scholarly journals P253 A qualitative study exploring meaningful improvement in bowel urgency among adults with moderate to severe Ulcerative Colitis

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S291-S292
Author(s):  
L Newton ◽  
A Guobyte ◽  
S McFadden ◽  
T Symonds ◽  
L Delbecque ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Qualitative Study ◽  
Rating Scale ◽  
Well Being ◽  
The United States ◽  
Numeric Rating Scale ◽  
Point Scale ◽  
Point Change ◽  
Meaningful Improvement ◽  
Point Reduction

Abstract Background Ulcerative Colitis (UC) is a chronic disease with periods of relapse and remission. Bowel urgency, the sudden or immediate need for a bowel movement, is one of the most bothersome symptoms experienced by patients with UC. This study explored how patients define urgency severity and what would be a meaningful improvement based on a numeric rating scale (NRS). Methods In-depth interviews were conducted in the United States with 19 adults with clinician-confirmed moderate to severe UC. Participants were asked to define levels of bowel urgency severity using an 11-point NRS (where 0 = no urgency and 10 = worst possible urgency) and to describe what would be a meaningful improvement based on how this change would impact their daily life. Interviews were audio-recorded, transcribed, and coded using thematic coding in NVivo. Results Mild bowel urgency was described as ranging between 0 to 3 on the 11-point scale by most UC patients (n=16, 84%). Mild was described as “almost normal” or “normal urgency” (n=6, 32%) and being able to make it to the bathroom with ease (n=5, 25%). Most participants (n=15, 79%) rated moderate urgency between 4 to 6 on the 11-point scale. At this level, participants commented that they would need to ensure they are close to a bathroom (n=7, 37%). Finally, ratings for severe urgency clustered between 6 to 8 (n=7, 37%) and 8 to 10 (n=12, 63%). Severe bowel urgency was described as an immediate or uncontrollable need (n=8, 42%) which impacts their ability to leave the home (n=7, 37%). When asked about what change on the urgency NRS would be meaningful, n=10 (53%) participants reported that a 1-point change would be meaningful, with most stating that any change was an improvement. Participants commented that a 1-point change would reflect improved emotional well-being and greater confidence to leave the home. In contrast, 9 (47%) participants wanted improvements of more than 1-point change; 5 (26%) indicated that a 2-point improvement was required to consider the change meaningful and 4 (21%) felt a 3-point change or more was needed. With this greater level of change, participants described having a significant improvement in urgency, with less frequent urges and improved emotional well-being. Conclusion This qualitative study revealed that UC patients largely agreed regarding ratings of ‘mild’ and ‘moderate’ bowel urgency on an 11-point severity scale. ‘Severe’ bowel urgency was split between two ranges suggesting the existence of ‘very severe’ bowel urgency. In addition, the majority of UC patients perceived a 1 or 2-point reduction on the urgency NRS as a meaningful change in their lives.

scholarly journals Solidarity, Vulnerability and Mistrust: How Context, Information and Government Affect the Lives of Women in Times of Zika

2019 ◽  
Author(s):  
Ana Rosa Linde Arias ◽  
Maria Roura ◽  
Eduardo Siqueira
Keyword(s):  
Public Health ◽  
Qualitative Study ◽  
Well Being ◽  
The United States ◽  
Epidemiological Surveillance ◽  
Sources Of Information ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Public Health Response ◽  
Individual Level

Abstract Background and Objectives The public health response to Zika outbreak has mostly focused on epidemiological surveillance, vector control, and individual level preventative measures. This qualitative study employs a social-ecological framework to examine how macro (historical, legislative, political, socio-economic factors), meso (sources of information, social support, social mobilization) and micro level factors (individual actions, behavioral changes) interacted to influence the response and behavior of women with respect to Zika in different contexts. Methods A qualitative study was carried out. Women were recruited through the snowball sampling technique from various locations in Brazil, Puerto Rico, and the United States. They were of different nationalities and ethnicities. Data were collected through semi-structured interviews. The data transcripts were analyzed using thematic analysis. Results Women in this study deemed the information provided as insufficient, which led them to actively reach out and access a variety of media sources. Social networks played a vital role in sharing information but also resulted in the spread of hoaxes or rumors. Participants in our research perceived socio-economic inequities but focused on how to remedy their microenvironments. They did not engage in major social activities. Lack of trust in governments placed women in vulnerable situations by preventing them to follow the guidance of health authorities. These impacts were also a result of the response tactics of health and government administrations in their failed attempts to ensure the well-being of their countries’ populations. Conclusions Our findings call for a broad spectrum of public health interventions that go beyond individual level behavioral change campaigns, to more comprehensively address the broader meso and macro level factors that influence womens’ willingness and possibility to protect themselves.

