护士采取深静脉血栓形成预防性措施意向量表的汉化及信效度检验

目的 对护士采取深静脉血栓形成预防性措施意向量表进行汉化,并对中文版量表进行信效度检验。方法 在取得原作者的授权后,严格遵循Brislin翻译回译模型对量表进行翻译、回译,邀请16名专家对量表的内容进行效度评价,得到中文版量表。同时采用该量表对674名ICU护士采取深静脉血栓形成预防性措施的意向进行评估,检验量表的信度及效度。结果 中文版量表共15个条目及4个开放式问题,经探索性因子分析共提取4个公因子,累计方差贡献率为82.66%;验证性因子分析结果显示模型拟合良好;效标关联效度显示相关系数为0.426,效标关联效度较为理想。量表总的Cronbach’s α系数为0.872,折半信度为0.840,重测信度为0.843(P<0.01);量表平均内容效度为0.870,量表各条目内容效度指数为0.900～1.000。结论 中文版护士采取深静脉血栓形成预防性措施意向量表具有良好的信效度,适合对我国ICU护士采取深静脉血栓形成预防性措施的意向进行评价。     

制度化环境中老年人生活空间评估量表的汉化及信效度检验

目的 对制度化环境中老年人生活空间评估量表进行汉化,并对中文版量表进行信效度检验。方法 在取得原作者的授权后,严格遵循Brislin翻译回译模型对量表进行翻译、回译,邀请6名专家对量表的内容进行效度评价,得到中文版量表。同时采用该量表对入驻医养结合型养老机构的210名老年人的生活空间水平进行评估,检验量表的信度及效度。结果 中文版量表共15个条目,经探索性因子分析共提取3个公因子,累计方差贡献率为77.22%;量表总的Chronbach’s α系数为0.876,重测信度为0.902(P<0.01),各维度的重测信度分别为0.841、0.809、0.695(P<0.01);量表平均内容效度为0.943,量表各条目内容效度指数为0.830～1.000。结论 中文版制度化环境中老年人生活空间评估量表具有良好的信效度,适合对我国医养结合型养老机构入住老年人的生活空间水平进行评价。     

血液透析跌倒风险指数量表的汉化及信效度检验

目的 汉化血液透析跌倒风险指数(dialysis falls risk index, DFRI)量表并检验其信效度。方法 遵循Brislin翻译模型对DFRI进行翻译、文化调试和预调查，形成中文版DFRI。使用该量表对衡阳市两所医院141例血液透析(hemodialysis, HD)患者进行评估，以检验其信效度。结果 中文版DFRI共7个条目，提取3个公因子，累计方差贡献率61.729%,内容效度指数为0.80～1.00,量表平均内容效度指数为0.967,Cronbach’s α系数为0.507,重测信度为0.948,评定者信度为0.926。该量表ROC曲线下面积为0.719,最佳截点值为≥5.25分，敏感度为0.773,特异度为0.580。结论 中文版DFRI量表具有较好的信效度及诊断效能，简捷有效，可用于我国HD患者跌倒风险评估。     

医院提供者视角下过渡期护理协调性量表的汉化及信效度检验

目的:对医院提供者视角下过渡期护理协调性量表（CTCS）进行汉化，并进行信效度检验。方法:采用Brislin翻译模型对CTCS进行翻译、整合、回译，经专家咨询和预调查后形成中文版CTCS，选取郑州市3所三级甲等医院222名参与协调过渡期护理服务的医院提供者进行问卷调查，对其进行信效度检验。结果:中文版CTCS包括4个维度、23个条目，量表的Cronbach’s α系数为0.924，各维度的Cronbach’s α系数为0.777～0.954，重测信度为0.878。量表水平的内容效度指数为0.925，通过探索性因子分析提取4个公因子，累积方差贡献率为70.320%。结论:中文版CTCS具有良好的信效度，可作为评估过渡期护理质量的工具。     

