Assessment of Functional Ability of People with Alzheimer's Disease

The aim of this study was to examine the sensitivity of the Assessment of Motor and Process Skills (AMPS) in discriminating between independent people, those with dementia of the Alzheimer's type (DAT) requiring minimal assistance to live in the community (DAT-min) and those with DAT requiring moderate to maximal assistance (DAT-mod). The subjects comprised 329 non-disabled older adults, 167 people with DAT-min and 292 with DAT-mod. The AMPS was used to measure the subjects' ADL motor and ADL process abilities. Significant main effects were seen for ADL motor and ADL process abilities. All three groups differed significantly in both motor and process mean ability measures and the proportion of people with DAT with ability measures below AMPS cut-off measures increased significantly as the functional level decreased. The ADL process scale was a more discriminative measure of ability to function in the community than was the ADL motor scale.     

The development of a scale to measure medical students' attitudes towards communication skills learning: the Communication Skills Attitude Scale (CSAS)

INTRODUCTION: There is little research identifying medical students' attitudes towards communication skills learning. This pilot study outlines the development of a new scale to measure attitudes towards communication skills learning. METHODS: First- and second-year medical students (n = 490) completed the 26-item Communication Skills Attitude Scale (CSAS) and 39 students completed the CSAS on a second occasion. Factor analysis was conducted to determine the factors underpinning the scale. The internal consistency of the subscales was determined using alpha coefficients. The test-retest reliability of the individual scale items were determined using weighted kappa coefficients and the test-retest reliability of the subscales were established using intraclass correlation coefficients. RESULTS: Maximum likelihood extraction with direct oblimin rotation resulted in a 2-factor scale with 13 items on each subscale. Factor I represented positive attitudes towards communication skills learning and factor II represented negative attitudes. Subscale I had an internal consistency of alpha=0.873 and an intraclass correlation of 0.646 (P < 0.001). Subscale II had an internal consistency of alpha=0.805 and an intraclass correlation of 0.771 (P < 0.001). The majority of items on the positive (n=9, 69.2%) and the negative attitude subscales (n=8, 61.5%) possessed moderate test-retest reliability. DISCUSSION: The development of a new and reliable scale to identify medical students' attitudes towards communication skills learning will enable researchers to explore the relationships between medical students' attitudes and their demographic and education-related characteristics. Further work is needed to validate this scale among a broader population of medical students.     

Reliability of the School AMPS measures

Abstract

Aim: The purpose of this study was to use a variety of methods to evaluate and cross-validate the reliability estimates of the quality of schoolwork performance measures in the School Version of the Assessment of Motor and Process Skills (School AMPS) (1). Methods: Split-half reliability was estimated based on School AMPS data from 6 194 students who had performed at least two school AMPS tasks. Two different split-half methods were used: splitting the School AMPS items vertically and splitting them horizontally. The Rasch equivalent of Cronbach's alpha for the full School AMPS evaluation and standard error of measurement (SEm) were also considered. Results: All three methods yielded high reliability coefficient estimates (r ≥ 0.70) and overall SEm was low. Conclusions: From a practice perspective, the results of this study are of clinical importance as they provide evidence that occupational therapists can have confidence in the consistency of the School AMPS measures when they are used in the process of making decisions about individual students, planning interventions, and later performing follow-up evaluations to measure the outcome.     

Girls,boys and early reading: parents’ gendered views about literacy and children's attitudes towards reading

This study investigated the relationship between children's attitudes towards reading and their parents’ gendered views about literacy (GVL). It was assumed that parents may have GVL by favouring girls in reading activities, which could limit boys’ enjoyment in reading activities. This study was conducted with 31 five-year-old children in first term at a school in South Australia. To measure children's enjoyment in reading-related activities, each child completed an individually administered Literacy Attitude Scale (LAS). Parents completed a questionnaire about their views on girls’ and boys’ early literacy and their book preferences. It was found that the parents’ GVL were significantly and negatively related to children's attitudes towards reading. Importantly, both male and female children of parents, with highly GVL, exhibited lower attitudes towards reading. Overall, girls reported significantly more positive attitudes towards reading than boys. A weak but notable correlation was found between parents’ perceptions about their children's attitudes towards reading and their children's self-reported reading attitudes.     

