Psychometric validation of the Core Self-Evaluations Scale in people with spinal cord injury

Purpose: Core self-evaluations (CSE) are the perceptions that people have about their overall worth and capability. CSE may be a useful global indicator of adaptation to disability and subjective well-being. The Core Self-Evaluations Scale (CSES) is the most common direct measure of CSE, but its use with persons with disabilities has not been validated. This study aims to evaluate the factorial and concurrent validity of the CSES in persons with spinal cord injury. Method: Two hundred forty-seven individuals with spinal cord injury completed an online survey consisting of the CSES, measures of the four CSE traits, and selected psychosocial variables. Results: Confirmatory factor analysis results provide support for the one-factor measurement structure of the CSES. When correlated with selected psychosocial variables, the CSES was found to perform in a similar fashion to an indirect measure of CSE constructed from measures of the individual CSE traits. Conclusions: The CSES demonstrated acceptable psychometric properties, and its use as a brief, cost-effective measure of CSE in rehabilitation research and practice is supported.

• Implications for Rehabilitation

• Core self-evaluations (CSE) are the perceptions that people have about their overall worth and capability, and the construct has promise as a global indicator of adaptation to disability and subjective well-being in rehabilitation research and practice.

• The Core Self-Evaluations Scale (CSES) is a brief, valuable and cost-effective instrument that can be easily used in both rehabilitation research and practice and has the potential to reduce burden associated with client/participant assessment.

• This study provided evidence of the factorial and concurrent validity of the CSES in persons with spinal cord injury, and supports its use in rehabilitation settings.

     

脊髓损伤后膀胱功能的量表评定

本文介绍一种脊髓损伤后膀胱功能的评定量表 ,该量表根据患者不同的膀胱功能状态和不同的膀胱排空方式 ,将膀胱功能分为5个等级 ,能体现脊髓损伤后膀胱功能改善的细微变化 ,内容科学、简便实用 ,有临床应用价值。     

Psychometric properties of the Iranian version of the Kogan's Attitudes Toward Older People Scale

Aim: The purpose of this study was to assess the psychometric properties “validity” and “reliability” of the Iranian version of Kogan's Attitudes Toward Older People Scale (KAOPS). Methods: The participants consisted of 350 nurses working in five teaching hospitals in Tehran, Iran. The scale was translated using the forward–backward translation technique. A two‐phase data collection design was used in 2 weeks following the first completion. Exploratory factor analysis, content validity, construct validity, internal consistency, and stability–reliability was employed to check the scale's psychometric properties. Results: The scale total scores were between 42 and 188. All of the 34 items were found to have significant item‐to‐total correlations (P < 0.05). Two factors were extracted –“prejudice' and “appreciation”– which contributed to the scale variance of 32.83% and 25.93%, respectively. Cronbach's alpha was 0.83 for the total scale as 0.83 for “prejudice” and 0.86 for “appreciation”. In addition, the scale stability was reported to be 0.90 and 0.83 for “prejudice” and “appreciation”, respectively. The average content validity was 0.95, and construct validity was in an acceptable range. Conclusion: The Iranian version of the KAOPS was shown to be a valid and reliable instrument for measuring nurses' knowledge about elders. This scale can be used in future studies to gather high‐quality data for improving elder care.     

Psychometric properties of the Swedish Diabetes Empowerment Scale

OBJECTIVE: This study was conducted to determine the psychometric properties of the Swedish version of the Diabetes Empowerment Scale (Swe-DES-23). RESEARCH DESIGN AND METHODS: A convenience sample of 195 patients with type 1 and type 2 diabetes completed the Swe-DES-23 questionnaire. To establish discriminant validity, Swe-DES subscales were compared with the Semantic Differential in Diabetes scale (SDD) and a general health scale (EVGFP). Construct validity was tested using factor analyses. To determine unidimensionality of the subscales, inter-item correlations were calculated. Internal consistency was tested by the use of the Crohnbach-alpha coefficient. RESULTS: The factor analysis resulted in four factors (empowerment subscales) with eigenvalues >1.0, explaining 60% of the variance. The four empowerment subscales: goal achievement, self-awareness, stress management and readiness to change showed Crohnbach-alpha values ranging from 0.68 to 0.91. Patients with good self-reported health and low burden of diabetes scored significantly higher on almost all empowerment subscales. Only weak correlations were found between metabolic control and the empowerment subscales. CONCLUSIONS: The SWE-DES-23 scale had acceptable validity and reliability and, thus, could be a suitable tool in evaluating empowerment-based education programmes. Further testing is needed to shorten the questionnaire.     

