Distance to first symptoms measured by the 6-min walking test differentiates between treatment success and failure in patients with degenerative lumbar disorders

Purpose The smartphone-based 6-min walking test (6WT) is an established digital outcome measure in patients undergoing surgery for degenerative lumbar disorders (DLD). In addition to the 6WTs primary outcome measure, the 6-min walking distance (6WD), the patient’s distance to first symptoms (DTFS) and time to first symptoms (TTFS) can be recorded. This is the first study to analyse the psychometric properties of the DTFS and TTFS. Methods Forty-nine consecutive patients (55 ± 15.8 years) completed the 6WT pre- and 6 weeks (W6) postoperative. DTFS and TTFS were assessed for reliability and content validity using disease-specific patient-reported outcome measures. The Zurich Claudication Questionnaire patient satisfaction subscale was used as external criterion for treatment success. Internal and external responsiveness for both measures at W6 was evaluated. Results There was a significant improvement in DTFS and TTFS from baseline to W6 (p < 0.001). Both measures demonstrated a good test–retest reliability (β = 0.86, 95% CI 0.81–0.90 and β = 0.83, 95% CI 0.76–0.87, both p < 0.001). The DTFS exceeded the 6WD capability to differentiate between satisfied (82%) and unsatisfied patients (18%) with an AUC of 0.75 (95% CI 0.53–0.98) vs. 0.70 (95% CI 0.52–0.90). The TTFS did not demonstrate meaningful discriminative abilities. Conclusion Change in DTFS can differentiate between satisfied and unsatisfied patients after spine surgery. Digital outcome measures on the 6WT metric provide spine surgeons and researchers with a mean to assess their patient’s functional disability and response to surgical treatment in DLD.

Examining minimal important change of the Canadian Occupational Performance Measure for subacute rehabilitation hospital inpatients

Background The Canadian Occupational Performance Measure (COPM) is an individualized patient-reported outcome designed to evaluate the self-perceptions of a patient’s occupational performance. Our study aimed to examine the minimal important change (MIC) in inpatients undergoing subacute rehabilitation. The MIC values were calculated using the three different anchor-based analyses with the transition index as an external criterion; the mean change method (MICMeanChange), the receiver operating characteristic (MICROC) analysis, and the predictive modeling method adjusted for the proportion of improved patients (MICadjust). In this study, the MICadjust value was considered as the most valid statistical method. We recruited 100 inpatients with various health conditions from subacute rehabilitation hospitals. Data were collected twice: an initial assessment and a reassessment one month later. The systematic interview format (Five Ws and How) was used for both the initial and second assessments to prevent information bias (response shift). Results Three patients who indicated deterioration on the transition index were excluded from all analyses, and 97 patients were analyzed in this study. The MICadjust values were 2.20 points (95% confidence interval 1.80–2.59) for the COPM performance score and 2.06 points (95% confidence interval 1.73–2.39) for the COPM satisfaction score. The MICMeanChange and MICROC values were considered less reasonable to interpret because the proportions of the improved patients subgroup were more than 50% (82.5%). Conclusions The MICadjust value estimates from this study can help detect whether the patients’ perceived occupational performance improved or did not change. The results support the multidisciplinary use of COPM in clinical practice and research on subacute rehabilitation inpatients.

ELICITED IMITATION AS A MEASURE OF L2 PROFICIENCY

Elicited imitation (EI), a short-cut measure of global proficiency in second language (L2) research, requires participants to listen to sentences and repeat them as closely as possible. To support instrument sharing and assessment of L2 proficiency for longitudinal and crosslinguistic research, we created a parallel form of an EI task (EIT) for L2 English originally developed by the third author and colleagues and investigated the reliability and validity of the original and new forms. Eighty-two participants completed the two EITs, an oral narrative task, and a self-diagnostic survey. Both forms exhibited high reliability and good alignment with external criterion measures. Both distinguished well among four proficiency levels in the sample. Further, participants’ perception of EI difficulty aligned well with their EI scores. We suggest some improvements to boost forms equivalence and discuss new insights about the nature of EI as reconstructive, integrative, modality independent, and with indirect links to communicative abilities. Our study seeks to make this English EIT instrument widely useful to the L2 research community.

