Development and factor analysis of an index of post-polio sequelae

Purpose.?This present study describes the development, factor structure and initial validation of the Index of Post-Polio Sequelae (IPPS).

Method.?The IPPS was tested on a sample of 849 community-dwelling polio survivors between the ages of 40 and 93 years old who participated in a large, national study of menopause and aging in late polio. Items from the IPPS were submitted to a factor analysis using principal components extraction and rotated to oblique simple structure using promax rotation. Convergent validity was assessed using bivariate correlation.

Results.?Three factors were extracted that accounted for approximately 53% of the variance in the original IPPS items. Factor 1 (Pain) was loaded most heavily by two items referring to muscle and joint pain. Factor 2 (Atrophy) was loaded by items referring to muscle atrophy, involved muscle weakness, and fatigue. Factor 3 (Bulbar) was comprised of two items referring to breathing and swallowing problems. Bivariate correlations between health and psychosocial variables and each of the factors all were significant and in expected directions.

Conclusions.?This first validation of a standardized scale to assess the severity of post-polio sequelae in polio survivors suggests a psychometrically sound instrument whose factor structure represents commonly reported problems in the extant post-polio literature.     

Management of a patient with post-polio syndrome

PURPOSE: To describe the current understanding of the management of patients with post-polio syndrome (PPS) and relate the research to a case study. DATA SOURCES: Standard neurology textbooks, current review and research articles, and a case study. CONCLUSIONS: More than 15 years following a diagnosis of poliomyelitis, a new onset of weakness, fatigue, joint pain, decreased endurance, muscle atrophy, gait disturbance, respiratory and swallowing problems, cold intolerance, and difficulties with activities of daily living might indicate a neurologic disorder called PPS. IMPLICATIONS FOR PRACTICE: Non-post-polio causes of weakness, fatigue or pain must be excluded before making a diagnosis of PPS. Approaches to management vary depending on the symptoms and level of disability. Reducing physical and emotional stress, energy conservation, adequate rest, modification of work and home environments, joint protection, and the use of orthoses, adaptive equipment, or mobility aids can reduce fatigue and preserve function.     

Development of an index of health utilizing factor analysis

A multivariate technique, factor analysis, was used to calculate an index number for each county in Mississippi and an overall state index number for the year 1970. Data on 55 indicators of health were factor analyzed (Principal components, Varimax rotation) and eight factors were extracted. These eight factors were identified as Resource population, Economics, Geriatrics, Social problems, Preventive medicine, Nutrition, Mortality, and Disability. Sixty-two per cent of the total variance was explained by these factors. The index numbers were standardized as percentages for ease of comparison across all 82 counties. Therefore, a multivariate technique has been used to quantify the elusive multidimensional term "health" and that is something which has not previously been adequately accomplished.     

论脊髓灰质炎后遗症矫形康复疗效标准

对脊髓灰质炎后遗症矫形治疗,参照国内外其它矫形效果评价方法,提出评价标准。还就评价要点,方法和时间进行了讨论。     

喀什地区脊髓灰质炎后遗症股骨干骨折患者30例的临床分析

目的总结和分析喀什地区脊髓灰质炎后遗症股骨干骨折的临床治疗方案。方法分析2011年1月至2014年1月治疗的伴有股骨干骨折后遗症的脊髓灰质炎患者的临床资料。参照AO/OTA对所有患者进行分类。探讨治疗疗效以及骨折AO/OTA分类与疗效的相关性。结果本研究共纳入研究对象30例,AO/OTA分类结果为3.2A型10例,3.2B型13例,3.2C型7例。均实施钢板内固定治疗。三组患者的治疗优良率分别为80.0%,92.3%和85.7%。三组治疗优良率组间比较并无统计学差异(χ2=0.748,P0.05)。结论钢板内固定对于不同类型的喀什地区脊髓灰质炎后遗症股骨干骨折患者患者治疗均有疗效显著。     

Prolonged benefit in post-polio syndrome from comprehensive rehabilitation: A pilot study

Purpose. To report physical, psychological and functional outcomes from a pilot study of a multi-disciplinary rehabilitation programme for post-polio syndrome (PPS).

