One Size Does Not Fit All: Discharge Teaching and Child Challenging Behaviors

This study compares quality of discharge teaching and care coordination for parents of children with challenging behaviors participating in a nursing implementation project, which used an interactive iPad application, to usual discharge care. Unlike parents in the larger quasi-experimental longitudinal project, parents of children with challenging behaviors receiving the discharge teaching application (n = 14) reported lower mean scores on the quality of discharge teaching scale–delivery subscale ( M = 8.2, SD = 3.1) than parents receiving usual care (n = 11) ( M = 9.6, SD = 4.7) and lower scores on the Care Transition Measure ( M = 2.44, SD = 1.09) than parents receiving usual care ( M = 3.02, SD = 0.37), with moderate to large effects (0.554–0.775). The discharge teaching approach was less effective with this subset, suggesting other approaches might be considered for this group of parents. Further study with a larger sample specific to parents of children with challenging behaviors is needed to assess their unique needs and to optimize their discharge experience.

Validity and reliability of the Palliative Care Transition Measure for Caregivers (PCTM-C)

ObjectivePatients suffering from advanced disease face different care transitions. The transition from acute to palliative care is challenging and may lead to the discontinuity of care. Family caregivers become important sources of information, as patients begin to experience difficulties in coping with emotional transition events. The Care Transition Measure was developed to evaluate care transitions as experienced by the elderly. It has never been used in palliative care. The aim of this study was to test the validity and reliability of a modified version of the Palliative Care Transition Measure, specifically the Palliative Care Transition Measure for Caregivers (PCTM-C).MethodThe study included two main phases. Phase I focused on the construction of a modified version of the Palliative Care Transition Measure through two focus groups and by computing the content validity index. Phase II focused on testing the psychometric properties of the PCTM-C on 272 family caregivers through confirmatory factor analysis.ResultThe content validity index for each of the items was higher than 0.80, whereas that for the scale was 0.95. The model tested with confirmatory factor analysis fitted the data well and confirmed that the transition measures referred to communication, integrated care and a trusting-relationship, and therefore the core dimensions of continuity according to existing conceptual models. The internal consistency was high (Cronbach's alpha = 0.94).Significance of resultsThe PCTM-C proved to be a suitable measure of the quality of such transitions. It may be used in clinical practice as a continuity quality indicator and has the potential to guide interventions to enhance family caregivers’ experience of care continuity.

Phoneme Segmentation of Tamil Speech Signals Using Spectral Transition Measure

Process of identifying the end points of the acoustic units of the speech signal is called speech segmentation. Speech recognition systems can be designed using sub-word unit like phoneme. A Phoneme is the smallest unit of the language. It is context dependent and tedious to find the boundary. Automated phoneme segmentation is carried in researches using Short term Energy, Convex hull, Formant, Spectral Transition Measure(STM), Group Delay Functions, Bayesian Information Criterion, etc. In this research work, STM is used to find the phoneme boundary of Tamil speech utterances. Tamil spoken word dataset was prepared with 30 words uttered by 4 native speakers with a high quality microphone. The performance of the segmentation is analysed and results are presented.