A comparative study on assessment procedures and metric properties of two scoring systems of the Coma Recovery Scale-Revised items: standard and modified scores

Objective: The study compared the metric characteristics (discriminant capacity and factorial structure) of two different methods for scoring the items of the Coma Recovery Scale-Revised and it analysed scale scores collected using the standard assessment procedure and a new proposed method. Design: Cross sectional design/methodological study. Setting: Inpatient, neurological unit. Participants: A total of 153 patients with disorders of consciousness were consecutively enrolled between 2011 and 2013. Intervention: All patients were assessed with the Coma Recovery Scale-Revised using standard (rater 1) and inverted (rater 2) procedures. Main outcome measures: Coma Recovery Scale-Revised score, number of cognitive and reflex behaviours and diagnosis. Results: Regarding patient assessment, rater 1 using standard and rater 2 using inverted procedures obtained the same best scores for each subscale of the Coma Recovery Scale-Revised for all patients, so no clinical (and statistical) difference was found between the two procedures. In 11 patients (7.7%), rater 2 noted that some Coma Recovery Scale-Revised codified behavioural responses were not found during assessment, although higher response categories were present. A total of 51 (36%) patients presented the same Coma Recovery Scale-Revised scores of 7 or 8 using a standard score, whereas no overlap was found using the modified score. Unidimensionality was confirmed for both score systems. Conclusion: The Coma Recovery Scale Modified Score showed a higher discriminant capacity than the standard score and a monofactorial structure was also supported. The inverted assessment procedure could be a useful evaluation method for the assessment of patients with disorder of consciousness diagnosis.

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The Characteristics of Mortality Predictor Scoring for Sepsis Patients in Haji Adam Malik Hospital

International Journal of Research and Review ◽

10.52403/ijrr.20211046 ◽

2021 ◽

Vol 8 (10) ◽

pp. 339-344

Author(s):

Abdul Halim Harahap ◽

Franciscus Ginting ◽

Lenni Evalena Sihotang

Keyword(s):

Sofa Score ◽

Scoring System ◽

Scoring Systems ◽

Developed Countries ◽

Apache Ii ◽

Apache Ii Score ◽

P Value ◽

Cross Sectional ◽

Cross Sectional Design ◽

Score Apache

Introduction: Sepsis is a leading cause of death in the Intensive Care Unit (ICU) in developed countries and its incidence is increasing. Many scoring systems are used to assess the severity of disease in patients admitted to the ICU. SOFA score to assess the degree of organ dysfunction in septic patients. The Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system is most often used for patients admitted to the ICU. CCI scoring system to assess the effect of comorbid disease in critically ill patients on mortality. The study aimed to describe the characteristics of the use of scoring to predict patients’ mortality admitted to Haji Adam Malik Hospital. Methods: This is an observational study with a cross-sectional design. A total of 299 study subjects met the inclusion criteria and exclusion criteria, three types of scoring, namely SOFA score, APACHE II score, and CCI score were used to assess the prognosis of septic patients. Data analysis was performed using SPSS. P-value <0.05 was considered statistically significant. Results: A total of 252 people (84.3%) of sepsis patients died. The mean age of the septic patients who died was 54.25 years. The SOFA score ranged from 0-24, the median SOFA score in deceased sepsis patients was 5.0. The APACHE II score ranged from 0-71, the median APACHE II score in deceased sepsis patients was 23.0. The CCI score ranged from 0-37, the median CCI score in deceased sepsis patients was 5.0. Conclusion: Higher scores are associated with an increased probability of death in septic patients. Keywords: Sepsis; mortality predictor; SOFA score; APACHE II score, CCI score.

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Abstract 13892: Self-care is Poor in Lay Caregivers of Patients With Heart Failure, Especially If Caring More Than Eight Hours Daily

Circulation ◽

10.1161/circ.142.suppl_3.13892 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Austin Matus ◽

Gladys Thomas ◽

Jenna Garo ◽

Michela Luciani ◽

Davide Ausili ◽

...