The Assessment of Motor and Process Skills as a measure of ADL ability in schizophrenia

Background: Functional impairments in schizophrenia are substantial, complex, and persistent. Objective measurement of ADL ability, functional capacity and performance is needed for effective intervention planning and outcome evaluation. Objective: To evaluate ADL ability in people with schizophrenia using the Assessment of Motor and Process Skills (AMPS) and to determine the utility of using the AMPS to predict levels of assistance required for successful community living. Method: In a retrospective audit, AMPS ADL measures of a consecutive sample of 64 people with schizophrenia admitted to a mental health facility were compared with normative data and with recommended “cut-off” measures for competency to live independently in the community. Results: Substantial difficulties were measured in both ADL motor (mean z = –1.5) and ADL process ability (mean z = –2.1). AMPS ability measures did not predict problems with independent living for 62.5% of the patients. Conclusion: People with schizophrenia admitted to an inpatient rehabilitation facility experienced significant difficulty performing ADL tasks. AMPS is a useful measure of ADL ability but should be used in conjunction with measures of functional performance in order to plan interventions and supports for people with schizophrenia that reflect the complexity of factors affecting community functioning.     

The Sex Knowledge and Attitude Test (SKAT)

The Sex Knowledge and Attitude Test (SKAT) was designed to measure knowledge, attitudes and degree of experience in a variety of sexual behaviors, and to be used as a teaching and research instrument. The SKAT has been administered to over 35,000 students, approximately two-thirds of whom have been medical students. SKAT has served two major objectives: to measure changes in knowledge and attitudes after a course or program in human sexuality and to demonstrate the deficiencies of medical and nursing education in preparing health professionals to aid patients with sexual problems. Additional types of research using the SKAT are suggested.     

Development, content validity, and piloting of an instrument designed to measure managers' attitude toward workplace breastfeeding support

Manager attitude is influential in female employees' perceptions of workplace breastfeeding support. Currently, no instrument is available to assess manager attitude toward supporting women who wish to combine breastfeeding with work. We developed and piloted an instrument to measure manager attitudes toward workplace breastfeeding support entitled the "Managers' Attitude Toward Breastfeeding Support Questionnaire," an instrument that measures four constructs using 60 items that are rated agree/disagree on a 4-point Likert rating scale. We established the content validity of the Managers' Attitude Toward Breastfeeding Support Questionnaire measures through expert content review (n=22), expert assessment of item fit (n=11), and cognitive interviews (n=8). Data were collected from a purposive sample of 185 front-line managers who had experience supervising female employees, and responses were scaled using the Multidimensional Random Coefficients Multinomial Logit Model. Dimensionality analyses supported the proposed four-construct model. Reliability ranged from 0.75 to 0.86, and correlations between the constructs were moderately strong (0.47 to 0.71). Four items in two constructs exhibited model-to-data misfit and/or a low score-measure correlation. One item was revised and the other three items were retained in the Managers' Attitude Toward Breastfeeding Support Questionnaire. Findings of this study suggest that the Managers' Attitude Toward Breastfeeding Support Questionnaire measures are reliable and valid indicators of manager attitude toward workplace breastfeeding support, and future research should be conducted to establish external validity. The Managers' Attitude Toward Breastfeeding Support Questionnaire could be used to collect data in a standardized manner within and across companies to measure and compare manager attitudes toward supporting breastfeeding. Organizations can subsequently develop targeted strategies to improve support for breastfeeding employees through efforts influencing managerial attitude.     

Changing the attitudes of `tomorrow's doctors' towards mental illness and psychiatry: a comparison of two teaching methods

The General Medical Council's document ` Tomorrow ' s Doctors ' (1993, GMC, London) recommended major changes in the undergraduate curricula of UK medical schools. In Nottingham, the fourth-year psychiatric attachment became shorter in duration, and interactive, problem-oriented, workshop-based learning replaced lectures. We compared the efficacy of this new teaching style in changing medical students' attitudes towards psychiatry and mental illness with that of old-style, didactic, lecture-based teaching. On the first and last days of their psychiatric attachment, 110 fourth-year medical students (45 old curriculum; 65 new curriculum) completed two self-administered attitudinal measures: the Attitude to Psychiatry Questionnaire (ATP-30) and the Attitude to Mental Illness Questionnaire (AMI). We found that students had favourable attitudes towards psychiatry and mental illness before the attachment. These attitudes became more positive after the attachment in students from both curricula, with no significant difference between the groups and no gender difference. Students found patient contact rewarding, become more accepting of community care, and had greater appreciation of the therapeutic potential of psychiatric interventions. The interactive, student-centred, problem-oriented teaching of the shortened new curriculum appeared as effective in changing medical students' attitudes as a longer attachment with traditional teaching.     

