scholarly journals The Relationship between Training and Mental Health among Caregivers of Individuals with Polytrauma

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Lillian Flores Stevens ◽  
Treven C. Pickett ◽  
Kathryn P. Wilder Schaaf ◽  
Brent C. Taylor ◽  
Amy Gravely ◽  
...  
Keyword(s):  
Mental Health ◽  
Short Form ◽  
Outcome Measurement ◽  
Self Esteem ◽  
Self Report ◽  
Care Recipient ◽  
Caregiver Training ◽  
Measurement Information ◽  
Patient Reported ◽  
Caregiver Mental Health

This was a hypothesis-generating exploration of relationships between caregiver training during TBI/polytrauma rehabilitation and caregiver mental health. In this cross-sectional study, 507 informal caregivers to US service members with TBI who received inpatient rehabilitation care in a Veterans Affairs’ Polytrauma Rehabilitation Center from 2001 to 2009 completed a retrospective, self-report survey. Embedded in the survey were measures of caregiver mental health, including the National Institutes of Health’s Patient Reported Outcome Measurement Information System (PROMIS) Anxiety and Depression Short Forms, the Rosenberg Self-Esteem scale, and the Zarit Burden Short Form. Though no groups endorsed clinical levels, mental health symptoms varied by caregiver training category (Trained, Not Trained, and Did Not Need Training). Caregivers who did not receive training on how to navigate healthcare systems endorsed higher depression and burden and lower self-esteem than those who did. Caregivers who did not receive training in supporting their care recipients’ emotions endorsed higher anxiety, depression, and burden and lower self-esteem than those who did. Analyses also suggested a different association between training and mental health based on caregivers’ relationship to the care recipient and the intensity of care recipient needs. Potential hypotheses for testing in future studies raised by these findings are discussed.

scholarly journals Screening for Anxiety and Depressive Symptoms in Type 2 Diabetes Using Patient-Reported Outcome Measures: Comparative Performance of the EQ-5D-5L and SF-12v2

2018 ◽  
Vol 3 (2) ◽  
pp. 238146831879936 ◽  
Author(s):  
Fatima Al Sayah ◽  
Arto Ohinmaa ◽  
Jeffrey A. Johnson
Keyword(s):  
Mental Health ◽  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Short Form ◽  
Outcome Measurement ◽  
Anxiety Symptoms ◽  
Receiver Operating Curve ◽  
Comparative Performance ◽  
Patient Reported

Objective. To evaluate the performance of EQ-5D-5L (EuroQol Five-Dimension, Five-Level Questionnaire) and SF-12-v2 (12-item Medical Outcomes Health Survey–Short Form, Version 2) in screening for anxiety and depressive symptoms in adults with type 2 diabetes. Methods. Cross-sectional data from a population-based study of type 2 diabetes in Alberta, Canada, were used. Anxiety symptoms (using the 2-item Generalized Anxiety Disorder questionnaire) were categorized into absent (<3) versus present (≥3). Depressive symptoms (using the 8-item Patient Health Questionnaire) were categorized according to two severity cut-points: absent (<10) versus mild (≥10), and absent (<15) versus moderate-severe (≥15). The performance of the measures in screening for anxiety and depressive symptoms was evaluated using receiver operating curve (ROC) analysis. Results. Average age of participants ( N = 1,391) was 66.8 years (SD 10.2), and 47% were female. Seventeen percent of participants screened positive for mild and 5.9% for moderate-severe depressive symptoms, and 11.3% for anxiety symptoms. For comorbid symptoms, 8.6% screened positive for anxiety and any depressive symptoms, and 4.6% for anxiety and moderate-severe depressive symptoms. The EQ-5D-5L anxiety/depression dimension and the SF-12 mental composite summary score had the best performance in screening for anxiety (area under ROC: 0.89, 0.89, respectively), depressive symptoms (any: 0.88, 0.92; moderate-severe: 0.90, 0.90), and comorbid anxiety and depressive symptoms (any: 0.92, 0.91; moderate-severe: 0.92, 0.90). These were followed by SF-12 feeling downhearted/depressed item (range = 0.83–0.85), while the lowest performance was for the EQ-5D-5L index score (0.80–0.84) and the SF-12 mental health domain (0.81–0.82). Conclusion. The EQ-5D-5L and the SF-12 are suitable tools for screening for anxiety and depressive symptoms in adults with type 2 diabetes. These tools present a unique opportunity for a standardized approach for routine mental health screening within the context of routine outcome measurement initiatives, where screening is recommended.