Keyword(s):

Self Care ◽

The Self ◽

Cross Sectional ◽

Day Range ◽

Care Recipients ◽

Scale Scores ◽

Trial Testing ◽

Cross Sectional Design ◽

Enrollment Data ◽

Virtual Support

Introduction: Most patients with HF are living at home with care provided to them by loved ones. Informal caregiving is demanding and stressful, may exceed the caregiver’s ability to adapt, and many eventually become care recipients themselves. Engaging in self-care may improve caregivers’ health. Purpose: To describe the self-care behaviors of HF caregivers and compare self-care behaviors based on hours of daily caregiving. Methods: Using a cross-sectional design, we analyzed enrollment data from lay caregivers in the iCare4Me clinical trial testing the efficacy of a virtual support intervention promoting caregiver self-care. All caregivers were providing informal care to someone with HF for ≥ 8 hours/week. Self-care behaviors were measured with two instruments: Health Self-Care Neglect scale (9 dichotomous items summed for a final score) and the Self-Care Inventory (3 scales: Self-Care Maintenance, Monitoring, and Management with standardized scores 0-100; higher scores, better self-care). A Health Self-Care Neglect score ≥ 2 is considered poor self-care. A Self-Care inventory score < 70 is considered inadequate. Hours of caregiving were self-reported. Results: The sample (n=40) was mostly older adults (56 ± 13.2 years, female 97.5%) and many were Black (37.5%). Caregivers reported caregiving (10.8± 8.4 hours/day, range 1-24 hours/day). Differences in self-care were observed between those caregiving > 8 hours (n=18, 18.4 ± 6.6) vs. ≤ 8 hours/day (n=22, 4.6± 2.6). Mean Health Self-Care Neglect was higher in caregivers reporting ≥ 8 hours/day compared to < 8 hours (6.7 ± 2.0 vs. 4.9 ± 2.1, p=0.004). The most commonly neglected areas of self-care were “Put off recreational activities you enjoy” and “Taken medications improperly”. All Self-Care Inventory scale scores were inadequate (Maintenance 69.1 ± 17.1, Monitoring 63.7 ± 21.8, Management 58.2 ± 18.9). Those providing care for ≥ 8 hours/day reported significantly poorer Self-Care Maintenance (64.1 ± 11.7 vs. 73.9 ± 19.4, p=0.03). Conclusion: Self-care is poor in all the caregivers, but especially among those responsible for caregiving relatively more hours/day. Interventions to improve caregivers’ self-care are needed.

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Euthanasia in adults with psychiatric conditions: A descriptive study of the experiences of Belgian psychiatrists

Science Progress ◽

10.1177/00368504211029775 ◽

2021 ◽

Vol 104 (3) ◽

pp. 003685042110297

Author(s):

Monica Verhofstadt ◽

Kurt Audenaert ◽

Kris Van den Broeck ◽

Luc Deliens ◽

Freddy Mortier ◽

...

Keyword(s):

Medical Condition ◽

Assessment Procedure ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Existential Suffering ◽

Somatic Disorders ◽

Psychiatric Conditions ◽

Assessment Procedures ◽

Current Guidelines ◽

Entire Procedure

To investigate the experience of psychiatrists who completed assessment procedures of euthanasia requests from adults with psychiatric conditions (APC) over the last 12 months. Between November 2018 and April 2019 a cross-sectional survey was sent to a sample of 753 psychiatrists affiliated with Belgian organisations of psychiatrists to gather detailed information on their latest experience with a completed euthanasia assessment procedure, irrespective of its outcome (i.e. euthanasia being performed or not). Information on 46 unique cases revealed that most APC suffered from comorbid psychiatric and/or somatic disorders, and had received different kinds of treatment for many years prior to their euthanasia request. Existential suffering was the main reason for the request. The entire procedure spanned an average of 14 months, and an average of 13.5 months in the 23 cases that culminated in the performance of euthanasia. In all cases, the entire procedure entailed multidisciplinary consultations, including with family and friends. Psychiatrists reported fewer difficulties in assessing due care criteria related to the APC’s self-contemplation – for example, unbearable suffering on top of the due care criteria related to their medical condition; incurability due to lack of reasonable treatment perspectives. In a few cases in which euthanasia was the outcome, not all legal criteria were fulfilled in the reporting physicians’ opinions. Both positive and negative experiences of the assessment procedure were reported: for example, reduced suicide risk for the APC; an emotional burden and a feeling of being pressured for the psychiatrist. This study confirms that euthanasia assessment in APC entails a lengthy process with diverse complexities, and psychiatrists require support in more than one respect if the assessments are to be handled adequately. Thorough evaluation of current guidelines is recommended: that is, to what extent the guidelines sufficiently address the complexities around (e.g.) assessing legal criteria or involving relatives. We formulate various avenues for further research to build on this study’s insights and to fill remaining knowledge gaps.

