scholarly journals 72 Validating MyHEARTSMAP, an emergency psychosocial self-assessment and management tool, among youth with minor traumatic brain injuries or minor orthopaedic injuries seen in the Paediatric Emergency Department

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e30-e30
Author(s):  
Erik Lamoureux ◽  
Takuro Ishikawa ◽  
Keith Yeates ◽  
Miriam Beauchamp ◽  
William Craig ◽  
...  
Keyword(s):  
Emergency Department ◽  
Convergent Validity ◽  
Assessment Tool ◽  
Social Issues ◽  
Pearson Correlation ◽  
Assessment Tools ◽  
Management Tool ◽  
Self Assessment ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency

Abstract Background Fewer than 20% of the estimated 1.2 million Canadian youths living with mental health (MH) concerns receive adequate care. Paediatric emergency department (PED) visits related to MH are increasing across North America. The online self-assessment tool, MyHEARTSMAP, was developed to facilitate screening of MH concerns in the PED and general practice. MyHEARTSMAP assesses 10 psychosocial areas, mapping to four domains of MH (Psychiatry, Function, Social, and Youth Health) to provide domain-specific recommendations for patient management (Figure A). Objectives We evaluated the convergent validity of MyHEARTSMAP when compared to established psychosocial self-assessment tools: Paediatric Quality of Life (PedsQL) and Strengths and Difficulties Questionnaire (SDQ). Design/Methods We conducted a cross-sectional study among youths and parents enrolled in a larger cohort study: Advancing Concussion Assessment in Paediatrics (A-CAP). Participants were children aged 8 to 16 years old with mild traumatic brain injury or orthopaedic injury and their parents. Participants were recruited from two PEDs in Alberta and British Columbia and were asked to complete MyHEARTSMAP, in addition to the PedsQL and SDQ completed in their A-CAP study procedures. We evaluated three MH domains from MyHEARTSMAP (PSYCHIATRY FUNCTION, AND SOCIAL) to their corresponding score sections in PedsQL (EMOTIONAL, SCHOOL, and SOCIAL) and SDQ (EMOTIONAL, none, and CONDUCT and PEER). We calculated Pearson correlation coefficients between these corresponding domains and sections. Results We recruited 40 child and parent pairs from Alberta and 82 from BC. The children were on average aged 12.6 years old (SD 2.2) and 44% were female. The tools screened participants as “at-risk” for various MH concerns at a rate of 26.7% to 60.8% for MyHEARTSMAP, 2.5% to 13.9% for PedsQL, and 12.3% to 16.0% for SDQ. Overall, MyHEARTSMAP was moderately correlated with PedsQL (mean ±95% CI: r = 0.405±0.151) and SDQ (mean ±95% CI: r = 0.322±0.162). Correlations (±95% CI) by MyHEARTSMAP domain for the child and parent versions, respectively, were as follows: PSYCHIATRY PedsQL (r = 0.483±0.140 / 0.509±0.134) and SDQ (r = 0.417±0.150 / 0.598±0.116); FUNCTION PedsQL (r = 0.578±0.122 / 0.455±0.143); SOCIAL PedsQL (r = 0.249±0.170 / 0.158±0.175) and SDQ (r = 0.207±0.172 / 0.067±0.178). Conclusion In conclusion, MyHEARTSMAP PSYCHIATRY and FUNCTION domains have moderate convergent validity to PedsQL and SDQ. Unlike PedsQL and SDQ, the evaluation of social issues in MyHEARTSMAP is MH-specific, resulting in low convergent validity for the SOCIAL domain.

scholarly journals P130: Feasibility of self-assessing functional status in older emergency department patients

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S111-S111
Author(s):  
V. Boucher ◽  
V. Boucher ◽  
M. Lamontagne ◽  
J. Lee ◽  
M. Émond
Keyword(s):  
Emergency Department ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Daily Living ◽  
Assessment Tool ◽  
Assessment Method ◽  
Assessment Tools ◽  
Self Assessment ◽  
Medical Reason ◽  
Significant Difference