Appraisal of Candidate Instruments for Assessment of the Physical Function Domain in Patients with Psoriatic Arthritis

2020 ◽  
Vol 48 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Ying Ying Leung ◽  
Ana-Maria Orbai ◽  
Alexis Ogdie ◽  
Pil Hojgaard ◽  
Richard Holland ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Physical Function ◽  
Outcome Measures ◽  
Physical Functioning ◽  
Working Group ◽  
Short Form ◽  
Outcome Measurement ◽  
Patient Reported Outcome Measures ◽  
Measurement Information ◽  
Patient Reported

Objective.Numerous patient-reported outcome measures (PROM) exist for the measurement of physical function for psoriatic arthritis (PsA), but only a few are validated comprehensively. The objective of this project was to prioritize PROM for measuring physical function for potential incorporation into a standardized outcome measurement set for PsA.Methods.A working group of 13 members including 2 patient research partners was formed. PROM measuring physical function in PsA were identified through a systematic literature review and recommendations by the working group. The rationale for inclusion and exclusion from the original list of existing PROM was thoroughly discussed and 2 rounds of Delphi exercises were conducted to achieve consensus.Results.Twelve PROM were reviewed and discussed. Six PROM were prioritized: Health Assessment Questionnaire (HAQ) and 4 modifications (HAQ-Disability Index, HAQ-Spondyloarthritis, modified HAQ, multidimensional HAQ), Medical Outcomes Study 36-item Short Form survey physical functioning domain, and the Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning module.Conclusion.Through discussion and Delphi exercises, we achieved consensus to prioritize 6 physical function PROM for PsA. These 6 PROM will undergo further appraisal using the Outcome Measures in Rheumatology (OMERACT) Filter 2.1.

scholarly journals Implementation of quality measures and patient-reported outcomes in an epilepsy clinic

Neurology ◽  
2019 ◽  
Vol 93 (22) ◽  
pp. e2032-e2041 ◽  
Author(s):  
Lidia M.V.R. Moura ◽  
Brandon Magliocco ◽  
John P. Ney ◽  
Eric M. Cheng ◽  
Gregory J. Esper ◽  
...  
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Outcome Measurement ◽  
Quality Measures ◽  
Patient Reported Outcome ◽  
Care Quality ◽  
Measurement Information ◽  
Physical And Mental Health ◽  
Patient Reported ◽  
Systematic Collection

ObjectiveTo see if systematic collection of patient-reported epilepsy quality measures can identify opportunities to improve care, and to examine the associations between these measures and physical and mental health.MethodsWe developed a patient-reported questionnaire for medication adherence, seizure frequency, medication side effects, and driving that included the Patient-Reported Outcome Measurement Information System–10 (PROMIS-10) (physical and mental health). We offered it to all adult patients seen twice in an epilepsy clinic (January 2017–January 2018). The questionnaire was available on the web as well as a tablet provided at appointment check-in. We used the first completed questionnaire to explore the relationship between patient-reported care quality and measures of physical and mental health.ResultsA total of 610 unique patients (15% of the total encounters) completed a survey. Respondents were comparable to nonrespondents. Respondents reported gaps in care or opportunities for quality improvement in 48.4% (n = 295) of the encounters. Of patients who reported at least 1 seizure per month over the previous 3 months, 55.2% (n = 100) reported problems with adherence, 30.0% (n = 131) reported having problems believed to be adverse reactions to anticonvulsants, and 15.2% (n = 41) reported driving. In addition, respondents who reported either seizures over the recent 3 months, nonadherence to treatment due to cost, or anticonvulsant-associated adverse effects had consistently worse physical and mental health (all p < 0.05).ConclusionsSystematic collection of epilepsy quality measures endorsed by the American Academy of Neurology can identify opportunities for quality improvement. Measures of epilepsy care quality predict outcomes that matter to patients.