Cross-cultural Validation of a Three Component Alcohol Attitude Scale

Attitudes and their measurement constitute important aspects of the study of human behavior regarding the use and abuse of alcoholic beverages. A Three Component Alcohol Attitude Scale was developed to measure three attitude components separately and in total. This study validated the scale utilizing a cross-cultural approach. Hypotheses were formulated on the assumption that, if the scale was valid, all 54 items in each of the instrument's three components, as well as the total scale, would discriminate significantly between a sample of US university students and their Egyptian counterparts in terms of their attitudes toward alcohol use and abuse. The scale was translated into Arabic, the English and Arabic scales then were administered to a sample of 400 university students at two comparable major universities in the US and Egypt. The data were subjected to Pearson's correlation, t-test, stepwise discriminate analysis, split-half, and Cronbach (alpha) reliability. Forty-nine of 54 items, each of the three components, and the total instrument discriminated significantly between US students and their Egyptian counterparts, confirming the previous validation of the scale.     

Who should assess medical students' communication skills: their academic teachers or their patients?

The objective of this study was to compare the assessment of medical students communication skills made by their academic teachers, with the assessment made by their role-playing `patients'. It was a cross-sectional study, conducted at the Department of General Practice, University of Sydney, Australia, and consisted of 519 undergraduate medical students. Teachers rated students' communication skills using ten specific criteria, each marked on a five-point Likert scale. Teachers then rated students' overall performance using a 10-point scale. Patients rated students' overall performance on the same 10-point Likert scale. Only two of the 10 criteria, as rated by the academic teachers, correlated with the role-playing patients' overall score, and all 10 criteria accounted for only 10·1% of the variance in that score. The academic assessors' overall score accounted for only 9·7% of the variance of the patients' overall score. The communications skills emphasized by academic teachers do not reflect the skills considered to be important by role-playing patients.     

A questionnaire to measure health practitioners' attitudes to partnership in medicine taking: LATCon II

Objectives To revise and improve an existing scale to measure health practitioners’ attitudes to partnership in medicine taking and to ascertain the views of medical students, nursing students and pre‐registration pharmacists on concordance. Background The traditional model of the practitioner‐patient interaction incorporates a practitioner‐centred approach, focusing on the disease rather than the patient. The philosophy of ‘concordance’ (or ‘partnership in medicine‐taking’) puts the patient at the centre of the interaction, with the patient interacting reciprocally with the practitioner. The Leeds Attitude to Concordance (LATCon) scale was developed in 2001 to assess practitioners’ and patients’ attitudes to concordance. However, thinking on concordance has developed since then and the present study aimed to revise the scale to ensure that it reflected current thinking and also to increase its reliability and validity. Design A pool of potential items was developed and sent to three subject experts for opinion. An attitudinal Likert scale of 31 items was developed. Its completion was followed by statistical item reduction to 20 items. The shorter scale was completed by the same participants 4–6 weeks later. Setting and participants The study was set in a university in the UK. Participants were 183 medical students, nursing students, and pre‐registration pharmacists. Results and discussion The study derived a 20 item scale, including five negatively‐worded items, with good levels of internal and test‐retest reliability. Factor analysis suggested five main factors. A statistically significant difference in attitudes was found between student nurses and medical students, and student nurses and pre‐registration pharmacists, with student nurses being more in agreement with the concordant approach. Overall, participants were in agreement with the concordant approach to medicine taking. The UK National Health Service advocates partnership in medical care and is encouraging both practitioners and patients to work to introduce this. There is increased awareness of the patients’ perspective by practitioners, but its impact on their practice remains unclear. Education and skills teaching must continue for the benefits of a concordant approach to be seen. The LATCon scale could play a useful role in education and training, and in research assessing the movement towards the new approach.     

