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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↗

PubMedDate not supplied

Stress identification and coping patterns in patients on hemodialysis.

The types and severity of stressors and methods of coping with stress were assessed for 35 patients on hemodialysis. Coping was measured with a tested scale and stress was evaluated with a scale developed for the study. Test-retest reliability of the stressor scale was satisfactory (rs = .71). Results indicated that stressors experienced by the hemodialysis patient can be measured with an objective tool; psychosocial stressors have an impact equal to that of physiological stressors. Fluid restriction was ranked as the highest psychosocial stressor and the top physiological stressors were muscle cramps and fatigue. Patients on dialysis for one to three years indicated the greatest amount of stress. Patients used problem-oriented coping methods significantly more than affective-oriented methods (t [34] = 7.06), p greater than .001). Optimism and controlling the situation were the two most common coping methods, and putting the problem out of one's mind and blaming someone else were the least important coping tools.

Adaptation, Psychological↗

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↗

PubMed1980

Hospital sisters: work attitudes, perceptions and wastage.

This study attempts to describe the attitudes and perceptions that hospital sisters have towards their work and the relationship, if any, of these attitudes and perceptions to absence, leaving intent and wastage. The theoretical approach adopted was based on the Minnesota Theory of Work Adjustment and the role stress theory originally developed at the University of Michigan, and the measures used included rating scales developed in these centres. The results indicated that most of the sisters were, in general, satisfied with their jobs, although a substantial minority were dissatisfied with and experienced role conflict and ambiguity from certain features of their working environment. Comparison of the leavers with the stayers revealed no difference between the groups on intrinsic satisfaction, absence and role ambiguity, but the leavers were less satisfied with extrinsic features of the job, and experienced more tension and role conflict than the stayers. The fairly strong 'mobility culture' reported by other research was supported and it was tentatively concluded that after a year or two, the job fails to provide the sister with sufficient challenge, and her propensity is to leave for more stimulating work. The implications of this conclusion are discussed.

Attitude of Health Personnel↗

PubMed1990

Impact of the Medicare fee schedule on payments to physicians.

Beginning in 1992, the Medicare program will pay physicians by the Medicare Fee Schedule, a system of geographically adjusted standardized payment rates based in part on the Resource-Based Relative Value Scale developed by Hsaio et al and in part on current Medicare payments. In our simulations of the Medicare Fee Schedule, we find that (1) redistributions of Medicare-allowed charges across specialities will be substantial but approximately only half the size projected by Hsaio, (2) there will be large redistributions among geographic areas that tend to compound the specialty redistributions, and (3) there will be wide variation within specialties as to how individual providers are affected. The majority of the redistributive impact of the Medicare Fee Schedule is attributable to implementation of a geographically adjusted system of standardized payments rather than to the particular work values developed by Hsiao et al in the Resource-Based Relative Value Scale.

Costs and Cost Analysis↗

PubMed1989

Development of an inexpensive and rapid two site microenzyme linked immunosorbent assay kit for human alpha fetoprotein.

Laboratory scale development of a two site micro enzyme linked immuno assay kit is described. The kit comprises rabbit anti human alphafetoprotein (AFP), anti human AFP IgG peroxidase conjugate and standard AFP. All the above reagents were prepared in the laboratory. The kit is eminently suitable for early screening of blood sample of pregnant women for neural tube defects of their fetuses and for the quantitation of AFP as a tumor marker. The assay kit was used to determine AFP in 76 sera from women at different stages of pregnancy. During 1st trimester AFP level was 18 to 119 ng/ml, during 2nd trimester the concentration varied from 85 to 302 ng/ml and during 3rd from 103 to 580 ng/ml. No evidence for maternal antibody to AFP was found. The above data agree with AFP level in pregnant women reported by earlier workers, using RIA or ELISA. The present ELISA kit would hopefully be much cheaper than internationally available ELISA kits for human AFP.

Enzyme-Linked Immunosorbent Assay↗

PubMed1990

Developmental delay in congenital myotonic dystrophy after neonatal intensive care.

