SAS program using unpaired t-test, ANOVA, and Pearson's Correlation Coefficients. The results were as follows: 1. There was a significant difference in the subjects perceived discomfort level (t = -3.49, p = .0010) between the onset of the disease (14.87 +/- 9.02) and the present (19.87 +/- 8.44). 2. There was a significant correlation between the MHLC-internal score and the MHLC-chance score (r = -.4366, p = .0011). 3. The findings related to the demographic variables regarding the MHLC scores were as follows: 1) Regarding sex, there was a significant difference for the MHLC-internal score (t = 4.2572, df = 15.2, p = .0007) between male (32.13 +/- 2.47) and female (27.56 +/- 4.17). But the MHLC-chance score for male (15.13 +/- 2.85) was lower (t = 3.153 9, df = 21.8, p = .0047) than for female (19.47 +/- 6.29). 2) Regarding educational background, the MHLC-chance score for the below-high school group (20.52 +/- 5.81) was higher (t = 2.5450, df = 51.0, p = .0140) than the college graduate group (16.41 +/- 5.76). 4. The average Self-esteem score was 26.87 (S.D. = 5.29) and there was a significant correlation between the Self-esteem score and the MHLC-chance score (r = .3122, p = .0026). 5. It was found that the subjects' Discomfort score was correlated with the Self-esteem score (r = -.3788, p = .0051) and the Life-satisfaction score (r = -.3570, p = .0087). It was also found that subjects' Self-esteem score was correlated with the Life-satisfaction score (r = .4474, p = .0008).

Arthritis, Rheumatoid↗

PubMed1992

Clinical and laboratory measures of postural balance in an elderly population.

The objective of this cross-sectional study was to compare scores on the Balance Scale with laboratory measures of postural sway and other clinical measures of balance and mobility. Thirty-one elderly subjects were assessed on the clinical measures and the laboratory tests of postural sway while standing still and in response to pseudorandom movements of the platform. The average correlation between the Balance Scale and the spontaneous sway measures was -.55. It was slightly lower (r = -.38) for the same parameters measured during the pseudorandom tests. There were high correlations between the Balance Scale and the Balance Sub-Scale developed by Tinetti (r = .91), Barthel Mobility sub-scale (r = .67), and timed "Up and Go" (r = -.76). The Balance Scale was the most efficient measure (effect size > 1) to statistically discriminate between subjects according to their use of each type of mobility aide (walker, cane, no aids). These data contribute to existing information on the performance of the Balance Scale and supports the validity of the Balance Scale in this geriatric population.

Activities of Daily Living↗

PubMed1977

Correlation between plasma chlorpromazine and its metabolites and clinical ratings in patients with acute relapse of schizophrenic and paranoid psychosis.

Nine patients diagnosed as having acute schizophrenic psychosis were treated with chlorpromazine. Their clinical response to drug treatment was measured by the use of a clinical rating scale developed from the Present State Examination, and a nurses rating scale. Plasma levels of chlorpromazine (CPZ), 7-hydroxychlorpromazine (7OHCPZ), monodesmethylchlorpromazine (NOR1CPZ) and chlorpromazine sulphoxide (SOCPZ), were monitored during the period of hospital treatment. Correlations were made between the increase in plasma levels of drug or metabolites and improvement in the different PSE scores. These showed that the most significant correlations occurred when symptoms with high diagnostic significance for schizophrenia (Group 1) and symptoms rating perceptual disorders (P) were correlated with plasma 7OHCPZ levels in plasma samples taken before the first morning dose of CPZ. The ration of 7OHCPZ to CPZ in these samples increased significantly as clinical ratings improved, this correlation being most highly significant against the Group 1 and P scores. The ratio of 7OHPCZ to SOCPZ increased significantly only in the case of Group 1 and P scores. This indicates a preferential shift of CPZ metabolism towards the formation of the active 7OHCPZ during the period of clinical improvement.

Acute Disease↗

PubMed1989

[A study on factors related to daily activities of post myocardial infarction patients].

The purpose of this study was to identify factors related to daily activities of post myocardial infarction patients. Data were collected from Aug. 1 to Aug. 31, 1988 through an interview schedule lasting for about 30-60 minutes by the investigators. Tools for this study were a daily activities scale and a subjective physical symptom scale developed by the researchers, and Zung's self rating depression scale. The subjects were 45 men 18 women post myocardial infarction patients who were receiving follow up care at SNU Hospital. The data were analyzed by percentage, mean, t-test, ANOVA, the Pearson moment Correlation Coefficient test, and Cronbach's a reliability test. The results were as follows. 1. Reliability of the daily activities scale was 0.91 by Cronbach's a. In the daily activities scale, items about transfer, exercise, and job related activities were most highly rated as meaningful to the post myocardial infarction patients. 2. The average daily activities score of these patients was 3.30 (maximum point:4) all scores were high except for exercise and job related activities. 3. There was a significant difference in daily activities according to sex; men had a higher daily activities score than women (T=2.32, P less than 0.05). 4. There was a significant difference in daily activities according to job status. Subjects having a job had a higher daily activities score. 5. The lower the depression score, the higher the daily activities score (gamma=-0.5748, P less than 0.05). 6. The lower the subjective physical symptoms score, the higher the daily activities score (gamma=-0.6015, P less than 0.05).

