Assessing functioning in adolescents with chronic fatigue syndrome: psychometric properties and factor structure of the School and Social Adjustment Scale and the Physical Functioning Subscale of the SF36

Background:Chronic fatigue syndrome (CFS) has a major impact on functioning. However, no validated measures of functioning for this population exist.Aims:We aimed to establish the psychometric properties of the 5-item School and Social Adjustment Scale (SSAS) and the 10-item Physical Functioning Subscale of the SF-36 in adolescents with CFS.Method:Measures were completed by adolescents with CFS (n = 121).Results:For the Physical Functioning Subscale, a 2-factor solution provided a close fit to the data. Internal consistency was satisfactory. For the SSAS, a 1-factor solution provided an adequate fit to the data. The internal consistency was satisfactory. Inter-item and item-total correlations did not indicate any problematic items and functioning scores were moderately correlated with other measures of disability, providing evidence of construct validity.Conclusion:Both measures were found to be reliable and valid and provide brief measures for assessing these important outcomes. The Physical Functioning Subscale can be used as two subscales in adolescents with CFS.

SELF-REPORTED PHYSICAL FUNCTIONING AND FACTORS ASSOCIATED WITH IT AMONG HIV INFECTED ADULTS ON ANTIRETROVIRAL TREATMENT AT THE UNIVERSITY OF GONDAR HOSPITAL, ETHIOPIA

Introduction: With the advent of Antiretroviral Therapy (ART), people living with HIV and AIDS (PLWHA) are living longer with chronicity. Reduced physical functioning decreases quality of life of people living with HIV and AIDS. Objective: This study was intended to assess self-reported physical functioning and factors associated with it among adult outpatients living with HIV and AIDS who are on ART at the University of Gondar Hospital HIV Care Clinic. Method: A cross-sectional study was conducted on 313 adults living with HIV and AIDS from March to May 2013. The Short Form-36 physical functioning subscale was used to assess physical functioning. The physical functioning subscale was transformed to range from 0 to a 100 to make all values on same metric, and mean was calculated. Finally normbased scoring method was used to determine whether they have good or poor physical functioning. Result: Total mean score of physical functioning was 59.43 (SD=10.7). Among 313 participants, 191 (61%) reported good physical functioning. More than half of the subjects (61%) were independent in work-capacity. Two hundred and nineteen (70%) individuals were independent in mobility and 96.8% in self-care. Good physical functioning was associated with CD4 counts ≥250 cells/mm3 [AOR=1.84, 95% CI:1.02,3.31], excellent general health [AOR=4.14,95% CI:2.12, 7.07], absent or very mild bodily pain [AOR=4.04, 95% CI: 2.03,6.59] and high bodily energy [AOR=7.70, 95% CI: 4.32, 8.52]. Conclusion: This study found that majority of the subjects had good physical functioning and were independent in self-care activities. Higher CD4 counts, vitality, general health and level of mild bodily pain were factors determining physical functioning. This research indicates the need of designing rehabilitation strategies for people living with HIV and AIDS.

Validation of the Thai version of the Duke Activity Status Index in patients with a previous myocardial infarction

Background: The Duke Activity Status Index is a widely used instrument for measuring functional status in patients with cardiovascular disease. However, items and subscales on this instrument have not been validated for Thai patients with a previous myocardial infarction (MI).Objective: To test the reliability and validity of the Thai version of the Duke Activity Status Index (DASI-T) in Thai patients with a previous MI using a cross-sectional study design.Methods: The DASI-T was translated using forward and backward translation methods and administered to 100 MI patients from outpatient departments of two general hospitals in Thailand. Internal consistency was determined to test reliability. Two criterion measures (i.e. Canadian Cardiovascular Society (CCS) classification, SF-36 physical functioning subscale) were used to test the concurrent validity of the DASI-T. Age group and CCS classification were used to determine known-groups validity of the DASI-T.Results: Cronbach’s α for the DASI-T total score was 0.76. No ceiling or floor effect was detected for the DASI-T total score. DASI-T total score was significantly correlated with the CCS classification (r = -0.68, P < 0.01) and SF-36 physical functioning subscale (r = 0.79, P < 0.01). DASI-T total scores could differentiate MI patients based on age (P = 0.040) or CCS classification (P = 0.000).Conclusion: The DASI-T is a potentially reliable and valid instrument with which to assess functional status in MI patients and is also useful to evaluate a treatment effect and be a guideline for clinical purposes (i.e. exercise prescription, risk stratification).

Sleep and physical functioning in family caregivers of older adults with memory impairment

ABSTRACTBackground:Sleep disturbance is common in caregivers of older adults with memory disorders. Little is known, however, about the implications of caregivers’ poor sleep with regard to their physical functioning.Methods:In this cross-sectional study, we investigated the association between objectively measured sleep and self-reported physical functioning in 45 caregivers (mean age = 68.6 years) who completed the Beck Depression Inventory-II, the Medical Outcomes Study SF-36, and the Mini-mental State Examination, and wore an actigraph for at least three days. Our primary predictors were actigraphic sleep parameters, and our outcome was the SF-36 Physical Functioning subscale.Results:In multivariate-adjusted linear regression analyses, each 30-minute increase in caregivers’ total sleep time was associated with a 2.2-point improvement in their Physical Functioning subscale scores (unstandardized regression coefficient (B) = 2.2, 95% confidence interval (CI) 1.0–3.4,p= 0.001). In addition, each 10-minute increase in time awake after initial sleep onset was associated with a 0.5-point decrease on the Physical Functioning subscale, although this was not statistically significant (B= −0.5, 95% CI −1.1, 0.1,p= 0.09).Conclusions:Our findings suggest that shorter sleep duration is associated with worse self-reported physical functioning in caregivers. Longitudinal studies are needed to determine whether poor sleep predicts functional decline in caregivers.