Development and Validation of a Knowledge, Attitude, and Practice Scale for Medication Safety in Patients with Chronic Kidney Disease: A Cross-Sectional Study

Purpose To develop a knowledge, attitude, and practice (KAP) scale for medication safety in patients with chronic kidney disease (CKD), test its reliability and validity, and provide a reliable assessment instrument for the self-medication of patients with CKD. Methods The initial scale was formulated based on the KAP theory together with a literature review, research group discussion and semi-structured interviews of patients with CKD. An expert panel consultation and pre-investigation were conducted to improve the scale. Next, 209 patients with CKD were enrolled to undertake the questionnaire linked to the primary scale. The item analysis, exploratory factor analysis (EFA), Cronbach’s alpha coefficient and split-half reliability were used to evaluate the validity and reliability of the scale. Results The primary scale consisted of 32 items with three dimensions. Three items were deleted after the item analysis. Then, the principal component analysis with Varimax rotation was employed to analyze the construct and factor structure. Finally, item 20 was deteled and the formal scale was formed with 28 items and four dimensions. The cumulative variance contribution rate was 65.132%. The alpha coefficient was 0.944 and the split-half reliability coefficient was 0.834 for the scale. Conclusion The KAP scale has good reliability and validity. It may be valuable for evaluating the levels of medication adherence and managing the self-medication of patients with CKD in China. In the future, further translation and validation in different regions with expansion of sample size are required, so that this scale can be further applied worldwide.

Patterns Of Relationships Between Verbal Memory, Language, And Verbal Intelligence In Preschoolers

Background: This study aims to identify whether language can be the mediator of the relation between verbal memory and verbal intelligence Methods: The participants that involved in this study are 51 preschool-age children in Pekanbaru, consisting of males (n=24) and females (n=27), ages four to six years. Cluster sampling technique was used to collect the sample. The abilities of verbal memory, language and verbal intelligence were assessed towards each participant individually. Wechsler Preschool and Primary Scale of Intelligence, Test of Auditory Processing Skill 3 and Developmental Profile 3 were assigned as the instrument of the test conducted in this study. Data analysis in this study uses mediator analysis. Results: This study found a positive correlation between verbal memory and verbal intelligence (r = 0.53; p<.05), language and verbal intelligence (r = 0.71; p<.05), language and verbal memory (r = 0.64; p<.05). Conclusion: According to the result of the analysis, it is evident that language can be the mediator of the relation between verbal memory and verbal intelligence.

Stimulation and cognitive function in short-stature preschoolers

Background Normal-height children generally have better cognitive function than growth-stunted, short-stature children. Children’s cognitive function reportedly improves with stimulation. However, a correlation between stimulation and cognitive function in children with a history of short stature remains unclear. Objective To assess correlation between stimulation and cognitive function in normal-height vs. short-stature preschool children. Methods A cross-sectional study with consecutive sampling was performed in four sub-district areas in Jakarta. Preschool-aged children and their primary caregivers from previous studies on short stature were eligible for inclusion. An Indonesian version of a questionnaire was used to assess stimulation. A psychologist assessed verbal IQ (VIQ), performance IQ (PIQ), and full-scale IQ (FSIQ) with the Indonesian version of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI). Data were analyzed using Pearson’s correlation and Chi-square tests, and P values <0.05 were considered to be significant. Results Of 62 subjects, 64.5% had normal height and 35.5% had short stature. Both normal-height and short-stature children had similar IQ outcome and history of stimulation. The stimulation was significantly correlated with FSIQ in normal-height children (r= 0.316; P=0.047), but not short-stature children (r=0.049; P=0.828). However, the percentage differences in VIQ, PIQ, and FSIQ between normal-height and short-stature children were not significant (P=0.409, 0.119 and 0.877, respectively). Conclusion There is a significant correlation between stimulation and IQ in normal-height children. Short-stature preschoolers were not worse in terms of IQ than normal-height preschoolers. Parents and caregivers should be encouraged to provide regular and adequate stimulation to their young children.

Variations in practice in cardiac neurodevelopmental follow-up programs

Over the last two decades, heart centres have developed strategies to meet the neurodevelopmental needs of children with congenital heart disease. Since the publication of guidelines in 2012, cardiac neurodevelopmental follow-up programmes have become more widespread. Local neurodevelopmental programmes, however, have been developed independently in widely varying environments. We sought to characterise variation in structure and personnel in cardiac neurodevelopmental programmes. A 31-item survey was sent to all member institutions of the Cardiac Neurodevelopmental Outcome Collaborative. Multidisciplinary teams at each centre completed the survey. Responses were compiled in a descriptive fashion. Of the 29 invited centres, 23 responded to the survey (79%). Centres reported more anticipated neurodevelopment visits between birth and 5 years of age (median 5, range 2–8) than 5–18 years (median 2, range 0–10) with 53% of centres lacking any standard for routine neurodevelopment evaluations after 5 years of age. Estimated annual neurodevelopment clinic volume ranged from 85 to 428 visits with a median of 16% of visits involving children >5 years of age. Among responding centres, the Bayley Scales of Infant and Toddler Development and Wechsler Preschool and Primary Scale of Intelligence were the most routinely used tests. Neonatal clinical assessment was more common (64%) than routine neonatal brain imaging (23%) during hospitalisation. In response to clinical need and published guidelines, centres have established formal cardiac neurodevelopment follow-up programmes. Centres vary considerably in their approaches to routine screening and objective testing, with many centres currently focussing their resources on evaluating younger patients.