Introduction: Geriatric Emergency Department (ED) guidelines recommend systematic screening of older patients for geriatric syndromes. However, compliance issues to this recommendation have already been observed. Self-assessment tools could be an interesting solution as self-assessed general, mental and physical health was shown to be predictive of functional decline and mortality. The Older Americans Resources and Services scale (OARS), is a simple geriatric functional assessment scale that is widely used by professionals to quantify patients’ ability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL). However, its use as a self-assessment tool has never been tested. Objective: to evaluate the feasibility of the self-assessed OARS compared to its standard administration by a research assistant (RA) in older ED patients. Methods: A planned sub-analysis of a single center randomized crossover pilot study in 2018 was realized. Patients aged ≥65 who consulted to the ED for any medical reason were included. Patients were excluded if they: 1) required resuscitation (CTAS 1); 2) were unable to consent/to speak French; 3) had a physical condition preventing the use of an electronic tablet. Patients were randomized 1:1 to either 1) tablet-based functional status self-assessment or 2) the RAs questionnaire administration at first, after which they crossed-over to the other assessment method. Paired t-tests were used to assess the score differences. Results: 60 patients were included. Mean age was 74.4 ± 7.6 and 34 (56.7%) participants were women. Mean OARS score according to RA was 25.1 ± 3.3 and mean self-assessed OARS score was 26.4 ± 2.5 (p < 0.0001). There was also differences when looking at the AVQ and AIVQ separately. Mean AVQ scores were 12.5 ± 1.8 and 13.5 ± 0.9 (p < 0.0001) and mean AIVQ scores were 12.6 ± 1.8 and 12.9 ± 1.8 (p = 0.04) for RA assessment and self-assessment, respectively. Conclusion: Our results show a statistically significant difference between RA assessment and patient self-assessment of functional status, and this difference seems to be more pronounced regarding AVQ than AIVQ. The study confirms that self-assessment of functional status by older ED patients is feasible, but further testing is required in order to confirm the validity and psychometric values of this self-administered version of the OARS.

scholarly journals Adolescents’ pain and distress during peripheral intravenous cannulation in a paediatric emergency setting

2021 ◽  
Author(s):  
Giorgio Cozzi ◽  
Marta Cognigni ◽  
Riccardo Busatto ◽  
Veronica Grigoletto ◽  
Manuela Giangreco ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Relief ◽  
Local Anaesthesia ◽  
Cross Sectional Study ◽  
Emergency Setting ◽  
Older Children ◽  
Cross Sectional ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Significant Difference

AbstractThe objective of the study is to investigate pain and distress experienced by a group of adolescents and children during peripheral intravenous cannulation in a paediatric emergency department. This cross-sectional study was performed between November 2019 and June 2020 at the paediatric emergency department of the Institute for Maternal and Child Health of Trieste, Italy. Eligible subjects were patients between 4 and 17 years old undergoing intravenous cannulation, split into three groups based on their age: adolescents (13–17 years), older children (8–12 years), and younger children (4–7 years). Procedural distress and pain scores were recorded through validated scales. Data on the use of topical anaesthesia, distraction techniques, and physical or verbal comfort during procedures were also collected. We recruited 136 patients: 63 adolescents, 48 older children, and 25 younger children. There was no statistically significant difference in the median self-reported procedural pain found in adolescents (4; IQR = 2–6) versus older and younger children (5; IQR = 2–8 and 6; IQR = 2–8, respectively). Furthermore, no significant difference was observed in the rate of distress between adolescents (79.4%), older (89.6%), and younger (92.0%) children. Adolescents received significantly fewer pain relief techniques.Conclusion: This study shows that adolescents experience similar pain and pre-procedural distress as younger children during peripheral intravenous cannulation. What is Known:• Topical and local anaesthesia, physical and verbal comfort, and distraction are useful interventions for pain and anxiety management during intravenous cannulation in paediatric settings. • No data is available on pain and distress experienced by adolescents in the specific setting of the emergency department. What is New:• Adolescents experienced high levels of pre-procedural distress in most cases and similar levels of pain and distress when compared to younger patients• The number of pain relief techniques employed during procedures was inversely proportional to patient’s age, topical or local anaesthesia were rarely used

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