护士健康教育胜任力量表的汉化及信效度检验

目的 对护士健康教育胜任力量表(I-CEpSE)进行汉化，并评价其信效度。方法 以Brislin翻译模型为基础，采用直译-回译法对原量表进行翻译，并通过文化调试和预测试形成中文版I-CEpSE。采用便利抽样法，于2021年5-6月对河南省二级以上医院的549名临床护士进行问卷调查，评价量表的信度和效度。结果 中文版I-CEpSE共58个条目，经探索性因子分析后共提取6个公因子，累计方差贡献率为83.104%;量表的Cronbach′s α系数为0.990,各维度Cronbach′s α系数分别为0.915～0.989;量表的内容效度指数为0.897,各条目的内容效度指数为0.833～1.000;量表的折半信度为0.901,各维度折半信度为0.854～0.973;量表的重测信度为0.947,各维度重测信度为0.811～0.958。结论 中文版I-CEpSE具有较好的信效度，可用于测评我国护士健康教育相关知识、实用技能和个人特质的水平。     

中文版心力衰竭患者自我护理行为量表的信效度检测

目的 翻译心力衰竭患者自我护理行为量表,检验该量表的信效度,开发适合我国国情的心力衰竭患者自我护理行为量表.方法 严格遵循量表翻译原则,对量表进行翻译、回译及文化调试;对200例心力衰竭患者进行测试,检验中文版量表的信效度.结果 中文版量表经过验证性因子分析结果显示,各拟合指数均在可接受范围内;量表总Cronbach's α系数为0.853,重测信度为0.861.结论 中文版心力衰竭患者自我护理行为量表的信效度符合心理测量学的要求,对评价我国心力衰竭患者自我护理行为现状有一定的应用价值.     

中文版癌症病人信息需求简明问卷的汉化及信效度测评

[目的]翻译中文版癌症病人信息需求简明问卷,并对该问卷的信效度进行初步评价。[方法]对癌症需求简明问卷(CNQ-SF)采取翻译、回译等方法,然后对355例癌症病人进行问卷调查,评定问卷信效度。[结果]中文版CNQ-SF量表共32个条目提取5个公因子,累积贡献率为61.666%,CNQ-SF的重测信度系数为0.835,量表的整体Cronbach’sα为0.903,维度1~维度5分别为0.924,0.916,0.864,0.791,0.665。[结论]中文版CNQ-SF量表具有良好的信效度,可用于中国癌症病人信息需求评估测量。     

尿失禁自我效能量表中文版的信效度研究

[目的]检验中文版尿失禁自我效能量表（GSE-UI）的信度和效度。[方法]引进并将尿失禁自我效能量表翻译为中文版,使用该中文版GSE-UI量表对100例老年女性尿失禁病人进行评估,分析GSE-UI的信效度。[结果]GSE-UI量表总的克朗巴赫α信度系数为0.92,4个潜在因子的克朗巴赫α信度系数均〉0.70;量表的4个潜在因子的构想基本符合数据的实际情况,χ2/df=2.25。[结论]中文版GSE-UI具有良好的信度和效度,可行性高,可作为未来研究以及测量尿失禁病人症状改善的测评工具。     

中文版痴呆心境评估量表的信效度研究

目的 翻译痴呆心境评估量表(Dementia Mood Assessment scale,DMAS),并对其信、效度进行初步评价.方法 翻译并修订DMAS,用中文版DMAS对133例老年期痴呆患者进行调查,对测定结果进行信、效度分析.结果 中文版DMAS的内容效度CVI值为0.95;以老年性痴呆生活质量量表(Quality of Life-Alzheimer's Disease scale,QOL-AD)为效标,其效标关联效度为-0.77;因子分析萃取了4个公因子,方差累计贡献率为54.95%.量表的Cronbach's α系数为0.81,重测信度为0.94,评定者信度为0.93.结论 中文版DMAS信、效度较好,可用于评价中国老年期痴呆患者的心境状况.     

