Validation of the World Health Organization’s Quality of Life Questionnaire with Parents of Children with Autistic Disorder

The World Health Organization’s Quality of Life Questionnaire-BREF (WHOQOL-BREF) has been used in many studies that target parents of children with Autistic Disorder. However, the measure has yet to be validated and adapted to this sample group whose daily experiences are considered substantially different from those of parents of children with typical development and parents of children with other disabilities. Therefore, this study was designed to examine the psychometric properties and the theoretical structure of the WHOQOL-BREF with a sample of 184 parents of children with Autistic Disorder. The factor structure for the WHOQOL-BREF was examined using exploratory and confirmatory factor analyses. Our analyses provided no evidence of a better model than the original 4-domain model. Nevertheless, some items in the measure were re-distributed to different domains based on theoretical meanings and/or clean loading criteria. The new model structure gained the measure’s required validity with parents of children with Autistic Disorder.     

Adverse Impact of Coercive Treatments on Psychiatric Inpatients’ Satisfaction with Care

Consumers’ satisfaction with inpatient mental health care is recognized as a key quality indicator that prospectively predicts functional and clinical outcomes. Coercive treatment experience is a frequently cited source of dissatisfaction with inpatient care, yet more research is needed to understand the factors that influence consumers’ perceptions of coercion and its effects on satisfaction, including potential “downstream” effects of past coercive events on current treatment satisfaction. The current study examined associations between objective and subjective indices of coercive treatments and patients’ satisfaction with care in a psychiatric inpatient sample (N = 240). Lower satisfaction ratings were independently associated with three coercive treatment variables: current involuntary admission, perceived coercion during current admission, and self-reported history of being refused a requested medication. Albeit preliminary, these results document associations between patients’ satisfaction ratings and their subjective experiences of coercion during both current and prior hospitalizations.     

Measuring quality of life in people with intellectual and multiple disabilities: Validation of the San Martín scale

Although there are numerous quality of life instruments in the, field of intellectual disability, most of them are addressed to those, people with the highest levels of functioning, while only a few are, suitable for people with the lowest levels (i.e., people with profound, and severe intellectual disabilities, or people with intellectual and, developmental disabilities and other significant medical conditions or, disabilities). This study provides reliability and validity evidence of, the San Martín Scale, a 95-item Likert scale questionnaire that is, completed by a third-party respondent. The validation sample was composed, of 1770 people from Spain with intellectual and developmental, disabilities that showed extensive or pervasive support needs (8.7% had, mild intellectual disability, 28.25% moderate, 41.6% severe, and 21.4%, profound). The age of the participants ranged between 16 and 77 years old, (M = 7.78; SD = 12.32). The results suggested that the eight quality of, life domains assessed on the scale are reliable (Cronbach's alpha ranging, from .821 to .933). Confirmatory Factor Analyses provided construct, validity evidences related to the internal structure of the San Martín, Scale, and indicated that the eight first-order factor solution provided, the best fit to the data over unidimensional and hierarchical solutions. Implications of these findings and guidelines for further research are, discussed.     

Validation of the Patient Health Questionnaire–9 and Patient Health Questionnaire–2 in the General Korean Population

ObjectiveThe Patient Health Questionnaire–9 (PHQ-9) and PHQ-2 have not been validated in the general Korean population. This study aimed to validate and identify the optimal cutoff scores of the PHQ-9 and PHQ-2 in screening for major depression in the general Korean population.MethodsWe used data from 6,022 participants of the Korean Epidemiological Catchment Area Study for Psychiatric Disorders in 2011. Major depression was diagnosed according to the Korean Composite International Diagnostic Interview. Validity, reliability, and receiver operating characteristic curve analyses were performed using the results of the PHQ-9 and Euro Quality of life-5 dimension (EQ-5d).ResultsOf the 6,022 participants, 150 were diagnosed with major depression (2.5%). Both PHQ-9 and PHQ-2 demonstrated relatively high reliability and their scores were highly correlated with the “anxiety/depression” score of the EQ-5d. The optimal cutoff score of the PHQ-9 was 5, with a sensitivity of 89.9%, specificity of 84.1%, positive predictive value (PPV) of 12.6%, negative predictive value (NPV) of 99.7%, positive likelihood ratio (LR+) of 5.6, and negative likelihood ratio (LR-) of 0.12. The optimal cutoff score of the PHQ-2 was 2, with a sensitivity of 85.3%, specificity of 83.2%, PPV of 11.6%, NPV of 99.5%, LR+ of 5.1, and LR- of 0.18.ConclusionThe PHQ-9 and PHQ-2 are valid tools for screening major depression in the general Korean population, with suggested cutoff values of 5 and 2 points, respectively.     