Psychometric properties of the Caregiving Burden Scale for Family Caregivers with Relatives in Nursing Homes: Scale development

Aim: Most family caregivers continue their caregiving for frail relatives after admitting them to long‐term care facilities. The characteristics of this caregiving differ from those related to caregiving in home‐care settings. Thus, a new tool to evaluate the burden of family caregivers in institutional settings is needed. The aim of this study was to develop a new scale, the Caregiving Burden Scale for Family Caregivers with Relatives in Nursing Homes, and to confirm its validity and reliability. Methods: We conducted two cross‐sectional questionnaire surveys. The participants were a convenience sample of family members of residents in seven nursing homes for the validation study and in three nursing homes for the test‐retest study in Japan. Statistical analyses examined exploratory/confirmatory factor analyses, internal consistency, concurrent/discriminate validity, and test‐retest reliability. Results: A four‐factor solution with 16 items was selected as the most interpretable questionnaire. In the confirmatory factor analysis, the indices of fitness highly supported these results. The Cronbach's alpha coefficient for the total score was 0.86 and varied between 0.77 and 0.87 in the four domains. The scale showed moderate correlation with the Nursing Home Hassles Scale, suggesting its concurrent validity. The four domains had only a medium correlation with each other, indicating discriminate validity. Conclusions: The developed scale has acceptable validity and reliability for measuring the caregiving burden of family members with relatives in Japanese nursing homes. Future studies using the scale might lead to the improvement of care for family members with relatives in a long‐term care setting.     

持续性脊髓压迫对脊髓损伤程度的影响

目的 探讨脊髓损伤(SCI)后脊髓压迫时间对损伤程度的影响。方法 以大脑皮层诱发电位(CSEP)和不同压迫时间为参数,自行设计一种犬的运动—静止压迫型SCI模型,选择T13为损伤中心,压迫脊髓,当 CSEP波幅下降达基础值的 50%时,维持静止压迫。将28只犬随机分为A、B、C、D 4组,A、B、C组脊髓分别受压30 min、90 min和180 min,D组为对照组,观察各组动物的组织病理学、影像学和行为学变化。结果 损伤组脊髓组织学均有损害,MRI显示损害程度随脊髓受压时间的延长逐渐加重( P<0.01);至术后28 d,各损伤组动物后肢功能均有恢复,BBB分级评分法评估组间有显著性差异( P <0.05)。结论 SCI后持续性脊髓压迫能加重损伤程度,应尽早解除脊髓压迫。     

脊髓损伤病人便秘的护理

介绍了脊髓损伤病人便秘的临床表现 ,重点综述了便秘病人的饮食调节、理疗、药物治疗及手术治疗的方法及护理     

外伤性脊髓损伤预后影响因素初探

目的寻找对外伤性脊髓损伤预后有促进作用的因素。方法采用回顾性方法对 12 1例脊髓损伤的患者恢复情况进行分析。结果采用专业康复治疗的患者的恢复率为 79 7% ,磁疗方法治疗的患者恢复二级的恢复率达 5 3 % ,明显高于其他方法。结论专业康复治疗对患者的恢复有明显的促进作用。磁疗对脊髓损伤患者预后有促进作用。     

