Psychometric Properties of the Long and Short Versions of the Young Schema Questionnaire: Core Beliefs Among Bulimic and Comparison Women

Young's Schema Questionnaire is a potentially valuable clinical and research tool for the investigation of core beliefs and has been well validated. However, at 205 items it is comparatively unwieldy. A briefer, 75-item version has recently been produced by Young, but lacks the psychometric validation that would demonstrate its utility relative to the longer version. The present study aimed to determine whether the long and short versions of the Schema Questionnaire have comparable psychometric properties among a clinical group of bulimics and a comparison group. The two forms had similar levels of internal consistency, and parallel forms reliability and discriminant validity, and their levels of clinical utility were broadly comparable. These findings support the use of the more convenient 75-item version of this questionnaire in clinical and research settings since its psychometric properties are similar to those of the long version. However, these results require replication with other clinical groups.     

Development and psychometric evaluation of the German version of the Medication Regimen Complexity Index (MRCI-D)

Background Several factors contribute to the complexity of pharmacotherapeutic regimens, like the total number of medications to be taken, the number of dosage units to take at a time, dosage frequency, as well as specific directions concerning the administration. The Medication Regimen Complexity Index (MRCI) is a validated instrument developed in English for the measurement of the complexity of a given pharmacotherapeutic regimen. Objectives Translation of the MRCI into German and evaluation of the translated instrument (MRCI‐D) in order to make it more easily accessible for use in German practice and research. Methods The process of validation included the translation of the English version to German, back‐translation into English, comparison of the back‐translated and the original versions, pre‐tests, and pilot‐testing of the German version by three raters using 20 medication regimens for inpatients. The subsequent psychometric evaluation included the calculation of inter‐rater and test–retest reliability, as well as the assessment of convergent validity. Results The number of medications correlated highly and statistically significantly with the MRCI‐D score (0.91, P < 0.001), indicating sufficient convergent validity of the instrument. Both inter‐rater and test–retest reliability were very high (intraclass correlation coefficients above 0.80 in all cases). Conclusion Our results demonstrate that the German version of the MRCI reflects the complexity of therapeutic regimens with similar validity and reliability as the established English version. Thus, it may be a valuable tool to analyse therapeutic regimens in both clinical practice and science.     

失禁相关性皮炎风险评估量表在失禁患者护理中的应用

目的 探讨失禁相关性皮炎风险评估量表在失禁患者中的应用效果。 方法 将454例住院失禁患者按入院顺序分为对照组和观察组。选取2014年1~6月的218例失禁患者为对照组,给予常规护理。选取2014年7~12月的236例失禁患者为观察组,采用失禁相关性皮炎风险评估量表评估后进行护理。比较2组失禁相关性皮炎的发生率。 结果 观察组失禁相关性皮炎发生率低于对照组(χ²=4.11,P<0.05)。 结论 对失禁患者采用失禁相关性皮炎风险评估量表评估后进行护理,可有效降低失禁相关性皮炎的发生率。     

会阴评估工具对ICU失禁患者失禁性皮炎发生的预警作用及相关危险因素分析

目的探讨会阴评估工具对ICU失禁患者失禁性皮炎的预警作用及诊断界值。方法选取ICU失禁患者130例为研究对象,记录分析130例失禁患者的失禁风险评估及临床资料,使用受试者工作特征曲线下面积评价会阴评估工具的预测性能和最佳诊断界值。结果 130例患者中,发生失禁性皮炎48例,占36.92%。危险因素分析结果表明,大便性状、失禁评分为失禁性皮炎的危险因素,红细胞计数为失禁性皮炎的保护因素。由ROC曲线可知,会阴评估工具曲线下面积为0.795(P0.01),会阴评估工具评分为8分时,其灵敏度(0.646)、特异度(0.850)具有最好的平衡性。结论会阴评估工具在预测ICU失禁患者失禁性皮炎中具有较高的灵敏度和特异度,值得广泛应用。     

Care dependency: testing the German version of the Care Dependency Scale in nursing homes and on geriatric wards

The purpose of this study was the psychometric evaluation of the German version of the dependency scale in nursing homes and on geriatric wards. The 15-item scale was originally developed in the Netherlands for assessing the care dependency of demented and mentally handicapped patients. Data of 81 nursing home residents and of 115 geriatric patients were collected. Residents and patients were assessed several time by professionals and nonprofessionals. Reliability was determined by Cronbach's alpha, showing very good results with values of 0.94 and 0.98. Inter-rater and intrarater reliability show moderate to substantial Kappa values. Criterion validity was examined by comparing the data of the scale with the German nursing personal regulation and the German statutory insurance. The results show that the scores of the Care Dependency Scale correlate to the scores of the two classifications. In general, the German version of the scale can be recommended for use in nursing homes and on geriatric wards.     