Validation of the Implementation Leadership Scale (ILS) with Supervisors’ Self-Ratings

Although often discussed, there is a lack of empirical research on the role of leadership in the management and delivery of health services. The implementation leadership scale (ILS) assesses the degree to which leaders are knowledgeable, proactive, perseverant, and supportive during evidence-based practice (EBP) implementation. The purpose of this study was to examine the psychometric properties of the ILS for leaders’ self-ratings using a sample of mental health clinic supervisors (N?=?119). Supervisors (i.e., leaders) completed surveys including self-ratings of their implementation leadership. Confirmatory factor analysis, reliability, and validity of the ILS were evaluated. The ILS factor structure was supported in the sample of supervisors. Results demonstrated internal consistency reliability and validity. Cronbach alpha’s ranged from 0.92 to 0.96 for the ILS subscales and 0.95 for the ILS overall scale. The factor structure replication and reliability of the ILS in a sample of supervisors demonstrates its applicability with employees across organizational levels.     

Eating Challenges in Children with Autism Spectrum Disorder: Development and Validation of the “Aut-Eat” Questionnaire (AEQ)

Journal of Autism and Developmental Disorders - The Aut-Eat Questionnaire (AEQ) provides a novel and comprehensive assessment of eating problems and patterns in children with ASD. To establish the...     

Factor Structure of the Children’s Behavior Questionnaire in Children with Williams Syndrome

To examine the factor structure of temperament in 5-10-year-olds with Williams syndrome, an exploratory factor analysis was conducted on the responses of parents of 192 children on the children's behavior questionnaire. Four factors were identified. Two corresponded to factors reported for typically developing children: effortful control and extraversion/surgency and two corresponded to the temperament constructs of withdrawal/inhibition and irritability/frustration and activity, observed in typically developing infants. Parents of 109 of the 192 participants also completed the anxiety disorders interview schedule, parent version. Children with an anxiety disorder other than specific phobia differed significantly from children without an anxiety disorder on all factors except extraversion/surgency. Children with attention deficit hyperactivity disorder (ADHD) differed significantly from children without ADHD on effortful control and extraversion/surgency.     

Neurodegenerative Disease Caregivers’ 5-HTTLPR Genotype Moderates the Effect of Patients’ Empathic Accuracy Deficits on Caregivers’ Well-Being

ObjectiveTo test the hypothesis that a functional polymorphism of the serotonin transporter gene (serotonin-transporter-linked polymorphic region [5-HTTLPR]), which is thought to be associated with differential environmental sensitivity, moderates the association between low levels of empathic accuracy (i.e., ability to recognize emotions in others) in patients with neurodegenerative disease and caregivers’ well-being.MethodsParticipants were 54 patients with neurodegenerative disease and their caregivers. Patients’ empathic accuracy was measured using a dynamic tracking task in which they continuously rated the emotions of a character in a film; accuracy was determined by comparing patient ratings with those made by an expert panel. Caregivers provided a saliva sample for genotyping. Caregivers’ well-being was measured as a latent construct indicated by validated measures of depression, anxiety, and negative affect.ResultsLower levels of patients’ empathic accuracy were associated with lower levels of caregivers’ well-being. Importantly, caregivers’ 5-HTTLPR genotype moderated this association such that lower empathic accuracy in patients predicted lower well-being for caregivers with the short/short genotype (standardized β = 0.66), but not for caregivers with the short/long (standardized β = 0.05) or long/long genotypes (standardized β = −0.21).ConclusionConsistent with previous findings that the short/short variant of 5-HTTLPR is associated with greater sensitivity to environmental influences, caregivers with the short/short variant manifest lower well-being when caring for a patient with low levels of empathic accuracy than caregivers with the other variants. This finding contributes to the authors’ understanding of biological factors associated with individual differences in caregiver vulnerability and resilience.     