Six infants with congenital myotonic dystrophy survived after neonatal intensive care. In later childhood they were assessed by the Griffiths Mental Development Scales: five children were functioning in the mildly handicapped to borderline range of development (DQ 64.0 to 79.0) and the remaining child was severely delayed in development (DQ 33.0). The five children with higher DQ values had a history of ventilatory support of 30 days or less after birth. By contrast, the remaining child with the lowest DQ value had been ventilated for 43 days. This study provides further evidence that prolonged ventilation after birth has prognostic significance in identifying severely affected cases with congenital myotonic dystrophy.

Child, Preschool↗

PubMed1990

[A study of factors influencing the state of adaptation of hemiplegic patients].

The purposes of this study are to delineate a profile of the state of a stroke patient's adaptation at 3 months after hospitalization and to explore the relationship between the level of adaptation and the variables which influence the adaptation of hemiplegic patients. To these ends, theoretical framework was derived basically from the stress adaptation model. The basic assumption underlying the level of adaptation is influenced by the presenting focal, contextual and residual stimuli. This group of stimuli is further operationalized and represented by a perception of stress, which is the perceived effect of the disability and by the mediating variables such as sociodemographic factors as an external conditioning variables and perceived social support and hardiness personality characteristics as an internal intervening variables. The dependent variables in this study is the level of physical, psychological and social adaptation and is hypothesized to be a function of the interaction between 3 sets of variables namely, the perceived disability effect, external conditioning variables and internal intervening variables. A total of fourty three subjects from 3 general hospitals in Seoul were observed and interviewed with the aid of 7 structured instruments. The data were collected twice on each subject: first, at the pre-discharge period and at 3 months post-discharge from hospital for the second time. The study was carried out for the period from February to August, 1988. The instruments used for the study include 4 existing scales and 3 scales developed by the researcher for this study. They are: 1) The ADL dependency scale and the scale of the clinical physical functions for the assessment of physical adaptation. 2) the SDS (self report of depression) to measure the level of psychological adaptation. 3) The scale for the amount of social activities for the measurement of the level of social adaptation. 4) The scale for the perceived effect of disability for the measurement of the focal stimuli. 5) The health related hardiness scale and the perceived interpersonal support self evaluation list (ISEL) for the measurement of the hardiness personality character and the perceived social support. The data obtained were analyzed using percentage, one way ANOVA, Pearson coefficients correlation and stepwise multiple regression. The findings provide valuable information about the present level of physical adaptation at 3 months after discharge. The patient revealed a decreased ADL dependency and lowered limitation of physical function as compared with pre-discharge state. Psychologically, the average degree of depression at follow up was within normal range of depression.(ABSTRACT TRUNCATED AT 400 WORDS)

Activities of Daily Living↗

PubMed1978

A diagnostic interview: the schedule for affective disorders and schizophrenia.

The Schedule for Affective Disorders and Schizophrenia (SADS) was developed to reduce information variance in both the descriptive and diagnostic evaluation of a subject. The SADS is unique among rating scales in that it provides for (1) a detailed description of the features of the current episodes of illness when they were at their most severe; (2) a description of the level of severity of manifestations of major dimensions of psychopathology during the week preceding the evaluation, which can then be used as a measure of change; (3) a progression of questions and criteria, which provides information for making diagnoses; and (4) a detailed description of past psychopathology and functioning relevant to an evaluation of diagnosis, prognosis, and overall severity of disturbance. This article reports on initial scale development and reliability studies of the items and the scale scores.

Bipolar Disorder↗

PubMed1988

Early parental loss and development of adult psychopathology.

We assessed the effect of parental loss during childhood on the development of psychopathology in 90 adults. The subjects with a history of adult psychopathology (PATH group), in comparison with subjects with no history of a psychiatric disorder (NO PATH group), had poorer quality of childhood home life and personal adaptation subsequent to parental loss as assessed by the Home Life and Personal Adaptation (HAPA) scale developed by us. Total HAPA scale scores were the single most powerful predictor of adult psychopathology, accounting for correct prediction of adult psychopathology in 80% (72/90) of the subjects. The PATH subjects had significantly increased plasma levels of cortisol and beta-endorphin immunoreactivity. Moreover, cortisol and adrenocorticotropic hormone levels significantly correlated with total HAPA scores. First-degree family history of psychiatric disorders, age at loss, and parental vs maternal loss were not significantly different between PATH and NO PATH subjects. We conclude that the quality of home life subsequent to early parental loss is critically related to the development of adult psychopathology. The hypothesis that early trauma results in enduring neuroendocrine alterations in hypothalamic-pituitary-adrenal axis function is examined.

