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.

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.

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.

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 The Norwegian PROMIS-29: psychometric validation in the general population for Norway

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Andrew M. Garratt ◽  
Joël Coste ◽  
Alexandra Rouquette ◽  
José M. Valderas
Keyword(s):  
General Population ◽  
Short Form ◽  
Outcome Measurement ◽  
National Registry ◽  
Postal Survey ◽  
Psychometric Validation ◽  
Measurement Information ◽  
Partial Credit Model ◽  
Structural Validity ◽  
Patient Reported

Abstract Background The Patient Reported Outcome Measurement Information System profile instruments include “high information” items drawn from large item banks following the application of modern psychometric criteria. The shortest adult profile, PROMIS-29, looks set to replace existing short-form instruments in research and clinical practice. The objective of this study was to undertake the first psychometric evaluation of the Norwegian PROMIS-29, following a postal survey of a random sample of 12,790 Norwegians identified through the National Registry of the Norwegian Tax Administration. Confirmatory factor analysis was used to assess structural validity. Fit to the Rasch partial credit model and differential item functioning (DIF) were assessed in relation to age, gender, and education. PROMIS-29 scores were compared to those for the EQ-5D-5L and the Self-assessed Comorbidity Questionnaire (SCQ), for purposes of assessing validity based on a priori hypotheses. Results There were 3200 (25.9%) respondents with a mean age (SD) of 51 (20.7, range 18 to 97 years) and 55% were female. The PROMIS-29 showed satisfactory structural validity and acceptable fit to Rasch model including unidimensionality, and measurement invariance across age and education levels. One pain interference item had uniform DIF for gender but splitting gave satisfactory fit. Domain reliability estimates ranged from 0.85 to 0.95. Correlations between PROMIS-29 domain, SCQ and EQ-5D scores were largely as expected, the largest being for scores assessing very similar aspects of health. Conclusions The Norwegian version of the PROMIS-29 is a reliable and valid generic self-reported measure of health in the Norwegian general population. The instrument is recommended for further application, but the analysis should be replicated and responsiveness to change assessed in future studies before it can be recommended for clinical and health services evaluation in Norway.

Translating CESD-20 and PHQ-9 Scores to PROMIS Depression

Assessment ◽  
2016 ◽  
Vol 24 (3) ◽  
pp. 300-307 ◽  
Author(s):  
Jiseon Kim ◽  
Hyewon Chung ◽  
Robert L. Askew ◽  
Ryoungsun Park ◽  
Salene M. W. Jones ◽  
...  
Keyword(s):  
Short Form ◽  
Outcome Measurement ◽  
Intraclass Correlation ◽  
Depression Scale ◽  
Correlation Coefficients ◽  
Patient Reported Outcome ◽  
Epidemiologic Studies ◽  
Measurement Information ◽  
Patient Reported ◽  
Patient Health

This study examined the accuracy of depression cross-walk tables in a sample of people with multiple sclerosis (MS). The tables link scores of two commonly used depression measures to the Patient Reported Outcome Measurement Information System Depression (PROMIS-D) scale metric. We administered the 8-item PROMIS-D (Short-Form 8b; PROMIS-D-8), the 20-item Center for Epidemiologic Studies Depression Scale (CESD-20), and the 9-item Patient Health Questionnaire (PHQ-9) to 459 survey participants with MS. We examined correlations between actual PROMIS-D-8 scores and the scores predicted by cross-walks based on PHQ-9 and CESD-20 scores. Intraclass correlation coefficients were used to assess correspondence. Consistency in severity classification was also calculated. Finally, we used Bland–Altman plots to graphically examine the levels of agreement. The correlations between actual and cross-walked PROMIS-D-8 scores were strong (CESD-20 = .82; PHQ-9 = .74). The intraclass correlation was moderate (.77). Participants were consistently classified as having or not having at least moderate depressive symptoms by both actual and cross-walked scores derived from the CESD-20 (90%) and PHQ-9 (85%). Bland–Altman plots suggested the smaller differences between actual and cross-walked scores with greater-than-average depression severity. PROMIS cross-walk tables can be used to translate depression scores of people with MS to the PROMIS-D metric, promoting continuity with previous research.