Validation of the Chinese version of the Assessment of Preschool Children’s Participation for children with physical disabilities

Purpose: To examine the psychometric properties of the Chinese version of the Assessment of Preschool Children’s Participation (APCP-C). Method: The APCP, a measure of participation in play, skill development, active physical, and social activities of preschool children, was translated into Traditional Chinese. Data on 94 Taiwanese children with physical disabilities aged 2 to 6 years were analyzed. Results: Internal consistency (Cronbach’s α = 0.85 and 0.86) and test–retest reliability (ICCs = 0.79) were excellent for total scores, and varied from excellent to poor for activity type scores. Items were generally relevant to the Taiwanese culture. Correlations between scores for the APCP-C and the Chinese version of the Pediatric Evaluation of Disability Inventory Mobility and Social Functioning scales in general supported convergent validity (r = 0.33–0.68) but less support for discriminant validity. Conclusions: The results provide evidence of reliability, cross-cultural validity, and limited support for construct validity of the APCP-C in measuring participation of children with physical disabilities.     

Family-centredness of professionals who support people with profound intellectual and multiple disabilities: Validation of the Dutch ‘Measure of Processes of Care for Service Providers’ (MPOC-SP-PIMD)

A Dutch version of the ‘Measure of Processes of Care for Service Providers’ (MPOC-SP) was developed to determine the extent to which professionals apply the principles of family-centred care in the rehabilitation of children with physical disabilities. However, no data were available on the reliability and construct validity of this instrument when it comes to supporting people with profound intellectual and multiple disabilities (PIMD). This study aimed to validate an adapted version of the Dutch MPOC-SP for assessing the family-centred behaviours of professionals who support this group (MPOC-SP-PIMD). A total of 105 professionals took part in the study. A Mokken scale analysis was conducted to determine whether the instrument satisfied the assumptions of both monotone homogeneity and double monotonicity. Loevinger's scalability coefficient (H) was used for the scalability of the entire scale and of each item separately. Rho was calculated as a measure of the internal consistency of the scales. The analyses resulted in two scales: a nine-item scale interpreted as ‘Showing Interpersonal Sensitivity’, with H = .39 and rho = .76, and a seven-item scale interpreted as ‘Treating People Respectfully’, with H = .49 and rho = .78. A validated version of the MPOC-SP-PIMD, suitable for supporting people with PIMD, consists of a subset of two scales from the original Dutch MPOC-SP. This instrument can be used to compare the family-centredness of professionals with parent's expectations and views. This information can be used in practice to match the support to the needs of the parents and family of the child with PIMD.     

Effect of Care Capacity on Stroke Patients’ Recovery in Activities of Daily Living: A Multi-Hospital Study

BackgroundThis study aimed to investigate whether care capacity for patients following stroke contributes to improved activities of daily living (ADL) at discharge from hospital based on the degree of stroke severity.DesignRetrospective, observational, longitudinal study.SettingAcute phase hospitals.ParticipantsFrom 2005 to 2011, 5006 patients with stroke at acute phase hospitals were registered in a database. There were 2501 individuals from 11 hospitals who met the following four criteria: (1) a pre-stroke modified Rankin Scale (mRS) score of 0–3; (2) admission to hospital within 7 days of suffering a stroke; (3) ischemic or hemorrhagic stroke; and (4) staying in hospital for 8–60 days.Main outcome measuresThe main outcome measure was the Functional Independence Measure (FIM, version 3.0) score at discharge. The FIM is an internationally used scale, which is used as an ADL outcome assessment scale for after rehabilitation.ResultsAmong patients with stroke, those with care capacity had higher FIM scores at hospital discharge than did those without care capacity (unstandardized coefficient = 2.3, P = 0.015). Examination of this relationship by stroke severity showed that the FIM score at discharge was only significantly higher in patients who suffered from a moderate to severe stroke (unstandardized coefficient = 7.0, P = 0.040). No associations were observed in patients who suffered from minor, moderate, or severe stroke.ConclusionsThese results suggest that care capacity facilitates total recovery of the FIM, especially among patients who suffer from a moderate to severe stroke.     

