COVID-19 Limitations on Doodling as a Measure of Burnout

Pre-COVID-19, doodling was identified as a measure of burnout in researchers attending a weekly, in-person health narratives research group manifesting team mindfulness. Under the group’s supportive conditions, variations in doodling served to measure change in participants reported depression and anxiety—internal states directly associated with burnout, adversely affecting healthcare researchers, their employment, and their research. COVID-19 demanded social distancing during the group’s 2020/21 academic meetings. Conducted online, the group’s participants who chose to doodle did so alone during the pandemic. Whether the sequestering of group participants during COVID-19 altered the ability of doodling to act as a measure of depression and anxiety was investigated. Participants considered that doodling during the group’s online meetings increased their enjoyment and attention level—some expressed that it helped them to relax. However, unlike face-to-face meetings during previous non-COVID-19 years, solitary doodling during online meetings was unable to reflect researchers’ depression or anxiety. The COVID-19 limitations that necessitated doodling alone maintained the benefits group members saw in doodling but hampered the ability of doodling to act as a measure of burnout, in contrast to previous in-person doodling. This result is seen to correspond to one aspect of the group’s change in team mindfulness resulting from COVID-19 constraints.

The Validation and Improvement of a Food Literacy Behavior Checklist for Food Literacy Programs

Food literacy is a multidimensional construct required to achieve diet quality. The Food Sensations® for Adults (FSA) program aims to improve the food literacy of low to middle-income adults living in Western Australia and is funded by the Western Australian Department of Health. The original published behavior checklist used to measure change in food literacy has been revised based on experience of the facilitators and the iterative development of the program. This research sought to assess the validity and reliability of the improved food literacy behavior checklist. A total of 1,359 participants completed the checklist over an 18-month period. Content, face, and construct validity were considered in the re-development of the checklist. An exploratory factor analysis of the checklist identified three factors: 1) Plan and Manage, 2) Selection, and 3) Preparation. Cronbach’s alpha coefficients of 0.883, 0.760, and 0.868 were found for each of the three factors respectively. These coefficients indicated good internal consistency and were higher than those found in the original checklist analysis. An external validation was undertaken with the original food literacy behavior checklist, and a strong positive relationship between the two tools was found. In addition to being used to evaluate FSA, this revised and extensively validated tool could provide guidance to others evaluating similar food literacy programs and contribute to international measurement research.

COVID-19 Limitations on Doodling as a Measure of Burnout

Pre-COVID-19, doodling was identified as a measure of burnout in researchers attending a weekly, in-person health narratives research group manifesting team mindfulness. Under the group’s supportive conditions, variations in doodling served to measure change in participants’ reported depression and anxiety—internal states directly associated with burnout, adversely affecting healthcare researchers, their employment, and their research. COVID-19 demanded social distancing during the group’s 2020/21 academic meetings. Conducted online, the group’s participants who chose to doodle did so alone during the pandemic. Whether the sequestering of group participants during COVID-19 altered the ability of doodling to act as a measure of depression and anxiety was investigated. Participants considered doodling during the group’s online meetings increased their enjoyment and attention level—some expressed it helped them to relax. However, unlike face-to-face meetings during previous non-COVID-19 years, solitary doodling during online meetings was unable to reflect researchers’ depression or anxiety. COVID-19 limitations necessitating doodling alone maintained the benefits group members saw in doodling but hampered the ability of doodling to act as a measure of burnout in contrast to previous in-person doodling. This result is seen to correspond to one aspect of the group’s change in team mindfulness resulting from COVID-19 constraints.

Kinematic Assessment to Measure Change in Impairment during Active and Active-Assisted Type of Robotic Rehabilitation for Patients with Stroke

Analysis of kinematic features related to clinical assessment scales may qualitatively improve the evaluation of upper extremity movements of stroke patients. We aimed to investigate kinematic features that could correlate the change in the Fugl-Meyer Assessment (FMA) score of stroke survivors through upper extremity robotic rehabilitation. We also analyzed whether changes in kinematic features by active and active-assisted robotic rehabilitation correlated differently with changes in FMA scores. Fifteen stroke patients participated in the upper extremity robotic rehabilitation program, and nine kinematic features were calculated from reach tasks for assessment. Simple and multiple linear regression analyses were used to characterize correlations. Features representing movement speed were associated with changes in FMA scores for the group that used an active rehabilitation robot. In contrast, in the group that used an active-assisted rehabilitation robot, features representing movement smoothness were associated with changes in the FMA score. These estimates can be an important basis for kinematic analysis to complement clinical scales.

The Association Between Sarcopenia and Functional Improvement in Older and Younger Patients Who Completed Inpatient Rehabilitation: A Prospective Cohort Study

Objective: To investigate the association between sarcopenia and functional improvement in patients older and younger than 65 years upon completion of an inpatient rehabilitation program.Design: Prospective cohort study.Participants: Adult consecutive patients who completed the inpatient rehabilitation program at a metropolitan tertiary referral hospital general inpatient rehabilitation unit.Methods: Sarcopenia status was determined using the European Working Group on Sarcopenia in Older People 2 algorithm, using muscle mass measured by BioImpedance Analysis and grip strength. Progress in rehabilitation was measured using change in the Functional Independence Measure and Goal Attainment Scaling score. To investigate the age group by sarcopenia status interaction we used quantile regression models with bootstrapped standard error estimation for functional improvement and linear regression model with robust standard error estimation for GAS score.Results: 257 participants [128 (50%) male, median age 63 years (IQR: 52–72)], 33(13%) with sarcopenia, completed inpatient rehabilitation [median length of stay 16 days (IQR: 11–27.5)]. Participants' median Functional Independence Measure change was 24 (IQR 15–33.5) and mean total Goal Attainment Scaling score was 57.6 (SD 10.2). Adjusting for admission Functional Independence Measure score, the median difference in Functional Independence Measure change between participants with and without sarcopenia was: −4.3 (95% CI: −10.6, 1.9); p = 0.17 in participants 65 years and younger, and 4.6 (95% CI: 1.0, 8.2); p = 0.01 in participants older than 65; age-by-sarcopenia interaction p = 0.02.Conclusions: Unlike younger people, older people with sarcopenia have greater functional improvement in inpatient rehabilitation than those without sarcopenia.