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Motor Competence in Adolescents: Exploring Association with Physical Fitness

Sports ◽

10.3390/sports7070176 ◽

2019 ◽

Vol 7 (7) ◽

pp. 176 ◽

Cited By ~ 2

Author(s):

Thórdís Gísladóttir ◽

Monika Haga ◽

Hermundur Sigmundsson

Keyword(s):

Physical Fitness ◽

Weak Correlation ◽

Motor Competence ◽

Standard Score ◽

Cross Sectional ◽

Assessment Battery ◽

Test Items ◽

Movement Assessment ◽

Fitness Measures ◽

Cross Sectional Design

The purpose of this study was twofold: First, to examine the correlation between adolescents’ performance on the Movement Assessment Battery for Children -2 (MABC-2) and the Test of Motor Competence (TMC), and second, to interpret the correlation between performance on physical fitness measures and motor competence. This study had a cross-sectional design, in which 101 adolescents age 15–16 years were recruited. The participants were assessed with the MABC-2 (eight tasks), the TMC (four tasks) and physical fitness measures (four tasks). Ninety-four participants completed all the test items (51% male). The correlation between the standard score of the MABC-2 and TMC total score was found to be moderate (r = −0.418). A weak correlation was found between MABC-2 and total score of physical fitness (r = 0.278), while the correlation between TMC and physical fitness was a little stronger (r = 0.361). However, when removing one measure from the TMC (the walking/running in slopes), the correlation was weak and not significant (r = 0.109). The results suggest that different test batteries can cause discrepancy in the results regarding correlation between motor competence and physical fitness in adolescents.

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Knee Pain During Daily Tasks, Knee Osteoarthritis Severity, and Widespread Pain

Physical Therapy ◽

10.2522/ptj.20130331 ◽

2014 ◽

Vol 94 (4) ◽

pp. 490-498 ◽

Cited By ~ 21

Author(s):

Daniel L. Riddle ◽

Paul W. Stratford

Keyword(s):

Knee Pain ◽

Pain Scale ◽

Womac Pain ◽

Widespread Pain ◽

Cross Sectional ◽

Knee Oa ◽

Bilateral Knee ◽

Scale Scores ◽

Cross Sectional Design ◽

High Level

Background The presence of widespread pain is easily determined and is known to increase the risk for persistent symptoms. Objective The study hypothesis was that people with no or minimal knee osteoarthritis (OA) and high Western Ontario and McMaster Universities (WOMAC) Pain Scale scores would be more likely than other subgroups to report widespread pain. Design A cross-sectional design was used. Methods Data were obtained from the Multicenter Osteoarthritis Study, which includes people with or at high risk for knee OA. The inclusion criteria were met by 755 people with unilateral knee pain and 851 people with bilateral knee pain. Widespread pain was assessed with body diagrams, and radiographic Kellgren-Lawrence grades were recorded for each knee. Knee pain during daily tasks was quantified with WOMAC Pain Scale scores. Results Compared with people who had high levels of pain and knee OA, people with a low level of pain and a high level of knee OA, and people with low levels of pain and knee OA, a higher proportion of people with a high level of knee pain and a low level of knee OA had widespread pain. This result was particularly true for people with bilateral knee pain, for whom relative risk estimates ranged from 1.7 (95% confidence interval=1.2–2.4) to 2.3 (95% confidence interval=1.6–3.3). Limitations The cross-sectional design was a limitation. Conclusions People with either no or minimal knee OA and a high level of knee pain during daily tasks are particularly likely to report widespread pain. This subgroup is likely to be at risk for not responding to knee OA treatment that focuses only on physical impairments. Assessment of widespread pain along with knee pain intensity and OA status may assist physical therapists in identifying people who may require additional treatment.