脊髓损伤病人的康复护理

从心理护理、制定康复护理目标、饮食指导、体位护理、膀胱功能训练、并发症的预防和护理、肢体功能训练、康复教育等8个方面介绍了脊髓损伤病人的康复护理。     

脊髓损伤病人的康复护理

从心理护理、制定康复护理目标、饮食指导、体位护理、膀胱功能训练、并发症的预防和护理、肢体功能训练、康复教育等8个方面介绍了脊髓损伤病人的康复护理。     

急性颈髓损伤患者的预见性护理

目的探讨急性颈髓损伤患者预见性的护理措施。方法回顾性分析、总结41例急性颈髓损伤患者早期的治疗与护理。结果除1例死亡,1例放弃治疗外,余39例患者均能控制病情、治愈并发症后出院。结论有预见性、针对性地实施护理措施,能有效减少并发症的发生,促进患者康复。     

颈脊髓损伤患者的呼吸道管理

探讨颈脊髓损伤患者呼吸道管理的方法,为提高临床疗效提供有效的保证。对我科2008年6月至2010年10月收治的38例颈脊髓损伤患者的呼吸道管理进行回顾性分析。38例颈脊髓损伤患者进行呼吸道管理后,呼吸功能完全恢复35例,3例发生急性呼吸衰竭死亡。颈脊髓损伤患者的呼吸道管理是颈椎骨折手术成功的关键性因素,合理可靠的呼吸道管理,为患者术后顺利恢复提供了有效的保障。     

胚胎脊髓对损伤脊髓的修复作用研究

目的探讨不同条件下胚胎脊髓移值修复成鼠急性脊髓损伤(SCI)的能力。方法成鼠胸髓损伤后分别移植孕14d胚胎脊髓(FSC组)、游离正中神经加胚胎脊髓(P＋F组)、带血管蒂正中神经加胚胎脊髓(V＋F组),术后8周行组织学检查。结果V＋F组胚胎脊髓与受体融合佳,体积增长速度、神经纤维和神经元数目显著高于P＋F、FSC组（P<0.01）,细胞分化比较好,突触较成熟,界面区也无明显的胶质增生。结论带血管蒂周围胚胎脊髓联合移植,对FSC的生长发育、对损伤神经元的再生能力均有一定的促进作用。     

电针结合耳针治疗急性脊髓损伤的临床研究

目的评估电针结合耳针治疗急性脊髓损伤的疗效和安全性。方法我院1999年1月～2004年5月期间急性脊髓损伤美国脊髓损伤学会（ASIA）损伤分级A级和B级患者56例，随机分为针灸治疗组和对照组。针灸治疗组采用双侧后溪和申脉点电针，与脊髓相关耳穴的耳针，同时配合康复治疗。对照组仅仅采用康复治疗。分别记录入院时、出院时及出院后1年ASIA损伤分级及ASIA神经（运动、感觉）功能状况评分、独立性功能评定（FIM）及不良反应。结果在神经（感觉和运动）功能和FIM评分方面针灸治疗组优于对照组（P〈0．05），无明显不良反应。结论早期采用电针结合耳针治疗急性脊髓损伤有较好的疗效和安全性。     

脊髓损伤患者F波时间离散度的研究

目的:探讨F波的时间离散度(F-CD)在脊髓损伤(SCI)患者中的应用价值。方法:比较F波的潜伏期及F-CD在29例正常对照组以及不同损伤程度的29例SCI患者之间的差异;评价SCI患者痉挛程度与F波的潜伏期及F-CD之间的相关性。结果:SCI患者的F-CD值为9.2±1.9ms;正常人的F-CD值为6.7±1.0ms;两者之间差异有显著性(P<0.0001)。F-CD值在完全性SCI(损伤程度A)的患者中偏大(10.8±1.7ms),且与其它损伤程度的患者相比差异有显著性意义(P<0.05);F-CD值在损伤程度为B、C和D的3组患者之间差异无显著性意义(P>0.05)。SCI患者痉挛Ashworth评分与F-CD之间的呈线性正相关(r=0.79031,P<0.0001)。F波的最小潜伏期在SCI患者和正常人之间的差异无显著性意义(P>0.05);SCI患者F波最小潜伏期与Ashworth评分之间无明显相关性(r=0.08168,P>0.05)。结论:F-CD可以作为SCI患者电生理评价的一个敏感性指标,用于评价SCI后的痉挛以及为完全性SCI患者提供客观的神经电生理依据。     