L2 GRIT

Given the longitudinal nature of L2 grit, the use of conventional research methodologies with cross-sectional data to examine the validity of L2 grit scale seems inadequate. The present research was an attempt to extend the domain-specific phase of research on L2 grit, with the pursuit of long-term goals at its core, into a dynamic one. Thus, we adopted a longitudinal confirmatory factor analysis-curve of factors model (LCFA-CFM) approach to trace changes in L2 learners’ grit at different points of time in an EFL course. LCFA-CFM ensures measurement invariance over time, deals with second-order latent variables, takes into account measurement errors, and is capable of assessing interindividual differences. With this in mind, we, first, employed LCFA to test the factor invariance of L2 grit based on a bifactor CFA model over time and, second, used CFM to measure change of L2 grit during an L2 course. To do so, we collected data from 437 adult EFL learners in Iran in four time phases using the L2 grit scale and analyzed them using Mplus 7.4. The model fit was accepted and invariance of the latent factor of L2 grit was confirmed over time. Also, the negative covariance between initial level of L2 grit and its rate of change over time (second-order latent variables) suggested a steeper increase in the construct over time for learners with lower initial scores of the construct. That is, L2 learners who started at a higher level of L2 grit experienced less change in L2 grit over time. The LCFA-CFM ensured that the factor structure of L2 grit is invariant over time and provided insights into how L2 grit changes over an L2 course.

Mindful of Personality Trait Change: Are Treatment Effects on Personality Trait Change Ephemeral and Attributable to Changes in States?

Objective: Are treatment effects on personality trait change ephemeral and attributable to change in clinical states? Data of an intervention study was used to examine if change in clinical states (e.g., stress or depression) accounts for change in personality traits and to test whether both changes in traits and clinical states were independently associated with substance use. Method: Seventy-nine substance use patients (Mage = 25.3, SD = 2.7; 35 % female) took part at a 4-week intervention and completed a total of 15 bi-monthly assessments across 28 weeks to measure change in traits and states during and after treatment. Results: The results suggest that participants showed large trait and state changes over time, which happened rapidly with the majority occurring during the first four weeks. Trait and state changes were highly correlated, but not perfectly redundant. Significant variance in personality trait change remained after controlling for change in clinical states. Moreover, both trait and state change independently predicted substance use. Conclusion: Personality trait change occurred relatively fast and was maintained until the last follow-up assessment six months after the end of the intervention. Also, the findings point to the notion that the conceptual distinction between traits and states may not be as important as originally thought.

937Rasch analysis of the Health Literacy Questionnaire in the Understanding Multiple Sclerosis online course cohort

Background We have built a six-week free online course to improve multiple sclerosis (MS)-related knowledge, health literacy (HL), and resilience among members of the MS community and interested laypeople, entitled Understanding MS. To evaluate the effectiveness of the course, we require an appropriate tool to measure HL in this cohort. Objective To evaluate the psychometric properties of the multidimensional Health Literacy Questionnaire (HLQ) in a cohort of Understanding MS online course enrolees. Methods Participants who enrolled in the first two open enrolments of the Understanding MS online course completed the HLQ (n = 1182) in an online survey prior to beginning course materials. We used Rasch analysis to assess the measurement properties of the HLQ. Results The nine subscales of the HLQ each had a good fit with the Rasch model; they were unidimensional, had good internal consistency and reliability and no item bias or local dependency measurement gaps were identified for participants with low or high scores in each of the nine subscales, creating a ceiling effect, meaning that the HLQ cannot reliably measure change in HL over time for these participants. The HLQ is a reliable measurement tool to assess change in HL for people with low to moderate HL levels who have room to improve, which is our target group. Conclusion The HLQ is useful for assessing HL in this and similar cohorts, but the assessment of HL change should consider the limitations described above. Key messages The HLQ has excellent measurement properties and is appropriate for assessing HL

Metacognitive Strategy Training Is Feasible for People With Aphasia

Metacognitive strategy training shows promise for reducing disability following stroke, but previous trials have excluded people with aphasia. Considering the high incidence of poststroke aphasia, it is important to determine whether people with aphasia can benefit from strategy training. The purpose of this study was to determine the feasibility of an adapted strategy training protocol for people with aphasia. We recruited 16 adults with mild-moderate aphasia from inpatient stroke rehabilitation. We examined recruitment and retention, intervention delivery and fidelity, participant engagement and communication, participant strategy mastery, and change in disability. Therapists demonstrated good fidelity to intervention elements. Participants demonstrated good engagement and fair communication. The sample achieved a mean Functional Independence Measure change of 21.8 ( SD = 16.2, Cohen’s d = .95), similar to matched controls without aphasia from previous trials. An adapted strategy training protocol appears feasible for people with aphasia in inpatient stroke rehabilitation. Future studies should examine the efficacy of this approach in larger samples.