scholarly journals Inter-rater variability in scoring of Addenbrooke’s Cognitive Examination – third edition (ACE-III)

2022 ◽  
Author(s):  
Miranda Julia Say ◽  
Ciarán O'Driscoll
Keyword(s):  
Healthcare Professionals ◽  
Dementia Diagnosis ◽  
Mental Health Team ◽  
Domain Specific ◽  
Self Confidence ◽  
Rater Variability ◽  
Scoring Accuracy ◽  
Level Of Experience ◽  
Addenbrooke’S Cognitive Examination ◽  
Scoring Error

Background: Despite its wide use in dementia diagnosis on the basis of cut-off points, the inter-rater variability of the ACE-III has been poorly studied.Methods: 31 healthcare professionals from an older adults’ mental health team scored two ACE-III protocols based on mock patients in a computerised form. Scoring accuracy, as well as total and domain-specific scoring variability, were calculated; factors relevant to participants were obtained, including their level of experience and self-rated confidence administering the ACE-III.Results: There was considerable inter-rater variability (up to 18 points for one of the cases), and one case’s mean score was significantly higher (by four points) than the true score. The Fluency, Visuospatial and Attention domains had greater levels of variability than Language and Memory. Higher levels of scoring accuracy were not associated with either greater levels of experience not higher self-confidence in administering the ACE-III.Conclusions: The results suggest that the ACE-III is susceptible to scoring error and considerable inter-rater variability, which highlights the critical importance of initial, and continued, administration and scoring training.

She “didn’t see my weight; she saw me, a mom who needed help breastfeeding”: Perceptions of perinatal weight stigma and its relationship with breastfeeding experiences

2021 ◽  
pp. 135910532098832
Author(s):  
Rachel Dieterich ◽  
Judy Chang ◽  
Cynthia Danford ◽  
Paul W Scott ◽  
Caroline Wend ◽  
...  
Keyword(s):  
Social Support ◽  
Healthcare Professionals ◽  
Body Image Dissatisfaction ◽  
Descriptive Study ◽  
Self Esteem ◽  
Weight Stigma ◽  
Depression And Anxiety ◽  
Self Confidence ◽  
Qualitative Descriptive ◽  
Suboptimal Breastfeeding

Weight stigmatization is related to emotional and psychological distress including low self-esteem, body image dissatisfaction, depression, and anxiety; all linked with suboptimal breastfeeding outcomes. This qualitative descriptive study explored postpartum individuals’ recalled experiences of weight stigma during interactions with perinatal healthcare professionals and its perceived influence on their breastfeeding experiences. Semi-structured phone interviews were conducted with (n= 18) participants. Three themes emerged: (1) “Size Doesn’t Matter: They Looked Beyond the Scale,” (2) “My Self-Confidence and Desire to Breastfeed is More Important than Weight,” and (3) “I Was on My Own”— Limited Social Support not Weight Stigma Influenced Breastfeeding.

scholarly journals Women’s advice to healthcare professionals regarding breastfeeding: “offer sensitive individualized breastfeeding support”- an interview study

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Ingrid Blixt ◽  
Margareta Johansson ◽  
Ingegerd Hildingsson ◽  
Zoi Papoutsi ◽  
Christine Rubertsson
Keyword(s):  
Healthcare Professionals ◽  
World Health ◽  
Evidence Based ◽  
Breastfeeding Support ◽  
Telephone Interviews ◽  
Self Confidence ◽  
Practical Support ◽  
Women’S Perceptions ◽  
Social Media Platforms ◽  
Health Organization