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Use of Rasch analysis to refine a patient-reported questionnaire on satisfaction with communication of the multiple sclerosis diagnosis

Multiple Sclerosis Journal ◽

10.1177/1352458513518261 ◽

2014 ◽

Vol 20 (9) ◽

pp. 1224-1233 ◽

Cited By ~ 7

Author(s):

A Solari ◽

M Grzeda ◽

A Giordano ◽

K Mattarozzi ◽

R D’Alessandro ◽

...

Keyword(s):

Multiple Sclerosis ◽

Rasch Analysis ◽

Measurement Properties ◽

Partial Credit Model ◽

Cross Sectional ◽

Metric Properties ◽

Patient Reported ◽

Scale Scores ◽

Item Checklist ◽

The Moment

Background: The Comunicazione medico-paziente nella Sclerosi Multipla – Revised (COSM-R) is a patient self-assessed questionnaire probing the moment of multiple sclerosis (MS) diagnosis disclosure (section 1, five items) and following period (section 2, 15 items). Objectives: This study examined COSM-R dimensionality and measurement properties through Rasch analysis (partial-credit model) and proposed a revised questionnaire. Methods: Cross-sectional COSM-R data were obtained from 1068 people with MS (PwMS, 1065 questionnaires) participating in four studies (102 centres). Mean age was 40 years (range 17–73); 70% were women; 53% were from Northern, 25% from Central, and 21% from Southern Italy. Results: Unidimensionality was not confirmed for COSM-R section 1, but was for section 2 after removal of three items. The revised instrument (COSM-S, Shortened) consisted of the original five-item checklist (section 1), modified by removing the table grouping of three items, and 12 of the original 15 section 2 items, which could now be summed and transformed into an interval scale. Scores were higher for items assessing emotional satisfaction than for those assessing informational satisfaction. Conclusions: The proposed COSM-S is a composite measure of satisfaction with MS diagnosis communication with improved metric properties over the original COSM-R, and whose section 2 satisfies Rasch model expectations.

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PROFIL SKALA KLINIS DAN SUBKLINIS MMPI-2 ADAPTASI INDONESIA PADA MAHASISWA SEMESTER 5 TAHUN AKADEMIK 2012/2013 FAKULTAS KEDOTERAN UNIVERSITAS SAM RATULANGI MANADO

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.5.1.2013.2629 ◽

2013 ◽

Vol 5 (1) ◽

Author(s):

Reni Ch. Ibrahim ◽

Herdy Munayang ◽

Barnabas H. R. Kairupan

Keyword(s):

Survey Design ◽

Demographic Data ◽

Univariate Analysis ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Clinical Scales ◽