脊髓损伤患者自主神经功能障碍的临床研究

目的:通过检测健康人群和不同节段脊髓损伤患者心率变异性（HRV），探讨脊髓损伤患者是否存在自主神经的功能障碍，以及不同节段脊髓损伤患者的自主神经的功能障碍程度是否相同。方法:依据脊髓损伤节段的不同将截瘫患者分为颈段及T1-5节段脊髓损伤组11例，T6-12脊髓损伤组7例， 腰髓损伤6例； 健康体检人群19例作为正常对照组。采用短程动态记录安静状态下心电图并进行HRV分析。结果:颈段及T1-5脊髓损伤组代表交感和迷走神经张力总合的低频检测结果301.41±358.60ms2较正常人群的620.19±333.36 ms2明显降低（P＜0.05），而且所有脊髓损伤组的低频/高频比值在C1-T5为1.66±1.00、T6-12为4.03±2.66、腰髓及以下为3.35±1.89，较正常人群的2.29±0.58明显异常（P＜0.05），同时不同脊髓损伤组之间的检测结果不存在显著性差异（P＞0.05）。结论:脊髓损伤患者存在自主神经的功能障碍，但不同节段脊髓损伤组之间的自主神经功能障碍不存在显著性差异。     

脊髓损伤患者医院感染危险因素分析

目的分析脊髓损伤患者医院感染的危险因素。方法对 1996年 1月— 2 0 0 2年 12月 ,我院收治的 88例脊髓损伤患者的医院感染情况即危险因素、病原体分析及药敏实验进行回顾性调查。结果医院感染率为 90 .91% ,其中主要为泌尿系感染(4 6.5 9% ) ,其次为呼吸道感染 (3 2 .95 % ) ;基础疾病、抗生素应用、侵袭性操作、年龄和病情的严重程度等是引起脊髓损伤患者医院感染的危险因素。结论减少危险因素、合理应用抗生素是降低脊髓损伤患者医院感染的有效措施。     

Barriers to and facilitators of coping with spinal cord injury for Iranian patients: a qualitative study

The purpose of the present study was to explore the perspectives and experiences of Iranian patients regarding barriers and facilitators to their ability to cope with spinal cord injury (SCI). A qualitative design, based on the content analysis approach, was used to collect and analyze the experiences of 18 patients with spinal cord injury in two centers in Tehran, Iran. After using purposeful sampling for selection of the participants, semi-structured interviews were held for data collection. Lack of "knowledge", "financial resources", "employment opportunities", "suitable facilities and accessibility" as well as "societal acceptance and support" emerged as barriers; and having "self-confidence", "religious beliefs", "support networks" and "positive thinking" emerged as facilitators in coping with spinal cord injury. Participants believed that with these hindering factors in place, adapting to their new condition had been difficult, therefore they can only manage to adapt partially to their situation. Additional multidisciplinary endeavors are needed to help this group cope adequately and further research is required to influence policy making and legislation processes efficiently.     

急性脊髓损伤后血清中ALT和AST活性变化的临床初步观察

目的：探讨血清中谷丙转氨酶（ＡＬＴ）和谷草转氨酶（ＡＳＴ）的活性与急性脊柱脊髓损伤的关系。并评价ＡＬＴ和ＡＳＴ活性的主民脊髓损伤严重程度的关系。方法：测定１３６例急性脊柱脊髓损伤患者在急性期及恢复期血清中ＡＬＴ和ＡＳＴ的水平,以及３０例急性仍柱骨折患者血清中ＡＬＴ和ＡＳＴ的浓度,分别进行统计学处理分析。结果：急性脊柱脊髓损伤患者血清中ＡＬＴ和ＡＳＴ活性显著高于其恢复期及单纯脊柱骨折患者,并且在急性