Abstract Background The World Health Organization recommends exclusive breastfeeding for 6 months followed by continued breastfeeding with complementary food up to 2 years of age or beyond. Few women achieve this recommendation in Sweden, and they often stop breastfeeding earlier than they would like. Investigating women’s advice to healthcare professionals is important for the provision of optimal breastfeeding support. The aim of this study was to explore women’s advice to healthcare professionals regarding support for continuing to breastfeed for at least 6 months. Methods This investigation used an exploratory study design, and a purposive sample of women was recruited between 2015 and 2016 through social media platforms. The work is a follow-up of an earlier study exploring women’s perceptions of the factors that assisted them in breastfeeding for at least 6 months. Telephone interviews were conducted with 139 Swedish women who reported that they had breastfed for at least 6 months. Women were asked the question, “Do you have any advice that you would like to give to healthcare professionals regarding breastfeeding support?”. The data were analysed using content analysis. Results The theme, “Professionals need to offer women sensitive, individualized breastfeeding support to promote a positive breastfeeding experience”, describes the women’s advice based on five categories: 1) providing evidence-based care, 2) preparing expectant parents during pregnancy, 3) creating a respectful and mutual dialogue, 4) offering individual solutions to breastfeeding problems, and 5) offering practical support. Conclusions This study highlights the importance of professionals providing evidence-based breastfeeding support in a sensitive and individualized manner. This consideration is an important prerequisite to strengthening women’s self-confidence and assisting them in reaching their breastfeeding goals, which may enhance the positive nature of their breastfeeding experience.

MINI-ADDENBROOKE'S COGNITIVE EXAMINATION (M-ACE): PRAGMATIC STUDY

2015 ◽  
Vol 86 (11) ◽  
pp. e4.139-e4
Author(s):  
Andrew Larner
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Disorders ◽  
Net Benefit ◽  
Dementia Diagnosis ◽  
Female Age ◽  
Diagnosis Of Dementia ◽  
Dsm Iv ◽  
Age Range ◽  
Addenbrooke’S Cognitive Examination ◽  
Pragmatic Study

ObjectiveTo test diagnostic accuracy of the mini-Addenbrooke's Cognitive Examination (m-ACE) compared to the MMSE for the diagnosis of dementia and MCI in consecutive referrals to a dedicated cognitive disorders clinic.Results: Of 135 consecutive new outpatients seen over 6 months (June–November 2014) administered the mini-ACE (F:M=64:71, 47% female; age range 18–88 years, median 60), 24 were diagnosed with dementia (DSM–IV–TR criteria) and 39 had MCI (Petersen criteria). Using the cutoffs defined in the index paper (≤25/30 and ≤21/30), m-ACE was sensitive (1.00, 0.92) but not specific (0.28, 0.61) for dementia diagnosis; it also proved useful for MCI diagnosis (sensitivities 1.00, 0.77; specificities 0.43, 0.82). Area under the ROC curve was 0.86. Effect size (Cohen's d) for m-ACE for dementia vs. no dementia was 1.53 (large) and for MCI vs no cognitive impairment was 1.59 (large); for MMSE the corresponding figures were 1.56 and 1.26. Weighted comparison suggested a small net loss for m-ACE vs MMSE for dementia diagnosis (–0.13) but a large net benefit for MCI diagnosis (0.38).Conclusions: In this pragmatic study, m-ACE proved quick, easy to use, and acceptable to patients, with metrics comparable to MMSE for dementia diagnosis and better for MCI diagnosis.

scholarly journals Variation and Interactional Non-Standardization in Neuropsychological Tests: The Case of the Addenbrooke’s Cognitive Examination

2019 ◽  
Vol 30 (3) ◽  
pp. 458-470
Author(s):  
Danielle Jones ◽  
Ray Wilkinson ◽  
Clare Jackson ◽  
Paul Drew
Keyword(s):  
Clinical Practice ◽  
Conversation Analysis ◽  
Neuropsychological Tests ◽  
Neuropsychological Test ◽  
Memory Clinic ◽  
Dementia Diagnosis ◽  
Addenbrooke’S Cognitive Examination ◽  
The Way

The Addenbrooke’s Cognitive Examination (ACE-111) is a neuropsychological test used in clinical practice to inform a dementia diagnosis. The ACE-111 relies on standardized administration so that patients’ scores can be interpreted by comparison with normative scores. The test is delivered and responded to in interaction between clinicians and patients, which places talk-in-interaction at the heart of its administration. In this article, conversation analysis (CA) is used to investigate how the ACE-111 is delivered in clinical practice. Based on analysis of 40 video/audio-recorded memory clinic consultations in which the ACE-111 was used, we have found that administrative standardization is rarely achieved in practice. There was evidence of both (a) interactional variation in the way the clinicians introduce the test and (b) interactional non-standardization during its implementation. We show that variation and interactional non-standardization have implications for patients’ understanding and how they might respond to particular questions.