Adaptation, Psychological↗

PubMedDate not supplied

The PRQ--a social support measure.

The Personal Resource Questionnaire (PRQ) is a two-part measure of the multidimensional characteristics of social support. Part one provides descriptive information about the person's resources, the satisfaction with these resources, and whether or not there is a confidant. Part two contains a 25-item Likert scale developed according to Weiss's relational dimensions and a five-item Self-Help Ideology scale. The PRQ was administered as the measure of one of the independent variables in a study of 149 male or female spouses of individuals with multiple sclerosis. Content and face validity procedures were completed previous to the study. An internal consistency reliability coefficient of alpha = .89 was obtained for the PRQ Part 2. Moderate intercorrelations for the dimensional subscales--intimacy, social integration, worth, and assistance--indicate that there is some overlap of these dimensions. Low intercorrelations between nurturance and the other four subscales suggest that nurturance is an independent scale. Modest predictive validity coefficients were obtained. At the present time the intended use of the PRQ is for research. Plans for tool development include obtaining further construct validity information and test-retest reliability.

Adult↗

PubMed1990

[Development of a scale to measure the self concept of cesarean section mothers].

Recently, the rate of cesarean section in Korea has been increasing. The results of several previous studies in foreign countries on the emotional responses of cesarean section mothers showed that they might experience difficulties in the mother-infant interaction due to fatigue, lack of early mother-infant interaction, disappointments, anger, feelings of loss of control, and other factors. Human behavior is said to be determined by one's self concept, and self concept is influenced by both internal and external environmental factors. A scale to measure the self concept of cesarean section mothers was needed in order to identify those who might have difficulties in the mother-infant interactions in future. The purposes of this study were to develop a measuring scale, and to test its reliability and validity. The process of this study was as follows. A structured interview was done with 50 cesarean section and vaginal delivery mothers to find their state of emotional reaction after giving birth to their babies. Based on the results of the interviews, a 50 items Likert scale was developed. The self concept of 268 cesarean section and vaginal delivery mothers who were hospitalized at six hospital in seoul were measured, during the period between Feb. 1 and April 30. Reviewing the discriminating power of each item by means of crosstabulation, ten items were selected for the final scale. The reliability and validity of this ten item scale were tested by Cronbach's alpha and t-test, using spss pc + package. The results of this study and recommendation are as follows. 1. The ten selected items were as follows. I feel pains in my breast. (-) I have a good appetite now. (+) I feel pains in my flank. (-) I feel fine now. (+) My body seems to have returned to its prepregnant state. (+) Thinking of the delivery process, I feel sorry. (-) I want to hold my baby in my arms. (+) I want to keep my own life, even if I became a mother. (-) I want to delegate the care of the baby to my mother/mother in law. (-) I think baby is my alter ege. (+) 2. The reliability of this scale was tested by Cronbach's alpha, and the coefficient of this scale was .8066. 3. The construct validity of this scale was tested by means of known group methods. The value of self concept for cesarean section mother was significantly lower than for vaginal delivery mothers (t = -5.51, df = 266, p = 0.007).(ABSTRACT TRUNCATED AT 400 WORDS)

Cesarean Section↗

PubMed1989

Validities of the Physical Estimation Scale in predicting running times.

Two studies were conducted with the purpose of examining the validity of the 12-item Physical Estimation Scale, developed by Safrit and Wood (1985), as a predictor of running performance. Physical Estimation Scale scores were not significantly related to running time at the 5-mi. distance but were significantly correlated with predicted and actual marathon finishing times.

Adult↗

PubMed1988

The experience and meta-experience of mood.

