The Wayfinding Questionnaire as a Self-report Screening Instrument for Navigation-related Complaints After Stroke: Internal Validity in Healthy Respondents and Chronic Mild Stroke Patients

Objective: To evaluate, psychometrically, a new measure of tearful emotionalism following stroke: Testing Emotionalism After Recent Stroke – Questionnaire (TEARS-Q). Setting: Acute stroke units based in nine Scottish hospitals, in the context of a longitudinal cohort study of post-stroke emotionalism. Subjects: A total of 224 clinically diagnosed stroke survivors recruited between October 1st 2015 and September 30th 2018, within 2 weeks of their stroke. Measures: The measure was the self-report questionnaire TEARS-Q, constructed based on post-stroke tearful emotionalism diagnostic criteria: (i) increased tearfulness, (ii) crying comes on suddenly, with no warning (iii) crying not under usual social control and (iv) crying episodes occur at least once weekly. The reference standard was presence/absence of emotionalism on a diagnostic, semi-structured post-stroke emotionalism interview, administered at the same assessment point. Stroke, mood, cognition and functional outcome measures were also completed by the subjects. Results: A total of 97 subjects were female, with a mean age 65.1 years. 205 subjects had sustained ischaemic stroke. 61 subjects were classified as mild stroke. TEARS-Q was internally consistent (Cronbach’s alpha 0.87). TEARS-Q scores readily discriminated the two groups, with a mean difference of −7.18, 95% CI (−8.07 to −6.29). A cut off score of 2 on TEARS-Q correctly identified 53 of the 61 stroke survivors with tearful emotionalism and 140 of the 156 stroke survivors without tearful emotionalism. One factor accounted for 57% of the item response variance, and all eight TEARS-Q items acceptably discriminated underlying emotionalism. Conclusion: TEARS-Q accurately diagnoses tearful emotionalism after stroke.

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Psychometric Comparisons of 2 Versions of the Fugl-Meyer Motor Scale and 2 Versions of the Stroke Rehabilitation Assessment of Movement

Neurorehabilitation and Neural Repair ◽

10.1177/1545968308315999 ◽

2008 ◽

Vol 22 (6) ◽

pp. 737-744 ◽

Cited By ~ 64

Author(s):

I-Ping Hsueh ◽

Miao-Ju Hsu ◽

Ching-Fan Sheu ◽

Su Lee ◽

Ching-Lin Hsieh ◽

...

Keyword(s):

Stroke Rehabilitation ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Stroke Patients ◽

Chronic Patients ◽

Retest Reliability ◽

Intraclass Correlation Coefficients ◽

Mild Stroke ◽

Test Retest Reliability ◽

Rehabilitation Assessment

Objective. To provide empirical justification for selecting motor scales for stroke patients, the authors compared the psychometric properties (validity, responsiveness, test-retest reliability, and smallest real difference [SRD]) of the Fugl-Meyer Motor Scale (FM), the simplified FM (S-FM), the Stroke Rehabilitation Assessment of Movement instrument (STREAM), and the simplified STREAM (S-STREAM). Methods. For the validity and responsiveness study, 50 inpatients were assessed with the FM and the STREAM at admission and discharge to a rehabilitation department. The scores of the S-FM and the S-STREAM were retrieved from their corresponding scales. For the test-retest reliability study, a therapist administered both scales on a different sample of 60 chronic patients on 2 occasions. Results. Only the S-STREAM had no notable floor or ceiling effects at admission and discharge. The 4 motor scales had good concurrent validity (rho ≥ .91) and satisfactory predictive validity (rho = .72-.77). The scales showed responsiveness (effect size d ≥ 0.34; standardized response mean ≥ 0.95; P < .0001), with the S-STREAM most responsive. The test-retest agreements of the scales were excellent (intraclass correlation coefficients ≥ .96). The SRD of the 4 scales was 10% of their corresponding highest score, indicating acceptable level of measurement error. The upper extremity and the lower extremity subscales of the 4 showed similar results. Conclusions. The 4 motor scales showed acceptable levels of reliability, validity, and responsiveness in stroke patients. The S-STREAM is recommended because it is short, responsive to change, and able to discriminate patients with severe or mild stroke.