scholarly journals Development and Validation of the Spiritual Impact Rating Scale for Women (SIRSW): A Tool for Assessing College Women's Spirituality

2019 ◽  
Vol 11 (7) ◽  
pp. 128
Author(s):  
Angela U. Ekwonye ◽  
Verna DeLauer ◽  
Terrence F. Cahill
Keyword(s):  
Gender Differences ◽  
Academic Success ◽  
College Women ◽  
Internal Consistency ◽  
Rating Scale ◽  
Well Being ◽  
Internal Consistency Reliability ◽  
The United States ◽  
Demographic Differences ◽  
Minimum Criteria

Spirituality impacts college student outcomes in the United States such as mental health, physical health, academic success, and healthy behaviors. Numerous studies consistently show gender differences on spirituality measures. The wealth of empirical evidence demonstrating gender differences in spirituality warranted the development of a tool for measuring college women's spirituality. The purpose of this study was to develop and examine the psychometric properties of the SIRSW, including its content validity, factorial structure, and internal consistency using a college women sample. A sample of 667 undergraduates (ages 18-26) at an all-women’s Catholic University in the upper Midwest completed the spirituality survey in Spring 2018. Demographic characteristics were analyzed using descriptive statistics. Demographic differences in spirituality score were assessed using t-test and one-way ANOVA. Psychometric characteristics of the SIRSW were assessed by evaluating variability, internal consistency reliability, and overall scale structure. There were no significant demographic differences in total spirituality score. Internal consistency was high (Cronbach alpha = 0.97). Item-scale coefficients were above the minimum criteria. Factor analysis revealed that the 16-items measuring spirituality fell under the one-factor component and accounted for 82% of the variance. The SIRSW was found to be a valid and reliable tool for assessing the spiritual well-being of college women. Understanding college women’s spirituality can inform the development of a spiritually oriented intervention that is consistent with their values enhancing their psychological, mental, and physical well-being.

scholarly journals Challenges with social distancing during the COVID-19 pandemic among Hispanics in New York City: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christopher J. Gonzalez ◽  
Bryan Aristega Almeida ◽  
George S. Corpuz ◽  
Hector A. Mora ◽  
Oluwatobi Aladesuru ◽  
...  
Keyword(s):  
New York ◽  
Qualitative Study ◽  
Community Health Center ◽  
Health Belief ◽  
Well Being ◽  
The United States ◽  
Structured Interviews ◽  
Social Distancing ◽  
Unpaid Care ◽  
Hispanic Adults

Abstract Background Hispanics in the United States are disproportionately affected by the novel coronavirus (COVID-19). While social distancing and quarantining are effective methods to reduce its spread, Hispanics, who are more likely to be essential workers and live in multigenerational homes than non-Hispanics, may face challenges that limit their ability to carry out these preventative efforts. We elicited the experiences of Hispanic adults with social distancing and self-quarantining during the COVID-19 pandemic in New York. Methods In this qualitative study, Hispanic adults receiving care at a federally qualified community health center in East Harlem, New York, were recruited for remote one-on-one semi-structured interviews from 5/15/2020 to 11/17/2020. Interviews were conducted by a bilingual interviewer in Spanish or English, using a semi-structured topic guide informed by the Health Belief Model. Audio-recordings were professionally transcribed. We used thematic analysis to iteratively code the data. Each transcript was independently coded by two research team members, then reconciled by a third. Major themes and subthemes were identified. Results Among 20 participants, four major themes emerged; Hispanics were: (1) fearful of contracting and transmitting COVID-19, (2) engaging in practices to reduce transmission of COVID-19, (3) experiencing barriers to social distancing and quarantining, and (4) facing an enduring psychological and physical toll from COVID-19. Conclusions Despite understanding the risks for contracting COVID-19 and taking appropriate precautions, Hispanics faced numerous challenges to social distancing and quarantining, such as living in crowded, multi-generational households, working as essential workers, and providing unpaid care to family members. Such challenges took a toll on their physical, emotional, and financial well-being. Our findings suggest that a tailored approach to public health messaging and interventions for pandemic planning are warranted among members of this community. Further research is needed to understand and mitigate the long term physical and psychological consequences of the pandemic among Hispanics.

scholarly journals Solidarity, Vulnerability and Mistrust: How Context, Information and Government Affect the Lives of Women in Times of Zika

2020 ◽  
Author(s):  
Ana Rosa Linde Linde Arias ◽  
Maria Roura ◽  
Eduardo Siqueira
Keyword(s):  
Public Health ◽  
Qualitative Study ◽  
Well Being ◽  
The United States ◽  
Epidemiological Surveillance ◽  
Sources Of Information ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Public Health Response ◽  
Individual Level