North Sulawesi ◽

Scale Scores ◽

Cross Sectional Design ◽

Social Introversion

Abstract: Students often deal with many internal or external demands. These conditions can lead to some academic and non-academic problems which influence their mental health. Depression and anxiety are the most common disorders experienced by students. This was a descriptive study with a cross sectional survey design. This study aimed to obtain the mental status of students of the academic year 2012/2013 Faculty of Medicine University of Sam Ratulangi Manado based on clinical and subclinical scales MMPI-2 Indonesian adapatation. Data were analyzed by using a univariate analysis of the SPPS 20 version. The results showed that of a hundred respondents the majority of them, in terms of socio-demographic data, were females (53%), age ≤20 (90%), origins of ethnicity and residences outside North Sulawesi (56% and 66%), two siblings and the second born (38%), while the parents occupations as civil servants (46% fathers and 49% mothers). The distribution of MMPI-2 clinical scales showed high profiles with the percentages as follow: Si (28%), D (27%), Pt (18%), Hs and Sc (12%), Hy (10%), Pd (7%), and Mf and Ma (2%). The greatest proportions of each subclinical scale based on the highest clinical scale scores were: D1 (88.9%), Si1 (82.1%), D4 (81.5%), and D5 (63%). Conclusion: Depression and social introversion scales were found as the highest and most predominant scales. Each student who showed a high scale profile should be paid more attention to from the Faculty council in order to prevent them from developing mental disorders. Keywords: profile, clinical scales, subclinical scales, MMPI-2, students. Abstrak: Mahasiswa hampir selalu diperhadapkan dengan banyak tuntutan internal dan atau eksternal yang dapat menimbulkan masalah-masalah akademis maupun non-akademis. Setiap masalah tersebut dapat memengaruhi kesehatan mentalnya. Depresi dan kecemasan merupakan gangguan mental yang paling umum dialami oleh mahasiswa. Penelitian ini bertujuan untuk mendapatkan status mental mahasiswa semester 5 Fakultas Kedokteran Universitas Sam Ratulangi Manado TA 2012/2013 berdasarkan skala klinis dan sub-klinis MMPI-2 adaptasi Indonesia. Penelitian ini merupakan penelitian deskriptif dengan menggunakan survei dan cross sectional design. Analisis data berupa analisis univariat dengan menggunakan SPSS 20. Hasil penelitian memperlihatkan bahwa dari 100 responden distribusi mahasiswa berdasarkan sosio-demografik terbanyak pada perempuan (53%), usia ≤20 (90%), yang berasal dari daerah dan suku di luar Sulawesi Utara (56% dan 66%), 2 bersaudara dan anak ke-2 dalam keluarga (38%), serta pekerjaan ayah dan ibu sebagai PNS (46% dan 49%). Distribusi skala klinis MMPI-2 pada mahasiswa dari semua skala menunjukkan profil yang tinggi dengan persentase berturut-turut dari tinggi ke rendah yaitu: Si (28%), D (27%), Pt (18%), Hs dan Sc (12%), Hy (10%), Pd (7%), serta Mf dan Ma (2%). Hasil yang menonjol pada skala subklinis berdasarkan skor tinggi skala klinis berturut-turut D1 (88,9%), Si1 (82,1%), D4(81,5%), dan D5 (63%). Simpulan: Berdasarkan skala klinis dan sub-klinis MMPI-2 adaptasi Indonesia, pada mahasiswa semester 5 Fakultas Kedokteran Universitas Sam Ratulangi Manado TA 2012/2013 skala yang tinggi dan skala yang menonjol ialah depression dan social introversion. Setiap mahasiswa dengan profil skala yang tinggi seharusnya mendapat perhatian dari pimpinan fakultas untuk mencegah timbulnya gangguan mental. Kata kunci: profil, skala klinis, subklinis, MMPI-2, mahasiswa.

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Hubungan sedentary lifestyle dengan fungsi kognitif lansia di UPT Pelayanan Sosial Tresna Werdha Jember

Journal of Community Empowerment for Health ◽

10.22146/jcoemph.43624 ◽

2019 ◽

Vol 2 (1) ◽

Author(s):

Ega Putri Nurwita ◽

Tantut Susanto ◽

Hanny Rasni

Keyword(s):

Physical Activity ◽

Cognitive Function ◽

Sedentary Lifestyle ◽

The Elderly ◽

Rank Test ◽

Standard Score ◽

Cross Sectional ◽

Normal Cognitive Function ◽

Global Physical Activity Questionnaire ◽

Cross Sectional Design

Cognitive function disorders in elderly is one of the problems found in Indonesia. Cognitive function is related to a person's lifestyle such as physical activity. Physical activity can increase brain nerve growth and affect cognitive function in elderly. However, the majority of the elderly choose sedentary lifestyle. Sedentary is a lifestyle by applying behavior when sitting, leaning back, and lying down which is done starting from waking up to the night before going to sleep continuously. The purpose of this study was to analyze the relationship between sedentary lifestyle and cognitive function among the elderly at UPT PSTW Jember. A cross-sectional design was conducted among 84 elderly at UPT PSTW Jember by using convenience sampling. A questionnaire was used to identify the sociodemography of participants while the data of sedentary lifestyle was obtained by using Global Physical Activity Questionnaire (GPAQ), and the data of cognitive function was taken using Mini Mental State Exam (MMSE). Spearman rank test was performed to answer the purpose of this study. Among 84 participants, it is shown that elderly are sedentary for 405 minutes/day, which are less than standard score (Ƶ = 1.377; p = 0.045). The cognitive function score of elderly is 27 which are greater than the standard score (Ƶ = 1.401; p = 0.040), so that the elderly has normal cognitive function. According to the result of the study, the sedentary lifestyle is related to cognitive function, the shorter duration of sedentary lifestyle, the cognitive function increases (r = -0.470; p < 0.001). Therefore, planned intervention is to make schedule routine physical activity and aerobic exercise to maintain cognitive function in elderly.