What students bring to medical school: attitudes toward health promotion and prevention

INTRODUCTION: Health care providers' positive attitudes toward prevention and health promotion are important in achieving national health care goals. Limited studies of incoming medical students have been conducted that measure predictors of positive attitudes toward health promotion and prevention. METHODS: Data were obtained from a 1993 curriculum evaluation survey of first-year students at five different medical schools in California. Attitudes toward health promotion and prevention were measured using a nine-question Prevention Attitude Scale (PAS). We developed 2 multivariate linear regression models using demographics, education choices, and personal social values and beliefs to predict PAS scores. We also performed bivariate analysis. RESULTS: Five hundred ninety-nine completed surveys were analyzed, with a response rate of 95%. Mean PAS score was 36.47 +/- 3.7 on a 0 to 44 scale. Female gender, Democratic party preference, and a planned specialty choice in preventive medicine or primary care predicted the highest PAS scores on bivariate analysis (p < 0.002). Significant correlation ( p < 0. 001) was shown between PAS scores and 2 additional scales regarding beliefs in associations of social factors and illness and in the importance of caring for the poor. Linear regression model using personal social values and beliefs explained 34% of the variance, as opposed to the demographic model that explained only 9% of the variance. CONCLUSIONS: In the schools studied, participating first-year medical students had moderately positive attitudes toward health promotion and prevention, as measured by PAS scores. In designing curriculum to improve medical students' attitudes toward health promotion and prevention, medical educators may need to consider other personal and social values held by medical students and to address the "political" aspects of health promotion and prevention. Future studies are needed to longitudinally follow medical student attitudes.     

Knowledge,attitude, and practice towards COVID-19: Research to develop a measuring instrument

ObjectiveTo evaluate the knowledge, attitudes, and behaviors of individuals about COVID-19 and to develop a valid and reliable scale that can measure these items about COVID-19 and other similar pandemic processes.DesignMethodological scale study with a quantitative approach.SiteCarried out at the Uludağ University Family Health Center in Bursa, Turkey.Participants415 individuals in the first phase and 367 in the retest phase.InterventionsCarried out between March 1, 2021, and April 30, 2021.Main measurementsReliability and factor analyses were performed and validity was evaluated. In factor analysis, a scale with 4 factors and 30 questions was obtained. Confirmatory factor analysis (CFA) was applied to the factor scores of the scale. Factors were named A-General Culture, B-Mask, Distance and Cleanliness, C-Mental Status, and D-Way of Information. A 3-point Likert-type scoring system was created for the responses.ResultsCronbach''s alpha value was 0.894. In factor modeling, 3 of the confirmatory factor analysis fit indices were good and 4 of them were acceptable, so our model was found to be appropriate. The scale was highly reliable, according to internal and external consistency coefficients. The scale was named the Turkey COVID-19 Attitude Scale. p values < 0.05 were considered statistically significant.ConclusionsThe valid and reliable Turkey COVID-19 Attitude Scale, which we developed to evaluate the knowledge, attitudes, and behaviors of individuals about COVID-19, can be used to guide research during COVID-19 and future pandemics.     

Involvement with a disease and primary care utilization.

Abstract Is it possible to predict from the attitdues toward diseases the likelihood of primary care utilization? Moreover, considering that an attitude is frequently defined as comprising three main elements: the affective, cognitive and instrumental (1, pp.36–37), is one of these elements predominant in determining the likelihood of medical helpseeking, or does the tendency to seek a General Practitioner's help vary in accordance with the degree of one's involvement in a disease in terms of all three elements? This latter would be similar to a recently identified pattern of engaging in preventive behaviour (2).** We believe that understanding the conditions under which attitudes toward diseases will enhance prediction of actual therapeutic behaviour may be of theoretical as well as practical significance. From the viewpoint of sociological theory it may comprise an additional step in the understanding of the association between attitude and actual behaviour. It may also contribute to the theory of medical helpseeking by stressing the role played by attitudes toward diseases in primary care utilization. From the practical aspect it primarily may assist the medical community, and specifically general practitioners, in understanding the factors that underlie consultation, mainly with respect to those cases which are frequently defined as trivial. It may also elucidate factors underlying delay in helpseeking. Moreover, it may assist planners of prepaid ambulatory services in assessing the volume of primary care utilization and the underlying predominant motivating factors.     