尿失禁自我效能量表中文版的信效度研究

[目的]检验中文版尿失禁自我效能量表(GSE-UI)的信度和效度.[方法]引进并将尿失禁自我效能量表翻译为中文版,使用该中文版GSE-UI量表对100例老年女性尿失禁病人进行评估,分析GSE-UI的信效度.[结果-]GSE-UI量表总的克朗巴赫α信度系数为0.92,4个潜在因子的克朗巴赫α信度系数均>0.70;量表的4个潜在因子的构想基本符合数据的实际情况,x<'2>/df=2.25.[结论]中文版GSE-UI具有良好的信度和效度,可行性高,可作为未来研究以及测量尿失禁病人症状改善的测评工具.     

Psychometric assessment of the German version of the Questionnaire about the Process of Recovery

Personal recovery is important for mental health services and service users; moreover, valid and reliable assessment instruments are necessary for measuring personal recovery. Therefore, this study aimed to evaluate the unidimensional factor structure of the German version of the Questionnaire about the Process of Recovery. The study was conducted using a cross-sectional design with a convenience sample. The questionnaire was completed by 200 patients of outpatient services of two psychiatric hospitals in Switzerland. A confirmatory factor analysis was conducted to validate the unidimensional factor structure of the German version of the Questionnaire about the Process of Recovery. Cronbach's alpha was calculated to assess the internal consistency. The results showed an overall acceptable model fit (χ² = 134.188, df = 90, P = 0.002; RMSEA = 0.050, 90% CI: 0.031–0.067; CFI = 0.937; TLI = 0.927) and excellent internal consistency (Cronbach's α = 0.91). These results are consistent with those of studies that have examined the Questionnaire about the Process of Recovery in other languages. This study provides preliminary evidence that the German version of the Questionnaire about the Process of Recovery is a reliable assessment instrument for measuring personal recovery among people with mental illness experiences. However, it is necessary to conduct further psychometric tests to verify the validity and reliability of the instrument. The German version of the Questionnaire about the Process of Recovery can be applied to both research and clinical practice, especially as a means of facilitating communication during the planning and evaluation of treatment goals.     

Transgenic analysis of the BmBLOS2 gene that governs the translucency of the larval integument of the silkworm,Bombyx mori

The larval integument of the silkworm, Bombyx mori, is opaque because urate granules accumulate in the epidermis. Although the biosynthetic pathway of uric acid is well studied, little is known about how uric acid accumulates as urate granules in epidermal cells. In the distinct oily (od) mutant silkworm, the larval integument is translucent because of the inability to construct urate granules. Recently, we have found that the od mutant has a genomic deletion in the B. mori homologue of the human biogenesis of lysosome‐related organelles complex1, subunit 2 (BLOS2) gene (BmBLOS2). Here, we performed a molecular and functional characterization of BmBLOS2. Northern blot analysis showed that BmBLOS2 was ubiquitously expressed in various tissues. We analysed the structure of a newly isolated mutant (od^B) allelic to od and found a premature stop codon in the coding sequence of BmBLOS2 in this new mutation. Moreover, the translucent phenotype was rescued by the germ‐line transformation of the wild‐type BmBLOS2 allele into the od mutant. Our results suggest that BmBLOS2 is responsible for the od mutant phenotype and plays a crucial role in biogenesis of urate granules in the larval epidermis of the silkworm. The relationships amongst Hermansky–Pudlak syndrome (HPS) genes in mammals, granule group genes in Drosophila and translucent mutant genes in B. mori are discussed.     

Comparing the codes of ethics of the six signatory associations of the Mutual Recognition Agreement

Abstract

Purpose: The Agreement for the Mutual Recognition of Professional Association Credentials (MRA) between six national associations provides a mutually negotiated expedited process for applying for certification in speech-language pathology by any of the signatory associations. Although the MRA recognizes common standards in academic and clinical practice and eases the process to have credentials recognized, an interesting concept is that SLPs who have membership in more than one association must adhere to the code of ethics in each association. Thus, as SLPs will need to abide by them the question then becomes, are the codes of ethics in the six national associations comparable?

Method: Using a content analysis procedure, the authors sought to identify similarities between the six codes of ethics.