结构化护理规程在预防EICU患者失禁相关性皮炎中的应用

目的:探讨结构化护理规程在预防EICU患者失禁相关性皮炎中的应用效果,为其他护理人员提供临床参考。方法:选取该院入住EICU的患者416例,采用历史对照实验方法分为试验组264例和对照组152例。对照组采用常规护理,试验组采用结构化护理规程。比较两组临床护理效果。结果:两组患者在性别、年龄、意识状态、失禁类型、大便失禁频次、血红蛋白、白蛋白等方面比较,差异均无统计学意义(均P>0.05);两组在未发生IAD、轻度IAD、中度IAD、重度IAD及真菌性皮疹方面比较差异均有统计学意义(均P<0.05)。结论:实行IAD的结构化护理规程后能有效降低患者发生IAD的风险,提高护理工作效率与质量,对临床护理人员具有指导意义。     

The care dependency scale, an assessment instrument

The Care Dependency Scale, an instrument for the assessment of patients'care dependency, has been translated into German. The scale was tested on (inter-) rater reliability and criterion and construct validity in a hospital population on geriatric, surgical and paediatric wards. As the results of this study were very satisfying, positive recommendations regarding the suitability of the scale for use in the German nursing care situation could be made. However further psychometric testing of the scale is important, for instance in other populations. A final conclusion is that the scale may be used in care settings in German-speaking countries.     

基于评估的分级皮肤护理干预方案在防治ICU失禁相关性皮炎中的应用

目的 探讨基于评估的分级皮肤护理干预方案在防治ICU失禁相关性皮炎(IAD)中的应用效果.方法 选取2015年1月~2016年10月该院收治的152例ICU失禁患者作为研究对象,根据随机数字表法将患者分为对照组和观察组各76例.对照组患者给予常规护理干预,观察组患者给予基于评估的分级皮肤护理干预方案.观察比较ICU治疗期间的IAD发生情况和发生IAD患者的治疗情况.结果 ICU治疗期间,观察组的IAD发生例数、IAD平均形成时间以及IAD严重程度均明显低于对照组,差异有统计学意义(均P<0.05);观察组的治疗有效率高于对照组,但差异无统计学意义(P>0.05);观察组的平均IAD愈合时间明显低于对照组,差异有统计学意义(P<0.05).结论 基于评估的分级皮肤护理干预方案在防治ICU失禁相关性皮炎中的应用效果显著,能够有效地降低ICU失禁患者的IAD发生率,提高发生IAD患者的治疗效果,值得临床推广应用.     

Additional Validation of the Pain Medication Questionnaire in a Heterogeneous Sample of Chronic Pain Patients

The present study represents the next stage in the development of a psychometrically sound, self-report screening tool used for assessing the potential pain-medication-misuse risk. A revised Pain Medication Questionnaire (PMQ) was initially designed to successfully evaluate such risk. A subsequent series of two additional studies further documented the clinical utility of the PMQ. A new shortened version of the PMQ was developed, and its psychometric properties, along with its predictive accuracy in identifying risk for medication misuse, were evaluated. Results revealed that the new version maintained the strong psychometric properties of the original PMQ. Moreover, its predictive accuracy was found to be high (85.5% accuracy). Thus, this revised, shortened PMQ can aid physicians in assessing for potential medication misuse, allowing them to more closely monitor at-risk patients during pain management treatment.     

Psychometric properties of the TSK-11: a shortened version of the Tampa Scale for Kinesiophobia

The Tampa Scale for Kinesiophobia (TSK) is one of the most frequently employed measures for assessing pain-related fear in back pain patients. Despite its widespread use, there is relatively little data to support the psychometric properties of the English version of this scale. This study investigated the psychometric properties of the English version of the TSK in a sample of chronic low back pain patients. Item analysis revealed that four items possessed low item total correlations (4, 8, 12, 16) and four items had response trends that deviated from a pattern of normal distribution (4, 9, 12, 14). Consequently, we tested the psychometric properties of a shorter version of the TSK (TSK-11), having excluded the six psychometrically poor items. The psychometric properties of this measure were compared to those of the original TSK. Both measures demonstrated good internal consistency (TSK: alpha=0.76; TSK-11: alpha=0.79), test-retest reliability (TSK: ICC=0.82, SEM=3.16; TSK-11: ICC=0.81, SEM=2.54), responsiveness (TSK: SRM=-1.19; TSK-11: SRM=-1.11), concurrent validity and predictive validity. In respect of specific cut-off scores, a reduction of at least four points on both measures maximised the likelihood of correctly identifying an important reduction in fear of movement. Overall, the TSK-11 possessed similar psychometric properties to the original TSK and offered the advantage of brevity. Further research is warranted to investigate the utility of the new instrument and the cut-off scores in a wider group of chronic pain patients in different clinical settings.     