Abstract Background The public health response to Zika outbreak has mostly focused on epidemiological surveillance, vector control, and individual level preventative measures. This qualitative study employs a social-ecological framework to examine how macro (historical, legislative, political, socio-economic factors), meso (sources of information, social support, social mobilization) and micro level factors ( i ndividual actions, behavioral changes) interacted to influence the response and behavior of women with respect to Zika in different contexts. Methods A qualitative study was carried out. Women were recruited through the snowball sampling technique from various locations in Brazil, Puerto Rico, and the United States. They were of different nationalities and ethnicities. Data were collected through semi-structured interviews. The data transcripts were analyzed using thematic analysis. Results Women in this study deemed the information provided as insufficient, which led them to actively reach out and access a variety of media sources. Social networks played a vital role in sharing information but also resulted in the spread of hoaxes or rumors. Participants in our research perceived socio-economic inequities but focused on how to remedy their microenvironments. They did not engage in major social activities. Lack of trust in governments placed women in vulnerable situations by preventing them to follow the guidance of health authorities. These impacts were also a result of the response tactics of health and government administrations in their failed attempts to ensure the well-being of their countries’ populations. Conclusions Our findings call for a broad spectrum of public health interventions that go beyond individual level behavioral change campaigns, to more comprehensively address the broader meso and macro level factors that influence womens’ willingness and possibility to protect themselves. Key words : Zika, women, social determinants, information, public health, maternal and child health

A Qualitative Study of the Social and Lived Experiences of Homebound Older Adults

2021 ◽  
pp. 073346482110403
Author(s):  
Joyce M. Cheng ◽  
George P. Batten ◽  
Nengliang (Aaron) Yao
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Lived Experiences ◽  
Well Being ◽  
The United States ◽  
Care Providers ◽  
Physical And Mental Health ◽  
Cross Sectional ◽  
Homebound Older Adults

Objective: The number of homebound older adults is increasing in the United States. We aimed to examine their social and lived experiences and to understand their perspectives on their situation, feelings, and coping mechanisms. Methods: We conducted a cross-sectional qualitative study using semi-structured interviews with 18 older homebound individuals in Central Virginia. Results: Homebound older adults experienced both physical and mental health challenges that restricted their ability to participate in activities of daily living, recreation, and social interactions. Participants often felt dependent, helpless, lonely, and socially isolated. Those who communicated regularly with friends, family, and health care providers reported positive benefits from these interactions. Discussion: Participants faced challenges to their physical, emotional, and mental well-being. Our findings might help clinicians, policymakers, and community organizations understand how to better support homebound older adults. We should provide educational opportunities, respect their autonomy, and implement initiatives to address their isolation and loneliness.

Pain intensity and interference with functioning and well-being in subgroups of patients with chronic pain treated with once-daily hydrocodone tablets

2015 ◽  
Vol 11 (6) ◽  
pp. 519 ◽  
Author(s):  
Adrian Bartoli, MD ◽  
Edward Michna, MD ◽  
Ellie He, PhD ◽  
Warren Wen, PhD
Keyword(s):  
Sleep Quality ◽  
Pain Intensity ◽  
Rating Scale ◽  
Short Form ◽  
Well Being ◽  
Pain Interference ◽  
Dose Titration ◽  
Meaningful Improvement ◽  
Once Daily ◽  
Subgroup Differences

Background: A previous 52-week trial of patients with chronic noncancer, nonneuropathic pain (CNNP) showed clinically meaningful improvement in pain intensity, pain interference, and physical health-related quality of life (HRQL) following daily treatment with an extended-release, once-daily hydrocodone (Hysingla® ER; HYD) bitartrate tablet.Objective: To examine treatment response within patient subgroups and to assess between-subgroup differences in effectiveness and side effect profile. Methods: Data were from an open-label 52-week trial of treatment with HYD tablets (20-120 mg, once-daily) for patients with moderate-to-severe CNNP. Binary subgroups were defined for the following six factors: age, gender, opioid experience, baseline pain severity, history of depression, and stable HYD dose at completion of a 45-day dose-titration period. Univariable and multivariable models examined changes in average pain intensity (API; 11-point numeric rating scale), pain interference (Brief Pain Inventory-Interference subscale [BPI-I]), physical and mental HRQL (36-item Short Form health survey Physical and Mental Component Summaries [PCS and MCS]), and sleep quality (Medical Outcomes Study Sleep Scale Sleep Problems Index [SPI]) from baseline to maintenance, and subgroup differences in adverse events.Results: All subgroups showed clinically meaningful improvements in API, BPII, and PCS scores; no subgroups showed improvements in MCS or SPI. Between subgroup comparisons found greater improvements for opioid-naïve patients and for patients with severe baseline pain. Incidence of adverse events differed minimally between subgroups.Conclusion: Regardless of subgroup, patients with CNNP treated with HYD showed clinically meaningful improvements in pain intensity, pain interference, and physical HRQL, although not in mental HRQL or sleep quality. Improvements were generally larger for opioid-naïve patients and patients with severe baseline pain.