scholarly journals Prevalence of mistreatment among physiotherapy interns in Nigeria: a preliminary study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Daha Garba Muhammad ◽  
Yusuff Tunde Gbonjubola ◽  
Ibrahim Ahmad Abubakar ◽  
Adekolurejo Tobi Elisha ◽  
Hassan Yusuf Ahmad
Keyword(s):  
Healthcare Professionals ◽  
Negative Impact ◽  
Well Being ◽  
Verbal Abuse ◽  
Common Type ◽  
Northwestern Part ◽  
Self Confidence ◽  
Burn Out ◽  
Preliminary Study ◽  
Prevalent Form

Abstract Background Healthcare professionals with the least experience, such as students and interns, are likely to face some form of mistreatments in the world of health professionals. Mistreatment has a negative impact on the victim’s well-being as it results in psychological distress such as burn out, lack of motivation and reduced performance. This study aims to explore mistreatment among physiotherapy interns in Nigeria with a view to protecting the future of the profession. Result Most of the participant were male (57.5%) and doing their internship in the northwestern part of the country (42.5%). Forty interns participated in the study, and 2/3 of them had experience of mistreatment. The most common type of mistreatment was yelling or shouting (60%), followed by someone taking credit for what an intern did (55%), humiliation or belittlement (50%), and threat of an extension beyond the 12 months (27.5%). Eighty-seven percent reported that the mistreatment changes their relationship with the perpetrator. Mistreatment led to stress in 70% of the respondent, affected the self-confidence of 62.5%, and led to decreased clinical output in 45% of the participants. Forty percent of the participants acquired depression due to the mistreatment. Conclusion Most physiotherapy interns experience mistreatment during the 1-year mandatory clinical internship. Verbal abuse is the most prevalent form of mistreatment, while the least is physical abuse. This study found that mistreatment has adverse effects on the health and work output of physiotherapy interns.

scholarly journals Benefits of Motivational Interviewing Application for Patients and Healthcare Professionals

2018 ◽  
Vol 128 (4) ◽  
pp. 170-173
Author(s):  
Katarzyna Szczekala ◽  
Krzysztof Wiktor ◽  
Katarzyna Kanadys ◽  
Henryk Wiktor
Keyword(s):  
Motivational Interviewing ◽  
Health Professionals ◽  
Healthcare Professionals ◽  
Sense Of Self ◽  
Therapy Outcomes ◽  
Patient Awareness ◽  
Therapeutic Adherence ◽  
Self Confidence ◽  
Initial Application ◽  
Social Rehabilitation

Abstract Motivational Interviewing (MI) is a collaborative, goal-oriented and focused on change, style of communication. It is characterised by the MI provider’s empathy, understanding, mental and emotional attitudes towards the patient. This non-judgemental conversation is aimed at strengthening inner motivation and commitment to attain the goal and is based solely on the individual’s reasons for change. The initial application of MI in clinical psychology has been modified appropriately to allow for its use in health care, rehabilitation, public health, social work, dentistry, social rehabilitation, coaching and education. It is recommended for introducing new behaviours, lifestyles and therapeutic adherence. The application of MI contributes to the enhancement of patient-healthcare worker communication, the patient’s concordance and compliance. On the other hand, learning and adopting this method in counselling is useful for healthcare professionals. In treatment, greater patient awareness and obedience lead to more conscientious responsibility for treatment and health, which in turn, produces better therapy outcomes that serve as confirmation of the merit of the therapy prescribed. The application of MI contributes to health professionals’ greater success, satisfaction, self-confidence and a sense of self-efficacy. The aim of this work is to present the essential features of MI as well as some interesting examples of research showing the benefits of using MI and ideas for training it. Non-systematic literature review of the years 2005-2018 on the use of MI in health promotion in PubMed provided evidence of wide use of MI by healthcare professionals.

scholarly journals Family Presence During Resuscitation: Adaptation and Validation into Spanish of the Family Presence Risk-Benefit Scale and the Self-Confidence Scale Instrument