Development and Validity of the Nurse Presenteeism Questionnaire

This study aimed to develop and test the reliability and validity of a multi-item nurses’ presenteeism behaviour questionnaire. Study 1 administered the Nurse Presenteeism Questionnaire (NPQ) to 250 Chinese nurses. Study 2, surveyed 650 nurses with the NPQ, the Sickness Presenteeism Questionnaire, the Stanford Presenteeism Scale, the General Health Questionnaire, and the Emotional Exhaustion Scale using convenience sampling. After item analysis, the subjects were randomly divided into two groups to verify the questionnaire structure. Study 1 revealed the nurses’ core symptoms when they go to work with illness, and the NPQ with 11 items was developed. Study 2’s item analysis revealed that 11 NPQ items had good discrimination (t = 22.67∼36.11, p &lt; 0.01) and high homogeneity. Besides, the scale had good reliability (Cronbach’s = 0.93) and external criterion validity (r = 0.24∼0.84, p &lt; 0.01). Thus, the NPQ can be used to measure presenteeism behaviour in nursing.

Comparison of Two Rating Scales With the Orofacial Esthetic Scale and Practical Recommendations for Its Application.

PurposeWe compared measurement properties of 5-point and 11-point response formats for Orofacial Esthetic Scale (OES) items to determine whether collapsing the format would degrade OES score precision.MethodsData were collected from a consecutive sample of adult dental patients from HealthPartners dental clinics in Minnesota (N=2,078). We fitted an Item Response Theory (IRT) model to the 11-point scale and six, derived 5-point scales. We compared all response formats using test (or scale) information, correlation between the IRT scores, Cronbach’s alpha estimates for each scaling format, correlations based on the observed scores for the seven OES items and the eighth global item, and the relationship of observed and IRT scores to an external criterion using orofacial appearance (OA) indicators from the Oral Health Impact Profile (OHIP).ResultsThe correlations among scores based on the different response formats were uniformly high for observed (0.97-0.99) and IRT scores (0.96-0.99); as were correlations of both observed and IRT scores and the OHIP measure of OA (0.65-0.69). Cronbach’s alpha based on any of the 5-point formats (α = 0.95) was nearly the same as that based on the 11-point format (α = 0.96). The weighted total information area for five of six, 5-point derived formats was 98% of that for the 11-point scale ConclusionsOur results support the use of scores based on a 5-point response format for OES items. The measurement properties of scores based on a 5-point response format are comparable to those of scores based on the 11-point format.

Psychometric Evaluation of a Big Five Personality State Scale for Intensive Longitudinal Studies

Despite enthusiasm for using intensive longitudinal designs to measure day-to-day manifestations of personality underlying differences between people, the validity of personality state scales has yet to be established. In this study, we evaluated the psychometrics of 20-item and 10-item daily, Big Five personality state scales in three independent samples ( N = 1,041). We used multilevel models to separately examine the validity of the scales for assessing personality variation at the between- and within-person levels. Results showed that a five-factor structure at both levels fits the data well, the scales had good convergent and discriminative associations with external variables, and personality states captured similar nomological nets as established global, self-report personality inventories. Limitations of the scales were identified (e.g., low reliability, low correlations with external criterion) that point to a need for more, systematic psychometric work. Our findings provide initial support for the use of personality state scales in intensive longitudinal designs to study between-person traits, within-person processes, and their interrelationship.

Psychometric Properties and Factor Structure of the Personality Inventory for DSM-5–Brief Form (PID-5-BF) in Iranian Student and Clinical Samples

Background The Personality Inventory for DSM–5, Brief Form (PID-5-BF) was developed to assess the DSM-5's alternative trait model for diagnosing personality disorders. Psychometric properties of PID-5-BF have been verified in some Western countries, but to our knowledge, no study has examined the psychometrics of PID-5-BF in Iranian settings. This is the first study designed to examine the factor structure, internal consistency, and convergent/discriminate validity of the Persian PID-5-BF with student and clinical samples in Iran. Methods 378 university students (n = 378; M-age = 16.35; 55.6 % females) and 150 clinical patients (n = 150; M-age = 43.81; 58.7 % men) completed the Persian version of the PID-5-BF and NEO-FFI. Confirmatory factor analyses (CFAs) were performed to examine the five-factor model of PID-5-BF. Also, internal consistency and external validity of PID-5-BF were calculated. Results Confirmatory factor analysis supported the proposed five-factor model of PID-5-BF in both groups. The Chronbach's alpha coefficient ranged from .57 (Disinhibition) to .65 (Psychoticism) for the student sample and from .48 (Antagonism) to .67 (Detachment) for the clinical sample, while when relying on the MIC values, the PID-5-BF subscales indicated acceptable internal consistency in both groups. PID-BF-5 significantly differentiated the clinical sample from the student sample (p < .001), indicating the measure's adequate discriminate validity. Additionally, PID-5-BF subscales yielded hypothesized association with the external criterion variable in only the student sample. Conclusion Our results support the use of the PID-5-BF as a screening measure of dimensional maladaptive personality traits in Iranian samples. However, future studies are needed to examine the convergent validity of PID-5-BF in Iranian clinical samples with suitable external criterion measures.