Result: The results revealed similarities between the six codes in areas such as responsibility to clients, professional conduct and practitioner competence.

Conclusion: The findings should not to be interpreted to imply that one code of ethics was better or more comprehensive than another, as each code of ethics must be understood and interpreted in temporal, situational and local cultural contexts. Rather, the discussion includes a proposal to create a unified document.     

Evaluation of the psychometric properties of the Korean version of the Cultural Competence Assessment

Aim

The 25 item Cultural Competence Assessment assesses the cultural competence of multiple types of healthcare providers. This study aimed to examine the validity and reliability of the Korean version of the questionnaire (KCCA) and to determine the need for changes to improve its validity and reliability.

Methods

Data from 161 hospital nurses were used for the item analysis and to assess the reliability and construct validity of the KCCA before and after the deletion of nine items.

Results

The KCCA did not demonstrate acceptable construct validity and subscale internal reliability. Nine items with high interitem correlations, high modification indices, and relatively lower factor loadings were deleted. The 16 item Modified KCCA showed improved construct validity, convergent and discriminant validity, and reliability.

Conclusion

While further psychometric evaluation of the Modified KCCA should be undertaken with larger samples and diverse professionals, the study's data provide evidence that the Modified KCCA might be a more suitable measure for use among Korean healthcare providers.     

Causes and consequences of the deficiencies of the lower limbs in the Republic of Guinea

Purpose: According to the last general census of 1996, the deficiency of lower limbs is the main cause of handicap in the Republic of Guinea. The objective of this study that took place in 2008 in Conakry is to analyze the main causes of this phenomenon, as well as to understand the reasons of their increase within the Guinean capital. Method: Our survey covered 244 Guineans out of which 170 men and 74 women were living in Conakry, aged between 10 and 68 years old (±12,6). Results: The main causes of the deficiencies are the poliomyelitis after-effects (40%), as well as other risk factors such as the road accidents and the failure of the health system. Whatever the nature of the deficiencies, their compensation is mainly based on the technical supports such as tricycles and wheelchairs. However, they are distributed in a random way and without any medical follow-up. Conclusion: The orthopedic care in the Republic of Guinea is insufficient and inadequate. Hence, certain individuals who need it the most do not receive it. This type of care is not always helpful and sometimes harmful to the health of the disabled persons.

Implications for Rehabilitation

• Orthopedic care in the Republic of Guinea is globally ineffective and whatever the nature of the lower limbs deficiencies, rehabilitation is mainly based on technical support such as tricycles and wheelchairs.

• They are usually supplied by private enterprises and are distributed during advertising campaigns in a random way without any medical follow-up.

• In the absence of this, the inappropriate use of wheelchairs and tricycles is not helpful and sometimes harmful to the health and to the autonomy of disabled persons.

     

An assessment of the triage performance of the efferent arm of the rapid response system

Objectives

To measure the triage performance of the efferent arm of a rapid response system (RRS) by assessing the 24 h outcome of patients triaged to remain on the ward after rapid response team (RRT) review.

Methods

We performed a retrospective observational study of all consecutive RRS activations between August 2005 and December 2011 in a university-affiliated hospital. Calls involving patients with documented limitations of medical therapy (LOMT) orders were excluded. We determined patients who were triaged to stay on the ward at the end of their first (index) call and analyzed their vital status and location 24 h later. Finally, we reviewed medical charts of patients triaged to remain on the ward and had a cardiac arrest and/or died within 24 h of RRT review.

Results

We studied 8304 RRT calls. We excluded 1794 calls involving patients with LOMT, 2165 that were repeat calls, 20 where data was missing, 650 where patients were immediately transferred to a high dependency (HDU) or an intensive care unit (ICU) and 92 where calls were rapidly upgraded to cardiac arrest calls. Thus, we identified 3583 index calls at the end of which patients were triaged to remain on the ward. Within 24 h, 454 (12.7%) of those had a repeat RRT activation and 378 were transferred to HDU/ICU. 12 (0.3%) suffered a cardiac arrest on the ward. Altogether, 14 (0.4%) patients died within 24 h of the index RRT activation. Of those 6 had LOMT applied after the call, 4 had been admitted to ICU in a further call and 6 (0.2%) patients had unexpected cardiac arrest on the ward.