Mood experience is comprised of at least two elements: the direct experience of the mood and a meta-level of experience that consists of thoughts and feelings about the mood. In Study 1, a two-dimensional structure for the direct experience of mood (Watson & Tellegen, 1985) was tested for its fit to the responses of 1,572 subjects who each completed one of three different mood scales, including a brief scale developed to assist future research. The Watson and Tellegen structure was supported across all three scales. In Study 2, meta-mood experience was conceptualized as the product of a mood regulatory process that monitors, evaluates, and at times changes mood. A scale to measure meta-mood experience was administered to 160 participants along with the brief mood scale. People's levels on the meta-mood dimensions were found to differ across moods. Meta-mood experiences may also constitute an important part of the phenomenology of the personal experience of mood.

Adult↗

PubMed1992

[Development of a scale for workers' coping behavior: its reliability and validity].

The purpose of this study is to develop a scale for measuring coping with job stressors. Stress process and coping function provide the theoretical framework. Coping is conceptualized as situation-specific behavior. We measure episodic coping, that is, the strategies that individuals actually use in coping with a particular situation. First, a preliminary scale, was prepared. It contained 39 coping behaviors with job stressor which were based on an open-ended pilot study. Next, factor analysis was conducted in order to identify the structure of the scale. Subjects of this study were 649 male employees and 91 female employees of a in manufacturing firm and research and development institute. By occupation they were comprised of 383 professionals, 99 technicians, 96 clerks, 104 miscellaneous workers and 58 of unknown occupation. Seven items in the preliminary scale were omitted because of their psychometrical properties. Finally, factor analysis showed three factors in the scale: positive action and cognition (11 items), avoidant action and cognition (10 items), and symptom management (11 items). The coping scale showed high conceptual validity and reliability.

Adaptation, Psychological↗

PubMed1986

A cross sectional study of somatic complaints of Nigerian females using the Enugu Somatization Scale.

Among Nigerian mentally ill a constant male-female ratio of 2:1, over-representation of single males and married females and the tendency for the females who seek psychiatric aid to be psychotic with schizoaffective disturbances have been observed. The question arose as to why this is so. To answer this, the Enugu Somatization Scale, developed in an effort to avoid the difficulty encountered in using Western diagnostic illness categories and scales for assessing mental illness in Nigeria was administered to 51 mentally ill females, 60 adolescent secondary school girls, 67 post secondary school females, 149 pregnant females, and 60 women who were once able to bear children but now no longer can. It was found that somatization is used by Nigerian females to contain their stress. The pregnant females scored lowest while those women who can no longer deliver scored highest. Pregnancy is seen as a state of rest from societal stress for the females, who otherwise are not allowed by the society to be so mentally ill as to seek a psychiatrist and who have to be psychotic to be able to do so. Various tentative, dynamic explanations of the items in the scale answered in the affirmative by a wide cross section of the women, based on the clinical experience of the author, are offered.

Adaptation, Psychological↗

PubMed1976

Factor analysis and multivariate scaling of anthropometric variables for the assessment of body composition.

This study was designed to identify the body composition factors measured by skinfold fat (S), girth (G), and diameter (D) variables and to provide multivariate scaling models that measure fat (F) and lean body weight (LBW) factors. A total of 7S, 11G, and 7D measurements were determined on 83 young women (YW) and 95 young men (YM). Body density (BD) was determined by the hydrostatic technique. All variables were factor analyzed, and F and LBW were used to validate isolated factors. The YM data showed one F factor and two LBW factors. LBW factor I measured muscle mass and bone structure; LBW factor II, bone D. The YW data isolated four factors: the same three of YM plus a second F factor specific to the pelvic girdle. Factor score models were used to develop scaling strategies to measure F and LBW factors. Full models of all 27 variables and restricted models of 14 S, G, and D variables were developed; the correlations between factor scores scaled from the full and restricted models ranged from 0.84 to 0.98. The multiple correlation between factor scores calculated from the restricted models and laboratory-determined F and LBW ranged from 0.90 to 0.94 for YM and from 0.88 to 0.89 for YW. The multivariate scaling models provide a valid field method of measuring body composition.

Adolescent↗