Concurrent validity of the short version of Montreal Cognitive Assessment (MoCA) for patients with stroke

The aim of the present study was to examine the concurrent validity of 2 Chinese versions of the short version of the Montreal Cognitive Assessment (MoCA) in patients with stroke, i.e., MoCA 5-minute protocol and National Institute for Neurological Disorders and Stroke and Canadian Stroke Network (NINDS-CSN) 5-minute Protocol. A total of 54 patients and 27 healthy controls were enrolled in this study. In this study, the Neurobehavioural Cognitive Status Examination (NCSE) was used as an external criterion of cognitive impairment. We found that the 5-min protocol did not differ from the MoCA in differentiating patients with cognitive impairments from those without (area under the receiver operating characteristic curve, AUC, of 0.948 for the MoCA 5-min protocol v.s. 0.984 for MoCA, P = 0.097). These three assessments demonstrated equal performance in differentiating patients with stroke from controls. The Chinese version of the MoCA 5-min protocol can be used as a valid screening for patients with stroke.

Responsiveness and Minimal Clinically Important Difference of the Five Times Sit-to-Stand Test in Patients with Stroke

This study aimed to analyze the responsiveness of the 5STS test among stroke patients and to estimate the MCIDs (minimal clinically important differences) for different severity levels of community ambulation and stages of recovery. The 5STS and comparator instruments (gait speed and Functional Ambulatory Category (FAC)) were evaluated at baseline. These measures were repeated at 4 (Stage 1) and 8 weeks (Stage 2), together with the Global Rating of Change (GROC). The MCIDs were calculated with two anchor-based methods using the GROC as the external criterion. Responsiveness to change for the 5STS was estimated analyzing the correlation with changes in the two comparator instruments and their capacity to discriminate improvement. For the 5STS test, while the MCIDs of the limited community ambulators were similar in the two stages (around 3 s), those of the household ambulators decreased from 1.9 s to 0.72 s. Spearman’s rho coefficients showed an acceptable correlation between changes in 5STS and changes for both the FAC and gait speed changes in both stages of recovery. Our study revealed that the 5STS is responsive to functional changes in patients with stroke and that their degree of severity and stage of recovery influence the MCID values of the 5STS.

Reliability and validity of an adapted hip abductor strength measure as a potential new fall risk assessment for older persons: a study protocol

Background Persons aged ≥ 65 years are currently the world’s fastest growing age group. An important complication of age is the increasing risk of falls. Falls have multifactorial etiology and modifiable risk factors open for interventions in prevention and rehabilitation, are of high interest. In this context, strong hip abductors seem to be important to prevent falls. A newly adapted measurement device to measure hip abductor strength (HAS) in a closed chain position was developed. We aim to assess feasibility, intra- and inter-tester reliability and construct and criterion validity of the new measure. Methods In two subsequent parts a feasibility, reliability and validity study with an adapted measurement instrument for the assessment of HAS (index test) in a closed chain position in persons aged ≥ 65 years will be conducted. Part I investigates feasibility of the measure in clinical settings as well as reliability of the new HAS test (n = 26). Part II evaluates construct and criterion validity (n = 169). Construct validity will be assessed cross-sectional, criterion validity by comparison with prospectively followed up fall history for 12 months (external criterion) and other functional fall risk assessments (Short Physical Performance Battery, Timed Up and Go test, usual gait speed and hand grip strength). Discussion Results of feasibility, will give insight in its applicability in daily clinical life and clinimetric properties will show if measurements of HAS in a closed chain position should be encouraged to include in fall risk assessments in older adults.