Natural History of Poland Syndrome: A Long-term Study of Functional and Psychosocial Outcomes

Hand ◽  
2020 ◽  
pp. 155894472096386
Author(s):  
Sarah M. Schippers ◽  
Hailee Reist ◽  
Qiang An ◽  
Joseph A. Buckwalter V
Keyword(s):  
Short Form ◽  
Outcome Measurement ◽  
Measurement Information ◽  
Strength Testing ◽  
Poland Syndrome ◽  
Population Norms ◽  
Long Term Study ◽  
Sf 36 ◽  
Patient Reported

Background Poland syndrome (PS) is a congenital condition characterized by pectoralis hypoplasia and an ipsilateral hand anomaly that frequently necessitates surgery in childhood. This study aimed to determine long-term functional and psychosocial implications of PS. Methods Patients underwent strength testing of their affected limb by comparing with their contralateral arm. They completed Disabilities of the Arm, Shoulder, and Hand (DASH), 36-item Short-Form Health Survey (SF-36), and several Patient-Reported Outcome Measurement Information System (PROMIS) surveys. Aggregate scores were compared with population norms. Results Twenty-eight patients were enrolled, and 16 returned for strength testing. The average age was 42 years (range, 18-65 years), and the average follow-up was 25 years (range, 1-52 years). Dynamometer testing showed decreased strength in shoulder internal rotation and abduction/adduction, hand grip, and key pinch/tip pinch. Average DASH and SF-36 scores were comparable with population norms. The PROMIS Upper Extremity score (46.2) was significantly lower than the average 50 (SD, 10.0); the Social Roles score (57.3) indicated significantly less disability than the general population. Seventy-nine percent reported higher than average satisfaction with life, 82% had normal self-esteem, and 21% and 4% met screening criteria for depression and anxiety, respectively. The Derriford Appearance Scale revealed that 68% of patients identified PS as their most self-conscious feature, with 36% reporting subsequent life adjustments. Conclusions This cohort of PS patients self-reported more favorable functional, psychological, and emotional outcomes than expected based on significant shoulder and hand strength deficits. Despite these deficits, patients make adaptations, allowing fulfilling lives with psychosocial functioning similar to their peers.

scholarly journals Feasibility, Validity, and Reliability of the 10-item Patient Reported Outcomes Measurement Information System Global Health Short Form in Outpatients with Systemic Lupus Erythematosus

2018 ◽  
Vol 45 (3) ◽  
pp. 397-404 ◽  
Author(s):  
Shanthini Kasturi ◽  
Jackie Szymonifka ◽  
Jayme C. Burket ◽  
Jessica R. Berman ◽  
Kyriakos A. Kirou ◽  
...  
Keyword(s):  
Mental Health ◽  
Lupus Erythematosus ◽  
Patient Reported Outcomes ◽  
Short Form ◽  
Measurement Information ◽  
Physical And Mental Health ◽  
Validity And Reliability ◽  
Sf 36 ◽  
Patient Reported ◽  
Health Domains