2020 ◽  
Author(s):  
Eva de Mingo-Fernández ◽  
Ángel Belzunegui-Eraso ◽  
María Jiménez-Herrera
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Health Professionals ◽  
Healthcare Professionals ◽  
Healthcare Providers ◽  
Likelihood Method ◽  
Moderate Intensity ◽  
Family Presence ◽  
Self Confidence ◽  
The Family ◽  
Confidence Scale

Abstract Background Since the 1980s, the controversial issue of family presence during cardiopulmonary resuscitation has been studied both to identify the perceptions, opinions and beliefs of health professionals, patients and family members, and to identify benefits and barriers, as well as to design training programs and protocols for its implementation. In 2008, Twibell et al designed a questionnaire that measured nurses’ perceptions of Risks-Benefits and Self-Confidence regarding Family Presence during Resuscitation. There are few studies in Spain on this practice, and therefore, this study is carried out using the same instrument, so that a comparison can be made.Methods The objective is to adapt and validate into Spanish the Family Presence Risk-Benefit scale and Family Presence Self-Confidence scale (FPRB-FPSC) instrument by Twibell et al. and thus, know the opinions of our healthcare professionals. For this purpose, a paper and online questionnaire was used. It was self-administered, semi-structured and translated cross-culturally. Statistical tests were carried out for the validity of the questionnaire. 541 healthcare professionals were invited to respond. The results were analyzed by means of factorial analysis with varimax rotation (maximum likelihood method), in addition to ANOVA and Student’s t-test to observe associations between different variables. The study was approved by the institutional review board of the Consorci Sanitari del Garraf, and by the clinical research Ethic Committee of the Fundació Unió Catalana Hospitals.Results 237 healthcare professionals answered the survey (69% women), of whom 167 were nurses. Healthcare providers who have experienced Cardiopulmonary Resuscitation barely reach 13%, with the majority being men and older people. As for the invitation to the FPDR, it barely reaches 5%, and regarding the willingness to include FP in the advance directives, 66% of the healthcare providers are in favor. Health professionals identify similar barriers to Family Presence and factors in its favor.The correlation between the two measured scales, FPRB-FPSC, is significant and has a moderate intensity of the relationship (r = 0.65 and α <0.001).Conclusions The Family Presence During Resuscitation (FPDR) generates controversy among health professionals, with a trend observed along with generational change, since younger professionals tend to accept the Family Presence better. The psychometric properties of the questionnaire indicate high validity and reliability. Risk-Benefit perception and self-confidence are related to the healthcare professionals who consider the Family Presence to be beneficial.

Family Presence During Invasive Procedures. A Pilot Study To Test a Tool

2021 ◽  
Author(s):  
Eva de Mingo-Fernandez ◽  
Ángel Belzunegui-Eraso ◽  
Guillermina Medina-Martín ◽  
Roser Cuesta-Martínez ◽  
María Jiménez-Herrera
Keyword(s):  
Health Professionals ◽  
Healthcare Professionals ◽  
Health Workers ◽  
National Standards ◽  
Moderate Intensity ◽  
Bivariate Analysis ◽  
Invasive Procedures ◽  
Validity And Reliability ◽  
Family Presence ◽  
Self Confidence

Abstract Background: Family presence during invasive procedures (FPDI) generates controversy in healthcare professionals.Objective: Evaluate the FPRB-FPSC tool for invasive procedures and find out the opinions of the medical and nursing staff on FPDI.Method: Descriptive quantitative. Online and paper questionnaire modified from a previous cross-cultural translation. A factor analysis was performed for the validity of the indices and a bivariate analysis for all the variables. Ethical approvals and research permissions were obtained according to national standards.Results: 120 healthcare professionals (22.18%) answered the survey. Cronbach’s α in Family Presence Risk-Benefit scale was 0.877. Cronbach’s α in Family Presence Self-Confidence scale was 0.937. The correlation between the Risk Benefit and Self-confidence variables is significant and with a moderate intensity of the relationship A lower predisposition to Family Presence during Invasive Procedures is observed. Doctors are more reluctant than nurses.Conclusions:The FPDI generates controversy since it alters the routines of health professionals when they decide whether to allow it or not. There is a tendency for younger professionals to support FPDI. In general, health professionals, mainly nurses, are not in favour of FPDI. Health workers who perceive fewer risks and more benefits in FPDI and have greater self-confidence are more in favour of FPDI. The psychometric properties and internal consistency of the questionnaire indicate validity and reliability of this tool.