Quality of life in depression scale (QLDS). Development, reliability, validity, responsiveness and application

1997 ◽  
Vol 12 (4) ◽  
pp. 199-202 ◽  
Author(s):  
H Tuynman-Qua ◽  
F de Jonghe ◽  
S.P. McKenna
Keyword(s):  
Quality Of Life ◽  
Internal Consistency ◽  
Rating Scale ◽  
Depression Scale ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Well Being ◽  
The United States ◽  
Good Reliability

SummaryThe joint development of the Dutch and English versions of the Quality of Life in Depression Scale (QLDS) is described. The QLDS is based on the needs model of quality of life developed by Hunt and McKenna. The scale has good reliability and internal consistency. Test-retest correlation coefficients were 0.94 and 0.87 in the United Kingdom and the Netherlands, respectively. Internal consistency alpha-coefficients were 0.95 and 0.92, respectively. The validity of the scale is highly acceptable. The QLDS was shown to correlate relatively highly with established measures of well-being, and scores obtained with the measure were related to severity of depression as assessed by the Hamilton Rating Scale for Depression. The QLDS was shown to be responsive to change in an open study with fluoxetine in 540 patients with major depression. The scale has wide applicability and has been shown to be user-friendly, both for respondents and administrators. It has been, or is in the process of being, tested for reliability and validity in the following additional countries: Australia, Austria, Belgium, Canada, Denmark, France, Germany, Italy, Morocco, Spain and the United States.

scholarly journals P126 The Urgency Numeric Rating Scale (NRS): a novel patient-reported outcome measure to assess bowel urgency in adult patients with ulcerative colitis

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S200-S200
Author(s):  
M C Dubinsky ◽  
A Naegeli DrPH, MPH ◽  
Y Dong ◽  
T Lissoos ◽  
V Arora ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Rating Scale ◽  
Bowel Movement ◽  
Numeric Rating Scale ◽  
Adult Patients ◽  
Study Item ◽  
Retest Reliability ◽  
Patient Reported ◽  
Test Retest Reliability ◽  
Numeric Rating

Abstract Background Ulcerative colitis (UC) is a chronic disease characterised by inflammation of the rectum and colon. Bowel urgency, the sudden need for a bowel movement, is one of the most bothersome and important symptoms of UC. Treatment goals in UC focus on restoration of normal bowel frequency, control of primary symptoms of bleeding and urgency, and resolution of inflammation. The Urgency Numeric Rating Scale (NRS) is a newly developed patient-reported measure to assess the severity of the urgency to have a bowel movement in adult patients with UC. Methods Development of the Urgency NRS was informed through semi-structured concept elicitation and cognitive debriefing interviews. The scale asks patients to report on the immediacy status of their UC symptom over the past 24 h on an 11-point horizontal NRS anchored at 0 (No urgency) and 10 (Worst possible urgency), with higher scores indicating worse urgency severity (i.e. immediacy of need to have a bowel movement). A 2-week daily diary pilot study was conducted to assess floor and ceiling effects, test–retest reliability and construct validity. Weekly average scores were calculated as mean score over each 7-day period. A bootstrapping simulation was used to assess test–retest with intraclass correlation coefficient (ICC) [≥0.70 = substantial agreement] between week 1 and week 2 scores. Content validity was assessed by Pearson and Spearman correlation with stool frequency (SF) and patient global rating of severity (PGR-S) scores using Cohen’s conventions [r ≥ 0.5 = large; 0.3 to ≤0.5 = moderate] using week 1 scores. Results Through qualitative interviews, 16 adult UC patients (mean age 37.9 ± 11.6 years; 50% female; 56% White) confirmed relevance, item content and comprehensiveness of the Urgency NRS. Forty-one adult UC patients (mean age 44.2 ± 14.6 years; 51% female; 56% White) completed the 2-week study. Item distributions were uniform, with no ceiling or floor effects for the Urgency NRS (Figure 1). Test–retest reliability was high (ICC = 0.877), with simulated 95% confidence intervals ranging from 0.770 to 0.947. There was a high correlation between average urgency NRS and PGR-S scores, and a moderate correlation was observed between average Urgency NRS and number of stools in the first week (Table 1). Conclusion Bowel urgency is an important symptom of UC, distinct from bowel frequency and rectal bleeding. The urgency NRS is a well-defined, content-valid and reliable measurement of bowel urgency that may be used to help characterise disease activity in adult patients with UC.

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