Method. Twenty-seven participants completed the nine-day programme and were available for re-assessment at three and six months. Physical outcome measures were muscle strength and endurance; psychological outcomes included illness perceptions (IPQ), depression and anxiety (HADS); functional outcomes were fatigue (HFS) and client-centred occupational performance and satisfaction (COPM).

Results. There was no significant change at six months for muscle strength or anxiety. Significant improvements were recorded for exercise endurance, depression and levels of fatigue. A shift towards an endorsement that the patient's own behaviour could be important in symptom severity of PPS was seen. Five out of 24 participants demonstrated significant clinical changes in occupational performance and satisfaction on the COPM.

Conclusions. Prolonged benefits were found for physical, psychological and functional outcomes. A qualitative study is planned to investigate the patient-reported benefits of attending the programme such as the support gained interacting with others with similar disability and in lifestyle adjustment such as pacing of physical activities.     

Climate,Health, and Nursing Tool (CHANT): A confirmatory factor analysis

Objective

To confirm the factor structure of the Climate, Health, and Nursing Tool (CHANT) tool via confirmatory factor analysis.

Design and sample

This is a cross-sectional analysis of voluntary, anonymous responses collected online in 2019, from a non-representative sample of 489 nurses from 12 nations with 95% of the respondents from the United States.

Measurements

A confirmatory factor analysis (CFA) was conducted to test a five-factor measurement model of the 22-item CHANT. Reliability was examined via Cronbach's α coefficient.

Results

The five CHANT subscales demonstrated acceptable reliability with Cronbach's α ranging from 0.67 to 0.91. The five-factor model of CHANT demonstrated good fit, x²(199) = 582.747, p < .001, CFI = 0.94, RMSEA = 0.06, and SRMR = 0.04 with statistically significant item-factor loadings.

Conclusion

CHANT is a reliable and robust instrument to measure nurses’ awareness, concern, motivation, and home and work behaviors regarding climate change and health, and is ready to be utilized in research, policy, professional settings, and among educators.     

Development of an instrument to measure strategic and clinical quality indicators in postoperative pain management

AIM OF THE STUDY: To develop and evaluate psychometric properties, that is reliability and validity, of an instrument to measure strategic and clinical quality indicators in postoperative pain management. BACKGROUND: Strategic and clinical quality indicators in postoperative pain management were previously developed from a tentative model of important aspects of surgical nursing care and assessed to have content validity, that is to be essential for the quality of care, realistic to carry out and possible for nurses to use to influence management. METHODS: The quality indicators were converted to items suitable for a patient questionnaire and were scored on a 5-point scale, with higher scores indicating higher quality of care. Inpatients from five surgical wards took part in this study on their second postoperative day. The response rate was 96% and the average ages of the female (n=120) and the male (n=78) respondents were 62 and 63 years, respectively. RESULTS: Items in the total scale had an average inter-item correlation >0.20 and an item-total correlation >0.30. Cronbach's coefficient alpha was 0.84 for the total scale. Four factors entitled 'communication', 'action', 'trust' and 'environment' emerged from an orthogonal factor analysis, with a cumulative variance of 61.4%. Patients who received epidural analgesia had higher scores on the total scale compared with those who did not receive epidural analgesia. Patients who reported more pain than expected had lower scores on the total scale compared with those who did not report more pain than expected. Correlation between the total scale and an overall pain relief satisfaction question was 0.53. CONCLUSION: The results suggest initial support for the new instrument as a measure of strategic and clinical quality indicators in postoperative pain management, but it must be further refined, tested and evaluated.     

Equating activities of daily living outcome measures: the Functional Independence Measure and the Korean version of Modified Barthel Index

Purpose: To create a crosswalk between the Functional Independence Measure (FIM) motor items and the Korean version of the Modified Barthel Index (K-MBI).

Method: Korean community-dwelling adult patients (n?=?276) completed the FIM and K-MBI on the same day in outpatient rehabilitation hospitals. We used a single group design with the Rasch common person equating and conducted a factor analysis of the co-calibrated item pool using the two measures. Rasch analysis was used to investigate the psychometrics of the equated test items in the identified factor structure(s). The correlation between FIM raw scores and converted K-MBI scores was examined.

