Value-Based Stroke Rehabilitation: Feasibility and Results of Patient-Reported Outcome Measures in the First Year After Stroke

Purpose

Structured application of patient-reported outcome measures (PROMs) is a key element in Value Based Healthcare. This study aimed to evaluate the feasibility of a broad set of PROMs reflecting similar patient reported health domains as proposed within the International Standard Set of Patient-Centered Outcome Measures After Stroke within the first year after stroke.

Methodological Challenges in Assessing Children's Mental Health Services Utilization

This paper describes the reliability and validity of the service assessment for children and adolescents (SACA) for use among Spanish-speaking respondents. The test-retest reliability of the instrument was assessed in a randomly selected clinical sample of 146 Puerto Rican children and adolescents aged 4–17. Both parents and children were administered the SACA twice by independent interviewers over an average 12-day follow-up period. The accuracy of parental and youth self-reports was assessed by comparing these reports to information obtained from medical records. The results showed that parents and children (aged 11–17) were able to report with fair to moderate reliability any last year use of mental health services, any outpatient mental health services, and school services. Residential and hospitalization services were reported by both informants with substantial test-retest reliability. Slight or no test-retest reliability was obtained for parent and child on the use of the specific type of mental health professionals, as well as parental reports of several treatment modalities. Substantial sensitivity of the SACA was obtained when comparing medical records to parental and child reports to lifetime use of any service and outpatient mental health service. Moderate sensitivity was obtained for last year use of mental health services for both parent and child informants.     

Evaluating the psychometric properties of the Mental Health Continuum-Short Form (MHC-SF) in Iranian earthquake survivors

Positive mental health is a significant dimension of human health that has an important role in promoting well-being. Research in well-being needs reliable and valid scales that measure all aspects of well-being and are available in multiple languages. This study aimed to examine the reliability and validity of the Persian translation of the Mental Health Continuum-Short Form (MHC-SF), a well-validated self-report scale assessing emotional, psychological, and social well-being. In the present study, the Persian translation of the MHC-SF was administered to 600 Iranian adults who survived a series of earthquakes in 2012. Internal consistency of the overall MHC–SF scale was excellent (0.91) and confirmatory factor analysis confirmed the three-factor structure originally proposed, with these three factors accounting for about 68 percent of variance of the variance. Results suggest that the Persian translation of the MHC-SF has strong psychometric properties and is likely of utility to researchers and practitioners in Iran.     

Preliminary evaluation of psychometric properties of the Finnish Borderline Personality Disorder Severity Index: Oulu-BPD-Study

Abstract

Background: Borderline personality disorder (BPD) is a severe disorder decreasing the functional ability of the patient and places an extensive burden on the healthcare system. There is a need for a reliable and valid instrument with which unstable recent BPD symptoms can be assessed in a short-term perspective, and which is applicable for clinical evaluations and treatment-outcome research. Aims: We evaluated the psychometric properties of the Borderline Personality Disorder Severity Index IV (BPDSI-IV) interview in a sample of Finnish BPD patients. Our study is a part of the randomized, monocentre Oulu-BPD trial, which compares the effectiveness of treatment by experts with treatment as usual. Methods. Patients (n = 71) were enrolled in a 2-year randomized controlled trial. The BPDSI-IV was used to assess recent manifestations of BPD. The internal consistency of the BPDSI-IV in the Finnish patient sample was analysed with Cronbach's alpha coefficient and mean item-total correlation. Discriminant validity was examined by comparing the Finnish BPD patient sample with the Dutch BPD patient and non-patient samples. Results. The Cronbach's alphas ranged from 0.58 to 0.79 being highest in Dissociation and lowest in Relationships. A total of five subscales out of nine exceeded the acceptable limit (≥ 0.70). With respect to mean item-total correlation, seven out of nine subscales had an acceptable correlation ≥ 0.30. Conclusions. The BPDSI-IV interview was applied for the first time in a Finnish sample of BPD patients. It appears to be a useful instrument for measuring and following the severity and the change of symptoms of patients with BPD.     

Validity and Reliability of a Korean Version of the National Institutes of Health Stroke Scale

Background and Purpose

The National Institutes of Health Stroke Scale (NIHSS) is a clinical assessment tool that is widely used in clinical trials and practice to evaluate stroke-related neurological deficits. The aim of this study was to determine the validity and reliability of the Korean version of the NIHSS (K-NIHSS) for evaluating Korean stroke patients.

Methods

The K-NIHSS was translated and adapted with regard to cultural and linguistic peculiarities. To examine its content validity, we quantified the Content Validity Index (CVI), which was rated by 11 stroke experts. The validity of the K-NIHSS was assessed by comparison with the Glasgow Coma Scale (GCS), the modified Rankin Scale (mRS), and the Barthel Index. The reliability of the K-NIHSS was evaluated using the unweighted kappa statistics for multiple raters and an intraclass correlation coefficient (ICC).

Results

The CVI of the K-NIHSS reached 0.91-1.00. The median K-NIHSS score at baseline was 3 (interquartile range, 2-7), and the mean±SD score was 6.0±6.6. The baseline K-NIHSS had a significantly negative correlation with the GCS at baseline and the Barthel Index after 90 days. The K-NIHSS also had a significantly positive correlation with the mRS after 90 days. Facial paresis and dysarthria had moderate interrater reliability (unweighted kappa, 0.41-0.60); kappa values were substantial to excellent (unweighted kappa, >0.60) for all the other items. The ICC for the overall K-NIHSS score was 0.998. The intrarater reliability was acceptable, with a median kappa range of 0.524-1.000.

Conclusions

The K-NIHSS is a valid and reliable tool for assessing neurological deficits in Korean acute stroke patients.     

自杀意向量表在中国高中学生中的评估——信度和效度研究

目的:尝试修订西方国家流行的自杀意向量表,并验证其在中国文化背景下高中学生群体里的信度和效度。方法:选取292名农村高中学生参加了研究。结果:自杀意向量表修订后具有较好的内部一致性信度。自杀意向量表得分与特质焦虑、绝望高度相关。结论:修订后的自杀意向量表能够适用于中国高中生人群。     

Reliability of Instruments in a Cooperative,Multisite Study: Employment Intervention Demonstration Program

Reliability of well-known instruments was examined in 202 people with severe mental illness participating in a multisite vocational study. We examined interrater reliability of the Positive and Negative Syndrome Scale (PANSS) and the internal consistency and test-retest reliability of the PANSS, the Rosenberg Self-Esteem Scale, the Medical Outcomes Study Short Form-36 (SF-36), and the Quality of Life Interview. Most scales had good levels of reliability, with intraclass correlation coefficients (ICCs) and coefficient alphas above .70. However, the SF-36 scales were generally less stable over time, particularly Social Functioning (ICC = .55). Test-retest reliability was lower among less educated respondents and among ethnic minorities. We recommend close monitoring of psychometric issues in future multisite studies.