Objective.To assess the feasibility, validity, and reliability of the Patient Reported Outcomes Measurement Information System Global Health Short Form (PROMIS10) in outpatients with systemic lupus erythematosus (SLE).Methods.SLE outpatients completed PROMIS10, Medical Outcomes Study Short Form-36 (SF-36), LupusQoL-US, and selected PROMIS computerized adaptive tests (CAT) at routine visits at an SLE Center of Excellence. Construct validity was evaluated by correlating PROMIS10 physical and mental health scores with PROMIS CAT, legacy instruments, and physician-derived measures of disease activity and damage. Test-retest reliability was determined among subjects reporting stable SLE activity at 2 assessments 1 week apart using intraclass correlation coefficients (ICC).Results.A diverse cohort of 204 out of 238 patients with SLE (86%) completed survey instruments. PROMIS10 physical health scores strongly correlated with physical function, pain, and social health domains in PROMIS CAT, SF-36, and LupusQoL, while mental health scores strongly correlated with PROMIS depression CAT, SF-36, and LupusQoL mental health domains (Spearman correlations ≥ 0.70). Active arthritis, comorbid fibromyalgia (FM), and anxiety were associated with worse PROMIS10 scores, but sociodemographic factors and physician-assessed flare status were not. Test-retest reliability for PROMIS10 physical and mental health scores was high (ICC ≥ 0.85). PROMIS10 required < 2 minutes to complete.Conclusion.PROMIS10 is valid and reliable, and can efficiently screen for impaired physical function, pain, and emotional distress in outpatients with SLE. With strong correlations to LupusQoL and SF-36 but significantly reduced responder burden, PROMIS10 is a promising tool for measuring patient-reported outcomes in routine SLE clinical care and value-based healthcare initiatives.

scholarly journals Healthcare providers’ perceived support from their organization is associated with lower burnout and anxiety amid the COVID-19 pandemic

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259858
Author(s):  
Katherine M. Reitz ◽  
Lauren Terhorst ◽  
Clair N. Smith ◽  
Insiyah K. Campwala ◽  
Maryanna S. Owoc ◽  
...  
Keyword(s):  
Healthcare System ◽  
Organizational Support ◽  
Lower Risk ◽  
Short Form ◽  
Outcome Measurement ◽  
Healthcare Providers ◽  
Measurement Information ◽  
Full Time ◽  
Health Crisis ◽  
Patient Reported

Background Professional burnout represents a significant threat to the American healthcare system. Organizational and individual factors may increase healthcare providers’ susceptibility or resistance to burnout. We hypothesized that during the COVID-19 pandemic, 1) higher levels of perceived organizational support (POS) are associated with lower risk for burnout and anxiety, and 2) anxiety mediates the association between POS and burnout. Methods In this longitudinal prospective study, we surveyed healthcare providers employed full-time at a large, multihospital healthcare system monthly over 6 months (April to November 2020). Participants were randomized using a 1:1 allocation stratified by provider type, gender, and academic hospital status to receive one of two versions of the survey instrument formulated with different ordering of the measures to minimize response bias due to context effects. The exposure of interest was POS measured using the validated 8-item Survey of POS (SPOS) scale. Primary outcomes of interest were anxiety and risk for burnout as measured by the validated 10-item Burnout scale from the Professional Quality (Pro-QOL) instrument and 4-item Emotional Distress-Anxiety short form of the Patient Reported Outcome Measurement Information System (PROMIS) scale, respectively. Linear mixed models evaluated the associations between POS and both burnout and anxiety. A mediation analysis evaluated whether anxiety mediated the POS-burnout association. Results Of the 538 participants recruited, 402 (75%) were included in the primary analysis. 55% of participants were physicians, 73% 25–44 years of age, 73% female, 83% White, and 44% had ≥1 dependent. Higher POS was significantly associated with a lower risk for burnout (-0.23; 95% CI -0.26, -0.21; p<0.001) and lower degree of anxiety (-0.07; 95% CI -0.09, -0.06; p = 0.010). Anxiety mediated the associated between POS and burnout (direct effect -0.17; 95% CI -0.21, -0.13; p<0.001; total effect -0.23; 95% CI -0.28, -0.19; p<0.001). Conclusion During a health crisis, increasing the organizational support perceived by healthcare employees may reduce the risk for burnout through a reduction in anxiety. Improving the relationship between healthcare organizations and the individuals they employ may reduce detrimental effects of psychological distress among healthcare providers and ultimately improve patient care.