Professional Competence and Computer Literacy in e-age, Focus on Healthcare

2006 ◽  
Vol 45 (03) ◽  
pp. 300-304 ◽  
Author(s):  
D. Engová ◽  
O. Štepánková
Keyword(s):  
Computer Literacy ◽  
Healthcare Professionals ◽  
New Technologies ◽  
Professional Competence ◽  
Healthcare Delivery ◽  
Healthcare Sector ◽  
Ict Skills ◽  
Domain Specific ◽  
Information And Computer Technology ◽  
Service Information

Summary Objectives: The healthcare sector is facing an enormous acceleration due to the emergence of new knowledge, drugs, devices and diseases. Professional competence, continuing education, service excellence and patient benefits can be facilitated by the developments in information and computer technology – computer literacy is becoming imperative for all who are involved in healthcare delivery. The paper attempts to identify solutions that can aid the process of ICT uptake for full benefit of patients and healthcare professionals. Methods: With the support of published literature, the article considers the importance of ICT skills in general and in healthcare and presents some advantages of generic vendor-independent methods of ICT certification. Results: Discussed are the preliminary results of the United Kingdom’s National Health Service information technology reform which addresses the need for intensified use of ICT and applies the ECDL concept. Conclusions: It is useful to complement the introduction of computer literacy as a qualification concept by a standardized accreditation of ICT skills. Solid level of computer literacy creates a reliable and efficient background for everyday activities of healthcare professionals, enables the application of further domain-specific training modules and prepares suitable environments for the introduction and acceptance of new technologies such as electronic health records and electronic transfer of prescriptions by positively transforming the attitudes of users towards them.

scholarly journals Family Presence During Resuscitation: Adaptation and Validation into Spanish of the Family Presence Risk-Benefit Scale and the Self-Confidence Scale Instrument

2021 ◽  
Author(s):  
Eva de Mingo-Fernández ◽  
Ángel Belzunegui-Eraso ◽  
María Jiménez-Herrera
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Healthcare Professionals ◽  
Statistical Tests ◽  
National Standards ◽  
Moderate Intensity ◽  
Validity And Reliability ◽  
Family Presence ◽  
Self Confidence ◽  
The Family ◽  
Confidence Scale

Abstract BACKGROUNDFamily Presence during Cardiopulmonary Resuscitation has been studied both to identify the opinions of health professionals, patients, and family members, and to identify benefits and barriers, as well as to design protocols for its implementation. R.Twibell and her team designed an instrument that measured nurses’ perceptions of Risks-Benefits and Self-Confidence regarding Family Presence during Resuscitation. There are few studies in Spain on this practice. MethodsThe aim is to adapt and validate into Spanish the Family Presence Risk-Benefit scale and Family Presence Self-Confidence scale instrument. For this purpose, this instrument was translated cross-culturally, and administered in paper and online version. Statistical tests were carried out for the validity of the questionnaire. 541 healthcare professionals were invited to respond. The results were analyzed by the same statistical procedures as in the original scale. Ethical approvals and research permissions were obtained according to national standards.Results 237 healthcare professionals (43.8%) answered the survey (69% women), of whom 167 were nurses. Validation of instruments: Cronbach’s α in Family Presence Risk-Benefit scale was 0.94. Cronbach’s α in Family Presence Self-Confidence scale was 0.96. Factor Analysis Kaiser, Meyer and Olkin (KMO) was greater than 0.9. The correlation between the two measured scales, is significant and has a moderate intensity of the relationship (r = 0.65 and α <0.001). A lower predisposition to Family Presence during Cardiopulmonary Resuscitation is observed, but the pure detractors are only 12%. Doctors are more reluctant than nurses.ConclusionsThe psychometric properties of the questionnaire in Spanish indicate high validity and reliability. Risk-Benefit perception and Self-Confidence are related to the healthcare professionals who consider the Family Presence to be beneficial. More studies in different contexts are necessary to confirm the psychometric results and validity of this instrument in Spanish.

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