Conclusions

The rate of unexpected cardiac arrest in the 24 h following RRT activation is very low for patients triaged to stay on the ward. Major triage errors by the RRT appear uncommon.     

Impairment of Changes in the Diameter of the Pancreatic Portion of the Superior Mesenteric Vein

Objective. A new ultrasonographic technique for detecting parenchymal stiffness of the pancreas is proposed. This technique measures changes in the diameter of the origin of the superior mesenteric vein (SMV) induced by deep inspiration. The origin of the SMV has extensive attachments to the pancreatic parenchyma; therefore, both physiologic enlargement and shrinkage of the venous lumen cannot occur without changes in the shape of the surrounding parenchyma. Therefore, increased parenchymal stiffness due to chronic pancreatitis (CP) may result in impaired changes in the venous diameter. To confirm this hypothesis, patients with CP and those with a normal pancreas were examined in this study. Methods. Twelve patients in each group were examined. Images of the origin of the SMV were obtained with a commercial ultrasound system. The smallest diameter of the SMV was measured during normal breathing. The patients were then asked to take a deep breath to increase the portal blood pressure followed immediately by the same measurements as performed during normal breathing, and the ratio of the change was calculated. Results. In the normal group, the diameter of the SMV changed by 79.5% ± 43.8% (mean ± SD), whereas a change of 1.4% ± 7.3% was observed in the CP group. The difference between the two groups was statistically significant (P < .0001). Conclusions. The physiologic change in the diameter of the origin of the SMV enhanced by deep inspiration may reflect the stiffness of the pancreatic parenchyma. Therefore, detection of an impaired diameter change may be useful for screening of CP.     

The influence of the distance between the backrest of a chair and the position of the pelvis on the maximum pressure on the ischium and estimated shear force

Purpose. For some people with leg disorders, the alternative to becoming bedridden is sitting in a wheelchair for long periods of time. The purpose of this study was to investigate the relation between the backrest of a chair and the position of the pelvis on the maximum pressure at the ischium and the estimated shear force encountered while sitting in a chair.

Methods. Ten healthy males aged 22.4 ± 2.3 years without pathologies in the leg and/or trunk participated in this study. The subjects were instructed to sit in a chair and the pressure and shear forces were measured under three sitting conditions: In the standard position, a 5 cm forward position and a 10 cm forward position. The effects of the positions of the pelvis on the maximum pressure at the ischium were measured by an instrument for measuring pressure distribution and the shear forces were estimated using an experimental model proposed by us.

Results. Comparisons were made among the three sitting positions; the range of displacement of the maximum pressure point was not significant. The estimated shear force on the seat was 15.5 ± 12.4 N in the standard position, 34.4 ± 8.5 N in the 5-cm forward position, and 53.2 ± 16.7 N in the 10 cm forward position. There were significant differences among the three values (p < 0.01).

Conclusions. Displacing the pelvis forward and leaning against the backrest tends to increase the shear force and raise the risk of decubitus ulcers.     

On the evaluation of the clinical effects of acupuncture

This paper reviews some of the recent randomised trials on acupuncture published in the literature, with particular reference to the definition of placebo (control), sham acupuncture and real acupuncture. Response rates of 30, 50 and 70% of placebo, sham and real acupuncture respectively, are suggested for the groups of patients studied. The statistical methodology necessary in the design of acupuncture trials, in order to detect differences of this order of magnitude, is discussed. If the postulated response rate had been envisaged at the onset of the trials here reviewed, then the majority of these trials have very low power at a conventional 5% level of significance. It is emphasised that one cannot necessarily conclude from trials which produce statistically non-significant results that acupuncture (when compared with placebo for example) is ineffective. The paper suggests that meaningful comparisons between alternative treatments may be made by using ‘pain free intervals’ with subsequent analysis using life table techniques. Tables are provided for determining appropriate patient numbers.