Correlates of attitudes toward the sexuality of the disabled person in selected health professionals

The attitudes of health professionals toward sexuality and disability have recently been under much scrutiny. These attitudes have been characterized as essentially negative. This study was undertaken in an attempt to clarify the relationship between attitudes toward sexuality, attitudes toward disability and attitudes toward the sexual behavior of the disabled.Fifty-three health professionals from three rehabilitation centers served as subjects. Subjects completed a research packet that included theAttitude Toward Disabled Persons Test, Sex Knowledge and Attitude Test and a researcher-designed Attitude Toward Sexual Behavior of the Disabled semantic differential.It was found that attitudes toward disability did not correlate with sex knowledge, attitudes or with attitudes toward the sexual behavior of the disabled. Attitudes toward the sexual behavior of the disabled is best predicted by attitudes toward premarital and extramartial sex and attitudes toward autoeroticism.The data indicate that attitudes toward the sexual behavior of the disabled are associated more with fundamental sex attitudes than with attitudes toward disability. Sex knowledge is not related to attitudes toward sexual behavior of the disabled. It was recommended that programs designed to change attitudes toward sexual behavior of the disabled should focus on attitudes as opposed to knowledge.She is also project director for the Sexual Adjustment Counseling Services project at George Washington University.The original research was conducted under the support of the University of North Carolina Medical School, Department of Allied Health Professions. Preparation of this article was supported by Department of Health, Education & Welfare Grant #RSA 15-P-57882/3-03.The author wishes to extend personal thanks to Debra Cornelius and Elaine Makas for their assistance in preparing this article.     

Utilizing AMPS ability measures to predict level of community dependence

The aim of the study was to examine the efficacy of utilizing Assessment of Motor and Process Skills (AMPS) ability measures as evidence for determining level of community dependence. The sample for the study was drawn from existing data from the AMPS International Project database, and consisted of adults from numerous world regions, with varying diagnoses and levels of ability (n=64,466). Findings support using ADL motor and process ability measures as evidence of a client's level of community dependence. When using ADL motor or process ability measures to identify the need for moderate to maximal assistance, the areas under the ROC curves were 0.74 (fair discrimination power) and 0.82 (good discrimination power), respectively. New ADL motor and process cutoff measures demarcating maximum assistance were set at 1.00 logit (sensitivity=0.70, specificity=0.66) and 0.70 logit (sensitivity=0.79, specificity=0.69), respectively. While ADL process ability continues to be the better predictor, the highest accuracy estimates occurred when motor and process decisions matched (n=30,835). For the first time, multiple AMPS cutoff measures, demarcating independent in the community and in need of maximal assistance, have been proposed.     

Personality,clinical performance and knowledge in paediatric residents

Summary. This study examines the relationship between personality, knowledge and teachers' evaluations of paediatric residents at a large, urban teaching hospital. All residents (n= 30 ) were graduates of foreign medical schools. Each resident completed the Myers-Briggs Type Indicator (MBTI) as a measure of personality and was rated (on a scale of 1-7) by teachers on each of 35 items representing 14 different aspects of clinical performance. These data were correlated with performance on the American Board of Pediatrics In-training Examination (ABPITE), and with demographic data. Ratings of knowledge were directly associated with scores on the ABPITE (r= 0.51 , P < 0.01 ) and with the MBTI continuous score for extraversion (r= 0.51 , P < 0.01 ), but inversely associated with age (r=?0.41, P < 0.01 ). ABPITE scores were also associated directly with MBTI Extraversion (r= 0.44 , P < 0.01 ) and inversely with age (r=?0.56, P < 0.001 ). Age and MBTI Extraversion were independently significant predictors of ABPITE (Multiple R= 0.64, P < 0.01 ) and ratings of knowledge (Multiple R= 0.59, P < 0.01 ). Results suggest that teachers' evaluations of knowledge have validity, and that age and introversion/extroversion play a significant role in both subjective and objective evaluations of paediatric knowledge. Demographic and personality variables may be predictive of knowledge acquisition, but are unrelated to many dimensions of clinical performance.     