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Abstract W MP53: The Prevalence and Characteristics of Attention Disorders in The Patients with First-onset Mild Hemorrhagic Stroke

Stroke ◽

10.1161/str.46.suppl_1.wmp53 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Haruki Tokida ◽

Masakazu Nishigaki ◽

Masaru Kuriyama

Keyword(s):

Selective Attention ◽

Acute Phase ◽

Hemorrhagic Stroke ◽

False Negative ◽

Previous History ◽

Attention Deficits ◽

Stroke Patients ◽

Attention Disorders ◽

First Onset ◽

Mild Stroke

Objectives: Recent study revealed that over 50 % of stroke patients had some form of attention deficits. However, few reports focused on acute phase and mild stroke patients. This study aimed to investigate the prevalence of attention disorders and the change of their symptoms during the hospitalization in the patients with first-onset mild hemorrhagic stroke. Methods: Study subjects were 231 consecutive patients diagnosed as hemorrhage stroke and treated at our hospital from 2011 to 2012. Patients with severe hemorrhage (i.e., amount of bleeding >5cc), with previous history of cerebrovascular diseases or dementia, with decreased level of consciousness or with impaired activity of daily living were not eligible to this study. Neuropsychological assessments were conducted by speech therapists at 1 and 2 week after stroke onset using Clinical Assessment for Attention (CAT) and examined how they changed. CAT was a test battery developed by the Japan Society for Higher Brain Dysfunction to evaluate deficit of attention disorders. Results: Among the study subjects, 46 patients met the selection criteria and 16 patients (34.8%, 6 men, mean age was 66) were identified as having attention disorders. Bleeding lesions were left putamen (n=3), right putamen (n=9) and right thalamus (n=4). Significant improvements were observed in two types of focused attention and auditory selective attention measures: percentage of correct answers of Visual Cancellation Task (VCT, p=0.027) and Auditory Detection Task (ADT, p = 0.01). Additionally, working hours in VCT was significantly shortened, and the false-negative rate was also significantly decreased (p= 0.028). In ADT, the false-positive rate was significantly decreased (p= 0.012). No significant changes were observed in other type of tasks. Discussion: More than one-third of patients showed attention deficits even though they had mild stroke. Only focused and selective attentions were improved in acute phase of mild stroke. These results suggested that improvement in focused and selective attention precede improvement in other attentional functions.

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BIMBINGAN ROHANI ISLAM DALAM MENUMBUHKAN RESPON SPIRITUAL ADAPTIF BAGI PASIEN STROKE DI RUMAH SAKIT ISLAM JAKARTA CEMPAKA PUTIH

Jurnal Ilmu Dakwah ◽

10.21580/jid.v36i1.1625 ◽

2017 ◽

Vol 36 (1) ◽

pp. 45

Author(s):

Zalussy Debby Styana ◽

Yuli Nurkhasanah ◽

Ema Hidayanti

Keyword(s):