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Correlation of Wells Score, Caprine Score, and Padua Score with Risk of Hypercoagulation Condition Based on D-dimer in Intra-articular, Periarticular, and Degenerative Fracture Patients of Inferior Extremity

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7252 ◽

2021 ◽

Vol 9 (B) ◽

pp. 1580-1585

Author(s):

Thomas Erwin Christian Junus Huwae ◽

Ahmad Heifan ◽

Muhammad Alwy Sugiarto

Keyword(s):

Scoring Systems ◽

Cross Sectional ◽

Vein Thrombosis ◽

Large Joint ◽

Inferior Extremity ◽

Increase Risk ◽

Wells Score ◽

Cross Sectional Design ◽

Deep Vein ◽

D Dimer

BACKGROUND: Surgery for large joint areas can increase risk of venous thromboembolism, which can be in the form of pulmonary embolism or deep vein thrombosis (DVT). As much as, 40–60% of hemostasis abnormalities, specifically hypercoagulable diseases, are suspected of causing this condition. The risk of developing DVT can be assessed using a physiological examination such as Wells score, Caprini score, and Padua score. The scoring systems assess some of the patient’s symptoms and risk factors for increasing the incidence of DVT. Hypercoagulation conditions can be assessed using D-dimer, which is often considered a gold standard in measuring hypercoagulation conditions or as an indicator of DVT. AIM: We aimed to investigate correlation of Wells Score, Caprine Score, and Padua Score with risk of hypercoagulation condition based on d-dimer in intra-articular, periarticular, and degenerative fracture patients of inferior extremity. METHODS: This study used a cross-sectional design and was conducted on 34 participants that undergoing periarticular surgery. This study compared the Wells, Caprini, and Padua scores test against hypercoagulation conditions confirmed by the D-dimer examination. RESULTS: The correlation between Wells, Padua, Caprini scores, and D-dimer was 0.676, 0.023, and 0.395, respectively. CONCLUSION: There was a significant relationship between the Padua scores and the D-dimer.

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Relationship of Self-Compassion, Hope, and Emotional Control to Perceived Burdensomeness, Thwarted Belongingness, and Suicidal Ideation

Crisis ◽

10.1027/0227-5910/a000697 ◽

2020 ◽

pp. 1-7

Author(s):

Laura R. Umphrey ◽

John C. Sherblom ◽

Paulina Swiatkowski

Keyword(s):

College Students ◽

Suicidal Ideation ◽

Emotional Control ◽

Thwarted Belongingness ◽

Perceived Burdensomeness ◽

Cross Sectional ◽

Self Compassion ◽

Positive Feelings ◽

Cross Sectional Design ◽

Relationship Of

Abstract. Background: Cultivating positive feelings of self in relationships with others can affect perceptions of belongingness and burdensomeness. Aims: The present study examines the relationships of self-compassion, hope, and emotional control to thwarted belongingness, perceived burdensomeness, and suicidal ideation. Method: Participants were 481 college students who completed scales measuring self-compassion, hope, emotional control, thwarted belongingness, perceived burdensomeness, and suicidal ideation. Results: Correlation and parallel mediation analysis results show relationships between self-compassion, hope, and emotional control with perceived burdensomeness, thwarted belongingness, and suicidal ideation. Limitations: The study is limited by its cross-sectional design, sample demographics, and inability to distinguish between individuals with suicidal ideation and those who attempt suicide. Conclusion: The results show that the relationships of self-compassion, hope, and emotional control to perceived burdensomeness, thwarted belongingness, and suicidal ideation are worth further investigation.

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