Results: Three measurement constructs were identified: self-care, mobility, involuntary movement. The equated test items in the three constructs demonstrated good person separation reliability (r?=?0.94–0.96) and good internal consistency (Cronbach’s alpha =0.93–0.97). The three crosswalks between the FIM raw scores and converted K-MBI scores demonstrated good correlations (r?=?0.91–0.93, all p?Conclusions: The Rasch equating method successfully created three crosswalks between the FIM motor items and K-MBI, with the equated test items demonstrating good psychometrics. The crosswalks would address the incomparable scoring systems between the FIM motor items and K-MBI.

• Implications for Rehabilitation

• The three crosswalk tables (scoring tables) would allow clinicians to compare or translate a patient’s motor scores between the FIM and K-MBI.

• The crosswalk tables would allow health-care administrators to track patients’ functional status across various rehabilitation facilities that exclusively use the FIM or K-MBI.

     

综合康复治疗乙型脑炎后遗症41例疗效观察

目的 对中医或综合康复治疗小儿乙脑后遗症的疗效进行对比观察。方法 41例患者分为中医治疗组和综合康复组。治疗前后对患儿后遗症进行功能评定。结果 综合康复组的运动功能障碍的恢复有显著提高,疗程明显缩短,与中医治疗组相比有显著性差异（P＜0．05）。结论 综合康复可有效地治疗流行性乙型脑炎后遗症,缩短后遗传恢复时间,利于运动系统及语言功能的恢复。     

A subjective measure of environmental facilitators and barriers to participation for people with mobility limitations

Purpose. The aim of this paper is to describe the development and psychometric properties of a self-report survey of environmental facilitators and barriers to participation by people with mobility impairments.

Method. A measure called the Facilitators And Barriers Survey of environmental influences on participation among people with lower limb Mobility impairments and limitations (FABS/M) was developed using items based on focus groups to ensure content validity. Discriminant validity was assessed on 604 individuals who completed the FABS/M once. Internal consistency and test-retest reliabilities were based on 371 individuals who completed two surveys.

Results. The FABS/M includes 61 questions, 133 items and six domains including the type of primary mobility device; built features of homes; built and natural features in the community; community destination access; community facilities access; community support network. Environmental items are scored for the frequency of encounter and the magnitude of influence on their participation. The internal consistencies and the test-retest reliabilities of the domains of the FABS/M ranged from low to moderate. The discriminant validity of domains differed for device and diagnostic groups.

Conclusion. The FABS/M joins the MQE and the CHIEF as another subjective measure for use in assessing environmental features important for understanding participation. The FABS can be used to assess the influence of environmental interventions at the individual and community levels of analysis. The type of primary mobility device that is used can be related to reported environmental barriers. Community-based improvements in built features, access to destinations, access to facilities and augmented support networks can be tracked through the reports of people with mobility impairments.     

A subjective measure of environmental facilitators and barriers to participation for people with mobility limitations

Purpose. The aim of this paper is to describe the development and psychometric properties of a self-report survey of environmental facilitators and barriers to participation by people with mobility impairments.

Method. A measure called the Facilitators And Barriers Survey of environmental influences on participation among people with lower limb Mobility impairments and limitations (FABS/M) was developed using items based on focus groups to ensure content validity. Discriminant validity was assessed on 604 individuals who completed the FABS/M once. Internal consistency and test-retest reliabilities were based on 371 individuals who completed two surveys.

Results. The FABS/M includes 61 questions, 133 items and six domains including the type of primary mobility device; built features of homes; built and natural features in the community; community destination access; community facilities access; community support network. Environmental items are scored for the frequency of encounter and the magnitude of influence on their participation. The internal consistencies and the test-retest reliabilities of the domains of the FABS/M ranged from low to moderate. The discriminant validity of domains differed for device and diagnostic groups.