scholarly journals Outcomes of Transforaminal Lumbar Interbody Fusion Using Unilateral Versus Bilateral Interbody Cages

Neurospine ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 854-862
Author(s):  
Conor P. Lynch ◽  
Elliot D.K. Cha ◽  
Augustus J. Rush III ◽  
Caroline N. Jadczak ◽  
Shruthi Mohan ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Short Form ◽  
Outcome Measurement ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Measurement Information ◽  
Lumbar Interbody Fusion ◽  
Bilateral Group ◽  
Patient Reported ◽  
The Impact ◽  
Unilateral Group

Objective: To assess the impact of bilateral versus unilateral interbody cages on outcomes for minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) procedures.Methods: A retrospective review for primary, elective, single-level MIS TLIF procedures with bilateral posterior instrumentation from 2008–2020 was performed. Patients were grouped according to unilateral or bilateral interbody cage use. Procedures performed without static interbody cages or indicated for trauma, infection, malignancy were excluded. Patient-reported outcomes (PROs) included visual analogue scale (VAS), Oswestry Disability Index, 12-item Short Form health survey physical composite score (SF-12 PCS), PatientReported Outcome Measurement Information System physical function (PROMIS-PF). PROs were collected preoperatively and postoperatively. Change in PROs (Δ) was calculated and compared between groups. Achievement of minimum clinically important difference (MCID) was calculated using established values from the literature. Achievement rates were compared between groups using logistic regression.Results: The study included 151 patients, with 111 unilateral and 40 bilateral cage placements. Charlson Comorbidity Index, diabetes, and insurance status differed between groups (p < 0.050). Prevalence of degenerative and isthmic spondylolisthesis (both p ≤ 0.002), operative level (p = 0.003), and postoperative length of stay (p = 0.022) significantly differed between groups. The unilateral group had lower 1-year arthrodesis rates (p = 0.035). Preoperative VAS leg (p = 0.017) and SF-12 PCS (p = 0.045) were worse for the unilateral group. ΔPROMIS-PF was greater for the bilateral group at 2 years (p = 0.001). Majority of patients achieved an overall MCID for all PROs, except VAS leg (bilateral group).Conclusion: While preoperative status and postoperative arthrodesis rates differed, patients achieved an MCID at similar rates regardless of use of unilateral or bilateral cages.

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 Measuring Self-Reported Cancer-Related Cognitive Impairment: Recommendations from the Cancer Neuroscience Initiative Working Group

2021 ◽  
Author(s):  
Ashley M Henneghan ◽  
Kathleen Van Dyk ◽  
Tara Kaufmann ◽  
Rebecca Harrison ◽  
Christopher Gibbons ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Working Group ◽  
Short Form ◽  
Outcome Measurement ◽  
Patient Reported Outcome ◽  
Measurement Information ◽  
Scientific Rigor ◽  
Increased Risk ◽  
Patient Reported ◽  
Measurement Information System

Abstract Cancer and its treatments are associated with increased risk for cancer-related cognitive impairment (CRCI). Methods and measures used to study and assess self-reported CRCI (sr-CRCI), however, remain diverse, resulting in heterogeneity across studies. The Patient-Reported Outcomes Working Group has been formed to promote homogeneity in the methods used to study sr-CRCI. In this report, using a psychometric taxonomy, we inventory and appraise instruments used in research to measure sr-CRCI, and we consider advances in patient-reported outcome methodology. Given its psychometric properties, we recommend the Patient-Reported Outcome Measurement Information System Cognitive Function Short Form 8a for measurement of sr-CRCI in cancer patients and survivors, at a minimum, in order to increase scientific rigor and progress in addressing CRCI.

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