Activities of Daily Living↗

PubMed1977

Assessing depressive symptoms in five psychiatric populations: a validation study.

Data from five psychiatric populations and a community sample are presented on the CES-D, 20-item self-report depression symptom scale developed by the Center for Epidemiologic Studies. Results show that the scale is a sensitive tool for detecting depressive symptoms and change in symptoms over time in psychiatric populations, and that it agrees quite well with more lengthy self-report scales used in clinical studies and with clinician interview ratings. Although a symptom scale cannot differentiate between diagnositc groups, the CES-D has demonstrated its validity as a screening tool for detecting depressive symptoms in psychiatric populations.

Adolescent↗

PubMed1988

Patient satisfaction with primary medical care. Evaluation of sociodemographic and predispositional factors.

As patient satisfaction has been demonstrated to influence certain health-related behaviors (e.g., compliance with medical regimens and use of medical services), research has attempted to identify its key determinants. Although the influence of patient characteristics often has been studied, attention has been focused on sociodemographic characteristics (e.g., age and sex) rather than attitudinal or situational factors (e.g., confidence in the medical care system and feelings of internal control) that may predispose one toward satisfaction with care received. Data to test the relative importance of these types of determinants were collected in a general household survey of 400 persons. The patient satisfaction scale developed and tested by Roghmann and his colleagues using nonmetric multidimensional scaling was used. Multiple regression analysis was performed on the data. Results show that certain predispositional factors (confidence in the community's medical care system, having a regular source of care, and being satisfied with life in general) are more important predictors of patient satisfaction than patient's age, sex, race, educational attainment, or income.

Consumer Behavior↗

PubMed1988

Predicting repetition of deliberate self-harm: a review of the literature in the light of a current study.

Three hundred and sixty-five patients exhibiting deliberate self-harm (DSH) were rated for DSH repetition on the six-item predictive scale of Buglass & Horton and on a five-point predictive scale developed from a previous study by the author. The Buglass & Horton scale was more sensitive and more specific overall and for female patients, but the five-point scale predicted better for males, especially those aged under 35. The results are discussed in relation to previous work on the prediction of DSH repetition.

Adult↗

PubMed1986

Change in adaptive behaviour of severely and profoundly mentally handicapped adults in different residential settings.

A demographic sample of 28 severely and profoundly mentally handicapped adults with a mental age of four years and below were assessed on Part 1 of the Adaptive Behavior Scale (ABS) at three points 18 months apart. The Griffiths Mental Development Scales and Reynell Developmental Language Scales were also conducted at the first and last assessment points. The subjects were resident in either a small community-based home, the parental home or other residential institutions. The small-home group showed the greatest adaptive behaviour change particularly in the areas of independent functioning, domestic skills and self-direction and on the scale total. Although reservations are expressed on the accuracy of assessment, the ABS data and the comparative result received some validation from the mental age and language assessments. Gains were independent of subject characteristics. The study adds to the literature showing adaptive behaviour gains arising from transfer from institutional to more normal residential environments. However, in attributing the results found to the general characteristics of the residential settings, the explicit programming emphasis of the small-home service should not be overlooked.

Adolescent↗

PubMed1980

Alprazolam, a new type anxiolytic in neurotic patients. A pilot study.

Alprazolam is a new type triazolobenzodiazepine anxiolytic agent. 115 neurotic patients were treated with alprazolam for 4 weeks in an open label study. The daily dose of alprazolam ranged from 0.4 to 3.2 mg (average: 1.4 mg). 73% of the subjects experienced a slight to remarkable improvement. A particularly high improvement rate was observed in patients with initially severe sleep disturbances. No serious side effects were noted. Comparative characteristics of neurotic patients with insomnia (insomnia neurotic patients) were investigated and the validity of the PNRS-D (Psychoneurotic Rating Scale developed by the authors) in comparison with the Hamilton Anxiety Rating Scale is discussed.

Adult↗

PubMed1989

A new approach to the measurement of cognitive deficits in dementia.

Although scales developed for use with the general population and those developed for use with patients with dementia provide important assessment tools, there are certain questions that might best be answered by cognitive scales that span the range of difficulty from that of the healthy older adult through that of the patient with mild to moderate dementia. To address this need, six cognitive scales are being constructed by using data from both healthy older adult and probable Alzheimer populations in item development and analysis. It is anticipated that these scales will be useful in addressing questions about patterns of deficits in dementias of different etiologies, progression or improvement of function in demented patients, and relationships between cognition and other variables in cognitively impaired patients.

Aged↗