Measuring Fatigue in Older Adults With Joint Pain: Reliability and Validity Testing of the PROMIS Fatigue Short Forms

2019 ◽  
Vol 27 (3) ◽  
pp. 534-553
Author(s):  
Alisha J. Hackney ◽  
N. Jennifer Klinedinst ◽  
Barbara Resnick
Keyword(s):  
Older Adults ◽  
Psychometric Properties ◽  
Internal Consistency ◽  
Joint Pain ◽  
Short Form ◽  
Outcome Measurement ◽  
Reliability And Validity ◽  
Measurement Information ◽  
Cross Sectional ◽  
Patient Reported

Background and PurposeLimited literature exists regarding the psychometric properties of the Patient-Reported Outcome Measurement Information System (PROMIS) Fatigue Short Form 8a. This study compared the psychometric properties of the 8a to the established PROMIS Fatigue Short Form 7a.MethodsThis was a cross-sectional study of 31 older adults with joint pain. Equivalent forms reliability and a Rasch analysis explored reliability (equivalent forms, internal consistency), validity (unidimensionality, item INFIT/OUTFIT), and additional psychometrics (item mapping).ResultsThe measures were equivalent in measuring fatigue (r = 0.75, p < .001) with good internal consistency (α = .87−.92). Both were unidimensional. Even though the 8a had better fitting items, neither measure could differentiate low levels of fatigue.ConclusionThe 8a has comparable psychometric properties to the 7a in this population. Future work is needed in larger, more diverse samples.

scholarly journals Development of the PROMIS Pediatric Physical Activity Item Banks

2020 ◽  
Vol 100 (8) ◽  
pp. 1393-1410 ◽  
Author(s):  
Carole A Tucker ◽  
Katherine B Bevans ◽  
Brandon D Becker ◽  
Rachel Teneralli ◽  
Christopher B Forrest
Keyword(s):  
Physical Activity ◽  
Differential Item Functioning ◽  
Outcome Measurement ◽  
Self Report ◽  
Measurement Information ◽  
Response Options ◽  
Item Banks ◽  
Item Functioning ◽  
Patient Reported ◽  
Parent Proxy

Abstract Objective The purpose of this study was to develop self-report and parent-proxy measures of children’s physical activity for clinical research and practice and to demonstrate a valid and reliable instrument of children’s lived experience of physical activity as reported by the children themselves or their parent proxies. Methods This study involved qualitative development of item pools followed by 2 cross-sectional validity and reliability studies. The National Institutes of Health Patient Reported Outcome Measurement Information System (PROMIS) instrument development standards were applied to create child self-report and parent-proxy physical activity instruments from previously developed, content-valid pools of physical activity items. Each item used a 7-day recall period and had 5 response options. Item bank calibration was based on national samples totaling 3033 children aged 8 to 17 years and 2336 parents of children aged 5 to 17 years. Quantitative analyses included reliability assessments, factor analyses, item response theory calibration, differential item functioning, and construct validation. Results The final item banks comprised 10 items each. The items were selected based on content and psychometric properties. The item banks appeared to be unidimensional and free from differential item functioning. They showed excellent reliability and a high degree of precision across the range of the latent variable. Child-report and parent-proxy 4- and 8-item fixed-length instruments were specified. The instruments showed moderate correlation with existing self-report measures of physical activity. Conclusion The PROMIS Pediatric Physical Activity instruments provide precise and valid measurement of children’s lived experiences of physical activity. Impact The availability of the PROMIS Pediatric Physical Activity instruments will support advances in clinical practice and research that require measurement of pediatric physical activity by self- and parent-proxy report.

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