Qualitative Research ◽

Data Collection ◽

Adaptive Response ◽

Research Data ◽

Spiritual Guidance ◽

Data Display ◽

Medical Patients ◽

Stroke Patients ◽

First Results ◽

Mild Stroke

This study is a qualitative reseachthat aims to describe how the spiritual guidance of Islam in cultivating spiritual adaptive response for stroke patients in hospitals Islam CempakaPutih Jakarta. This research is qualitative research. Source of research data is binroh officers as well as all stroke patients with mild stroke were treated qualification and post-stroke patients who are undergoing physiotherapy in Jakarta, CempakaPutih RSI. Methods of data collection using interviews, observation, and documentation. The first results showed that stroke patients had a spiritual response adaptive, second, implementation of Islamic spiritual guidance in cultivating spiritual response is adaptive stroke patients with stroke patients to visit. Efforts are being made binroh officers to cultivate spiritual adaptive response is to encourage motivation, suggestion, support and education of worship during illness, such as providing guidance procedures for prayer, ablution, tayammum and exercising. Not only officer binroh who provide spiritual touch but all stakeholders in the hospital as nurses, physiotherapists, doctors, etc. also participated giving spiritual touch, the facilities and the best service both medical and non-medical patients, so that patients become optimistic about the pain and able to achieve adaptive spiritual response.***Penelitian ini merupakan penelitian kualitatif yang bertujuan untuk mendiskripsikan bagaimana bimbingan rohani Islam dalam menumbuhkan respon spiritual adaptif bagi pasien stroke di rumah sakit Islam Jakarta Cempaka Putih. Jenis penelitian ini merupakan penelitian kualitatif. Sumber data penelitian adalah petugas binroh serta seluruh pasien stroke dengan kualifikasi stroke ringan yang dirawat dan pasien pasca stroke yang sedang menjalani fisioterapi di RSI Jakarta Cempaka Putih. Metode pengumpulan data menggunakan wawancara, observasi, dan dokumentasi. Metode analisis data menggunakan model Miles dan Huberman, meliputi data reduction, data display, conclusion. Hasil penelitian menunjukkan bahwa pertama pasien stroke memiliki respon spiritual adaptif, kedua, Pelaksanaan bimbingan rohani Islam dalam menumbuhkan respon spiritual adaptif pasien stroke adalah dengan visit ke pasien stroke. Upaya yang dilakukan petugas binroh untuk menumbuhkan respon spiritual adaptif adalah dengan memberikan semangat motivasi, sugesti, support dan edukasi ibadah selama sakit, seperti memberikan tuntunan tatacara sholat, wudhu, tayammum beserta prakteknya. Tidak hanya petugas binroh saja yang memberikan sentuhan rohani tetapi seluruh stakeholder yang ada dirumah sakit seperti perawat, fisioterapis, dokter dll juga ikut serta memberikan sentuhan rohani, fasilitas dan pelayanan terbaik medis maupun non medis kepada pasien, sehingga pasien menjadi optimis terhadap sakitnya dan mampu mencapai respon spiritual adaptif.

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Abstract TP37: Negative Diffusion-Weighted Imaging in Mild Ischemic Stroke Patients: An Exploratory Analysis of a Single-Center Six-Year Cohort

Stroke ◽

10.1161/str.48.suppl_1.tp37 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Marie Louise Schmitz ◽

Grethe Andersen ◽

Irene Mikkelsen ◽

Mette H Madsen ◽

Achala Vagal ◽

...

Keyword(s):

Ischemic Stroke ◽

University Hospital ◽

Stroke Work ◽

Imaging Data ◽

Single Center ◽

Stroke Patients ◽

True Rate ◽

Complete Reversal ◽

Mild Stroke ◽

Mri Characteristics

Background: DWI-negativity was observed in nearly one third of patients with non-disabling ischemic stroke in a recent study and complete reversal of DWI-positivity was reported in 2% of mild-moderate strokes after IV rtPA treatment. We sought to identify acute DWI-negativity and DWI reversal rates in an independent cohort treated with IV rtPA because of mild stroke symptoms (defined as NIHSS 0-5). Methods: We reviewed a prospective single-center registry of consecutive, IV rtPA-treated patients at Aarhus University Hospital from 2004 to 2010 with a substantial number of strokes with low (0-5) NIHSS scores and reviewed their acute (<4.5 hours) and 24-hour MRI characteristics. Acute MRI is standard stroke work-up imaging at our center (except for patients with MRI contraindications). The local practice was to prefer IV rtPA treatment in mild stroke patients if clinical suspicion was supported by either MRI DWI positivity or other imaging data (MRI-perfusion lesions or visualized arterial occlusions on MRA). Only patients with final diagnoses of ischemic stroke upon hospital discharge were included in this analysis. Results: Among 694 patients treated with IV rtPA from 2004-2010, 266 (38.3%) had NIHSS 0-5. Among these mild stroke patients, 238 received acute MRI and 107 had 24-hour follow-up MRI. Acute DWI-negativity was observed in 32/238 (13.5%; 95% CI 9.4-18.4) patients prior to IV rtPA treatment. Among the cohort with both acute and 24-hour MRIs, acute DWI-negativity was present in 15/107 (14.0%) patients and persisted in 8/15 (53.3%; 95% CI 26.6-78.7). Of 92 DWI-positive patients, only 2/92 (2.1%) became DWI-negative at 24 hours. An association of acute DWI-negativity with younger age (OR 0.98; 95% CI 0.96-1.01) or lower NIHSS (OR 0.90; 95% CI 0.69-1.18) was not found in this cohort. Conclusions: Acute DWI-negativity was observed in ~14% of ischemic strokes with NIHSS 0-5, and half remained negative at 24 hours following IV rtPA. DWI reversal from positive to negative, possibly representing an averted infarction, occurred in 2% of patients. These rates may be lower than the true rate of DWI-negativity and reversal in mild stroke, given limitations of this analysis, including DWI-positivity influencing the initial IV rtPA decision.