Perceptions towards disability among social work students in Israel: Development and validation of a new scale

Over the last decades, the disability movement has been advocating for a paradigmatic shift in how disability is perceived and managed: from a medical or individual perspective focusing on the person's body and mind to a social perspective emphasizing the context and barriers of disability. However, we still know little about the perceptions of helping professionals, particularly social workers who work closely with disabled people. Thus, the aim of the current study is to develop and validate a scale—Perceptions Toward Disability Scale (PTDS)—to measure how social workers view disability: as an individual or social category. This paper describes the three phases of the scale's construction. First, scale items were formulated and its content validity was examined. Next, a pilot of 30 social workers completed a questionnaire and an initial exploratory factor analysis was conducted. In the third and main phase, the final draft was completed in 2016 by 565 Israeli social work students to assess its psychometric properties. Both exploratory and confirmatory factorial validity and discriminant validity analyses were conducted. The results of a confirmatory factor analysis revealed two distinct factors: an individual perspective of disability comprised of eight items (α = 0.77) and a social perspective of disability comprised of ten (α = 0.66). Subsequent analyses supported the scale's discriminant validity as indicated by the lack of an association between the Attitude Toward Disabled Persons Scale (ATDP) and the social model subscale (r = .13, p = .19) and by the weak negative relation with the individual model subscale (r = ?.25, p = .01). These findings show that the PTDS possesses promising construct validity and provide support for its utility. This easy‐to‐administer instrument offers several practical benefits and can serve as a framework for further empirical research regarding social work practice with disabled people.     

Worry Regarding Major Diseases Among Older African-American,Native-American,and Caucasian Women

ABSTRACT

This study examined whether community characteristics, particularly community attitudes regarding mammography use, are associated with women's use of mammography in rural communities. Forty communities in predominantly rural areas of Washington State were selected for inclusion in this study based on their size and distance from an urban center. Characteristics of the communities were assessed as were characteristics of women living in the communities. From each community, random samples of 352 women between 50 and 80 years old participated by completing a telephone survey that included questions on a variety of topics, including their use of mammography. Logistic regression analyses revealed community of residence to be a significant predictor of individual women's mammography use after adjusting for individual level predictors of mammography use including age, education, employment, marital status, financial situation, and ease of access to medical services. An examination of the influence of community characteristics revealed women living in communities with supportive community attitudes towards mammography use report higher levels of mammography use than do women living in communities with less supportive attitudes. The presence or absence of male or female physicians or of mammography facilities in a local community was not associated with statistically significant effects on women's mammography use. Community attitudes are associated with mammography use in rural communities. Public health interventions that change community attitudes may have effects that extend beyond the people directly contacted by these interventions.     

Infant Feeding Attitudes and Knowledge among Socioeconomically Disadvantaged Women in Glasgow

Objectives This study: (1) investigated infant feeding attitudes and knowledge among socioeconomically disadvantaged mothers in an urban community with historically low breastfeeding rates, (2) examined the influence of women’s social networks on infant feeding attitudes and decisions, and (3) validated a measure of infant feeding attitudes and knowledge in this population (Iowa Infant Feeding Attitude Scale, IIFAS). Methods Women attending a prenatal clinic (n = 49) reported on: (1) demographics, (2) infant feeding attitudes and knowledge (IIFAS), (3) feeding intent, (4) opinions about breastfeeding in public, and (5) social networks. Feeding method at discharge was abstracted from hospital charts. Social network members (n = 47) identified by the prenatal sample completed interviews covering: (1) demographics, (2) infant feeding attitudes and knowledge (IIFAS), (3) prior infant feeding methods and recommendations, and (4) opinions about breastfeeding in public. Results Mean IIFAS scores were low in both groups, indicating neutral to negative breastfeeding attitudes; mothers’ scores were lower than social network members. Higher maternal IIFAS score was significantly associated with intended and actual breastfeeding. A social network positive towards breastfeeding was significantly associated with mothers’ positive attitude towards breastfeeding. Both mothers and social network members support breastfeeding in public. IIFAS internal consistency was robust for both mothers and social network members. Predictive validity was demonstrated by significant positive association between score and intended and actual feeding methods. Conclusions Knowledge and attitude predict breastfeeding initiation in this population. Social network members may influence mothers’ feeding choices. This research is important because attitudes and knowledge derived from the IIFAS can be used to develop and evaluate breastfeeding promotion programs.