Conclusion. The FABS/M joins the MQE and the CHIEF as another subjective measure for use in assessing environmental features important for understanding participation. The FABS can be used to assess the influence of environmental interventions at the individual and community levels of analysis. The type of primary mobility device that is used can be related to reported environmental barriers. Community-based improvements in built features, access to destinations, access to facilities and augmented support networks can be tracked through the reports of people with mobility impairments.     

Aphasia and stroke therapeutic alliance measure (A-STAM): Development and preliminary psychometric evaluation

Abstract

Purpose: The therapeutic alliance, also known as the therapeutic relationship, may influence treatment process and outcome in aphasia rehabilitation; however, we currently lack a reliable tool to measure this relationship. This study aimed to develop a novel measure of the therapeutic alliance applicable to this population and provide preliminary evidence of the measure’s psychometric properties.

Method: Statements were generated from the: (1) therapeutic alliance literature, (2) qualitative interviews with stakeholders, and (3) Q methodological insights with people with aphasia (PWA) (n?=?455). A representative sample of statements was identified from the data set (n?=?57) and reviewed by expert panels (professionals and PWA), culminating in a 42-item clinician and patient version of the aphasia and stroke therapeutic alliance measure (A-STAM). Reliability and validity of both the clinician and patient versions of A-STAM were investigated with 34 Clinician-patient dyads engaging in therapy.

Result: Internal consistency and test–retest reliability were excellent for both clinician (α?=?92; ICC = 0.93) and patient versions of A-STAM (α?=?0.92; ICC = 0.97). In both versions, scores correlated highly with psychotherapeutic measures of therapeutic alliance, indicative of good construct validity (r_s = 0.75; r_s = 0.77).

Conclusion: The findings establish the preliminary reliability and validity of A-STAM and support further investigation into the measure’s psychometric properties in larger samples.     

The health-related quality of life of patients suffering from the late effects of polio (post-polio)

In Sweden alone, there are today approximately 10 000-16 500 polio survivors. Between 60% and 80% experience new symptoms several years after the initial attack of poliomyelitis. The aims of this study were to investigate and describe the self-rated health-related quality of life and functional status of a group of Swedish patients with post-polio, to investigate whether any differences within the group could be related to demographic or disease-specific data and to compare the post-polio patients with individuals sampled from the general population. Data were obtained by using two questionnaires, the Swedish Health-Related Quality of Life Questionnaire (SWED-QUAL) and the Sickness Impact Profile (SIP). A total of 150 patients, 86 women and 64 men with median age 61 (20-82) years, were consecutively included. The study showed that the patients mainly reported that their physical, functional status was affected by their post-polio condition. Factors found to be associated with the physical, functional status were age and the number of parts of the body affected by the polio. On comparing the post-polio patients with two samples from the Swedish general population, it was found that the patients reported a poorer functional status and health-related quality of life. The women with post-polio reported more pain, as compared with both the men with post-polio and the women in the general population sample. The family life of the patients - in contrast to their physical abilities - did not seem to be affected by the new deteriorating condition. It is concluded that, owing to the wide range of symptoms, the patients with post-polio need care and support from multidisciplinary teams, including nurses and occupational therapists.     

Modified Research Utilization Questionnaire: Development and Validation Study among Italian Nurses

Purpose

The purpose of this study was to develop the modified research utilization questionnaire (M-RUQ) and to establish its content and face validity, construct validity, and reliability.

脊髓灰质炎后遗脊柱侧凸矫形术的康复治疗效果评价

目的评价脊髓灰质炎后遗脊柱侧凸术患者康复治疗的效果.方法对照组15例患者于术后3个月开始接受康复功能训练,而观察组36例患者于手术前后进行全面康复治疗.两组在术后并发症、骨融合时间、日常生活能力评定(ADL评分)等方面进行比较.结果比较两组患者术后早期并发症发生率,有着显著的差异(P<0.01),而术后晚期并发症均为0.在术后3个月测定ADL评分,观察组与术前相比,有着显著的差异(P<0.01),而对照组则无明显差别(P>0.05);两组脊柱融合时间,也有着显著的差异(P<0.01).结论对脊髓灰质炎后遗脊柱侧凸手术的患者进行有计划的康复治疗,对预防术后并发症,促进脊柱融合时间和日常生活能力提高起着重要的作用.