Modification of the Children’s Sleep Habits Questionnaire for Children with Autism Spectrum Disorder

Sleep problems are common in children with autism spectrum disorder (ASD) and adversely impact daytime functioning. Although no questionnaires have been developed to assess sleep in children with ASD, the 33-item Children’s Sleep Habits Questionnaire (CSHQ) is widely used in this population. We examined the factor structure of the CSHQ in 2872 children (age 4–10 years) enrolled in the Autism Treatment Network. A four-factor solution (Sleep Initiation and Duration, Sleep Anxiety/Co-Sleeping, Night Waking/Parasomnias, and Daytime Alertness) with 5–6 items per factor explained 75% of the total variation. Ten items failed to load on any factor. This abbreviated 23-item four-factor version of this measure may be useful when assessing sleep in children with ASD.     

Caregivers for persons with Alzheimer’s disease

Families have always cared for relatives with dementia, but scientific advances in diagnosis, management, and treatment will make caring more challenging as more people are diagnosed in early stages and more live longer in severe stages with better health care. This paper discusses the increasing prevalence, the economic value and cost of caregiving, the impact of caregiving in families with and without dementia, the subjective experience of dementia and quality of life, the ethical challenges of clinician-family partnerships, the complexity of family systems and processes that impact care patterns, homicide-suicide in caregiving, long-term care staff training, and theoretic models.     

Longitudinal Assessment of Parental Satisfaction with Children’s Psychiatric Hospitalization

Objective To examine trends over time in parents’ satisfaction with their children’s prior psychiatric hospitalization and whether such trends are related to postdischarge outcomes. Study Design/Data Collection Parents of 107 child inpatients completed a satisfaction survey at discharge. Satisfaction with the same inpatient stay was re-assessed 3, 6, and 12 months after discharge. Parents also provided ratings of behavioral symptoms at admission, discharge, and at postdischarge follow-ups. Principal Findings Random regression analyses indicated significant decline in satisfaction from discharge to follow-up. The proportion of parents reporting that they were not satisfied doubled between discharge and 3-month follow-up. Parents whose satisfaction appraisals shifted from satisfied at discharge to not satisfied at follow-up also provided mean ratings of their child’s disruptive behavioral problems at follow-up that were higher than those of parents who reported satisfaction with inpatient care at both times. Conclusions Findings suggest that appraisals of inpatient care are subject to change, and may become more negative when clinical improvement associated with hospitalization dissipates in the months following discharge.     

Satisfaction with Weight Loss: Examining the Longitudinal Covariation Between People’s Weight-loss-related Outcomes and Experiences and Their Satisfaction

Background  

Recent research has shown that satisfaction with weight loss is predictive of weight loss maintenance, yet empirical evidence for how people derive satisfaction with weight loss is quite limited.     

Quantitative Validation of the n-Butanol Sniffin’ Sticks Threshold Pens

Odorant pens are used by medical practitioners and researchers to assess olfactory dysfunction. Despite their routine use, there are currently no data on the gas-phase odorant concentrations released from the pen tips or whether these concentrations scale linearly with the aqueous-phase concentrations inside the pens. The commercially available Sniffin’ Sticks odor threshold test containing n-butanol was chosen for evaluation. The gas-phase concentration of n-butanol at the tip of each pen was measured directly in a new set of pens via proton-transfer-reaction mass spectrometry (PTR-MS). Measurements were additionally made on the same pens after 6 months and two older pen sets, namely a 3-year-old (used) and 4-year-old (new) set. Furthermore, application-related tests were made to determine the performance of the pens during routine use and under stress. These data demonstrate that the gas-phase n-butanol concentrations of the threshold pens are linear over the entire set, both for brand-new pens and 6 months later; this reflects the expected performance that was previously only assumed. Furthermore, the application–simulation tests demonstrated a good performance of the pens when used according to their intended protocol. Measurements of the older pen sets suggest that storage conditions are more critical than usage for pen stability. The present findings confirm that the n-butanol odorant pens are an appropriate tool for threshold testing, provided they are stored and handled correctly.