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ANALISIS BIAYA SATUAN METODE ACTIVITY BASED COSTING DALAM EVALUASI TARIF PELAYANAN KESEHATAN DI ERA JKN (Studi Kasus Pasien Stroke di Rumah Sakit Kristen Mojowarno)

Jurnal Ekonomi dan Bisnis Airlangga ◽

10.20473/jeba.v26i12016.79-95 ◽

2016 ◽

Vol 26 (1) ◽

pp. 79

Author(s):

. Soewatoen

Keyword(s):

Unit Cost ◽

Indirect Costs ◽

Activity Based Costing ◽

Labor Costs ◽

Stroke Patients ◽

Severe Stroke ◽

High Care ◽

Mild Stroke ◽

Christian Hospital ◽

The Cost

Mojowarno Christian Hospital is an organization that is move in health services that produce multi-product, theratio of consumption of each product is different and significant indirect costs therefore needed to determine theservice tariff calculation of unit cost in the hospital with Activity Based Costing Method. The purpose of this studywas to determine the calculation of unit costs of care and outcomes of stroke patients fare calculation using theunit cost from Activity Based Costing method hospital compared with rates prevailing at the moment and ratesINA CBGs. This type of research is a qualitative case study. Based on calculations by the method of ActivityBased Costing obtained Unit Cost for Outpatient is Rp. 749.705, Unit Cost for Emergency Care Unit Mild Strokeis Rp 664.093;Medium Stroke Rp. 1.424.683, Severe Stroke Rp. 2.282.755,-. Unit Cost for Room type III MildStroke is Rp. 3.899.786, Medium Stroke Rp. 5.874.646, Severe Stroke Rp. 7.892.496; Unit Cost for Room type IIMild Stroke is Rp. 4.859.510, Medium Stroke Rp. 7.557.913, Severe Stroke Rp. 10.294.306; Unit Cost for Roomtype I Mild Stroke is Rp. 6.097.530, Medium Stroke Rp. 9.728.198, Severe Stroke Rp. 13.391.856; Unit Cost forVIP Room Mild Stroke is Rp. 10.953.150, Medium Stroke Rp. 18.240.533, Severe Stroke Rp. 25.540.906 ; UnitCost for High Care Unit Mild Stroke is Rp. 3.710.121, Medium Stroke Rp. 5.655.278, Severe StrokeRp. 9.477.309 and Unit Cost Intensive Care Unit Mild Stroke is Rp. 7.010.169, Medium Stroke Rp. 10.605.350,Severe Stroke Rp. 17.727.429,-.Each unit cost plus the cost of materials and direct labor costs, it can be seen thatthe cost of treatment of each disease severity have enough material price difference. It is because the higher theseverity of the disease makes the longer the treatment, the more use the service activities, and service facilities, itsmake the cost is higher. The comparison resoult showed that hospital rates prevailing at this time and the resultsof the calculation using the ABC method for stroke patients is higher than the rate of INA CBGs.

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Abstract TP161: Sexual Dysfunction in Mild Stroke

Stroke ◽

10.1161/str.51.suppl_1.tp161 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Jennifer Blum ◽

Caroline Wisialowski ◽

Susan Taboada ◽

Sarah Clark ◽

Ilene Staff ◽

...

Keyword(s):

Sexual Dysfunction ◽

Safety Concern ◽

Clinical History ◽

Descriptive Statistics ◽

Self Report ◽

Convenience Sample ◽

True Incidence ◽

Post Stroke ◽

Physical Limitations ◽

Mild Stroke

Background: Stroke impacts several aspects of patients’ lives and sexual dysfunction post stroke has been reported in 40%-50% of patients. Current investigations have revealed links to depression, however this has not been examined specifically in mild stroke. Objective: To determine prevalence and factors associated with sexual dysfunction after mild stroke Design/methods: A retrospective study was conducted on a self-report questionnaire completed by a convenience sample of patients during a hospital follow-up appointment in the stroke clinic. Patients were asked about sexual dysfunction after stroke and if yes, to specify the cause: safety concern, physical limitation, consequence or change in libido. In addition, patients completed a PHQ-9 to measure depression, Fatigue Assessment Scale (FAS), and the Montreal Cognitive Assessment (MoCA). A thorough review of clinical history including NIHSS, mRS and demographics was completed by researchers. Descriptive statistics were used to identify and understand the patient population. Mild stroke was defined as NIHSS ≤ 5. Results: In our study of 135 patients, 21 (16%) did not respond to the sexual dysfunction question. Of the 114 who responded, only 11 (9.6%) reported sexual dysfunction and 9 (81%) attributed their sexual dysfunction to physical limitations. Descriptive statistics of the respondent subgroup indicate that the cohort was 59% male with a median (IQR) age of 64 (57,75) and that 52% were living with someone at the time. The mean NIHSS on discharge was 1 (IQR 0-3) and 77% were ischemic strokes. Few patients experienced post stroke depression (21.9%, N=25), and the cohort reported low levels of fatigue (median FAS=19). Low incidence and response rates precluded an analysis of specific predictors in this cohort. Conclusion: Physical limitations are reported to be the main cause of post stroke sexual dysfunction. Roughly 1 in 10 patients with mild stroke reported experiencing sexual dysfunction, however twice as many did not respond to the question. Therefore, the true incidence is unclear, prompting the need for further investigation on post stroke sexual dysfunction in mild stroke.

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The Assessment of Children's Social Skills Through Self-Report: A Potential Screening Instrument for Classroom Use

Measurement and Evaluation in Counseling and Development ◽

10.1080/07481756.2003.12069068 ◽

2003 ◽

Vol 35 (4) ◽

pp. 218-229 ◽

Cited By ~ 31

Author(s):

Carla Kmett Danielson ◽

Carolyn Roecker Phelps

Keyword(s):

Social Skills ◽

Screening Instrument ◽

Self Report ◽

Children's Social Skills ◽

Classroom Use

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Screening for Borderline Personality Disorder With the McLean Screening Instrument: A Review and Critique of the Literature

Journal of Personality Disorders ◽

10.1521/pedi_2019_33_451 ◽

2019 ◽

pp. 1-11 ◽

Cited By ~ 2

Author(s):

Mark Zimmerman ◽

Caroline Balling

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

High Sensitivity ◽

Screening Instrument ◽

Borderline Personality ◽

Self Report ◽

Cutoff Score ◽

Cutoff Scores ◽

Diagnostic Detection

Borderline personality disorder (BPD) is underdiagnosed in clinical practice. One approach towards improving diagnostic detection is the use of screening questionnaires. It is important for a screening test to have high sensitivity because the more time-intensive/expensive follow-up diagnostic inquiry will presumably only occur in patients who are positive on the initial screen. The most commonly studied self-report scale specific for BPD is the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD). We summarize the performance of the scale across studies, examine the performance of the scale using different cutoff scores, and highlight the approach used by investigators in recommending a cutoff score. Most studies of the scale have taken a case-finding approach in deriving the cutoff score on the scale instead of a screening approach. For the purposes of screening, it may be more appropriate for the cutoff score on the MSI-BPD to be less than the currently recommended cutoff of 7.

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