Patients' beliefs about medicines in a primary care setting in Germany

Objectives The aim of this study was to explore patients' beliefs about medicines by administering the German version of the Beliefs about Medicines Questionnaire (BMQ) in a primary care setting among chronically ill patients and to examine its psychometric properties. The BMQ assesses patients' beliefs about their individual prescribed medication as well as their beliefs about medicines in general. Methods A cross‐sectional survey of 485 chronically ill patients was performed. The German version of the BMQ was evaluated in terms of internal consistency, validity and scale structure. To assess validity the Medication Adherence Report Scale (MARS‐D) and the Satisfaction with Information about Medicines Scale (SIMS‐D) were applied. Results The BMQ showed good internal consistency (Cronbach's α 0.79–0.83). Patients' belief about the specific necessity of their medicines correlated positively with the MARS‐D (ρ = 0.202; P < 0.01). There were significant correlations in the predicted direction between the MARS‐D and all the BMQ subscales with the exception of the General‐Overuse subscale (ρ = ?0.06; P = 0.30). Relationship to the SIMS‐D was comparable to the original study. Factor analysis corroborated the scale structure. Conclusions The BMQ is a suitable instrument to measure patients' beliefs in medicines in German primary care settings. Most patients in our sample had positive beliefs concerning the necessity of their medication. Their levels of concern were associated with higher non‐adherence.     

某三级甲等医院失禁相关性皮炎现状调查分析

目的了解住院患者失禁相关性皮炎患病率及相关因素。方法采用横断面观察法,以某时点某所三级甲等医院1375名住院患者为观察对象。结果失禁现患率为13.81%,失禁相关性皮炎现患率为13.15%,IAD合并压疮46.2%,合并皮肤撕裂伤11.5%。IAD现患率前三位科室为重症监护室42.9%,神经内科22.2%,普通内科12.9%。80岁以上患者占65.4%,住院7 d患者占80.8%,卧床患者占96.2%。失禁患者使用与皮肤p H值相近清洁溶液及皮肤保护剂比例只有3.14%和9.9%。结论卧床患者,年龄80岁、住院时间7 d、频繁失禁患者需要重点预防IAD发生。护理人员对IAD发生预见性不足,失禁患者皮肤保护性预防措施有待加强。     

Clinical challenges of preventing incontinence-associated dermatitis

Incontinence-associated dermatitis (IAD) is a common skin disorder in patients with faecal and/or urinary incontinence. The past decade has seen a huge growth in publications focusing on the complexity and inconsistency of the clinical observation of IAD and the differentiation between IAD and pressure ulcers. IAD and superficial pressure ulcers cause confusion in clinical practice when trying to determine the true nature and underlying pathology of the lesion. It is a daily challenge for health professionals in hospitals, nursing homes and community care to maintain a healthy skin in patients with incontinence. The aim of this article is to provide a brief update on recent developments regarding the differentiation between pressure ulcers and IAD and the prevention of IAD. Recommendations for clinical practice and research are provided.     

Nurses Improving Care for Healthsystem Elders (NICHE): using outcomes and benchmarks for evidenced-based practice

This article describes Nurses Improving Care for Healthsystem Elders (NICHE), a project begun in 1992 with four pilot hospitals. These pilot hospitals gathered baseline data using a geriatric institutional assessment profile (GIAP) with a pre- and postdesign to capture changes in staff attitudes, knowledge, and perceptions of the care of older adults. Based on the success of the pilot effort, NICHE, now in its eighth year, has evolved into a program that involves 32 health systems comprising 105 hospitals nationally. To date, more than 10,000 GIAPs have been collected by NICHE hospital staff. All NICHE settings are able to benchmark their GIAP data against comparable institutions (eg, urban, rural, university, community settings) to understand how they compare and then interpret the data at their unique sites. The opportunities for continuous quality improvement through the NICHE program are described.     

Ferrans and Powers' Quality of life index applied in urinary incontinence research--a pilot study

Scand J Caring Sci; 2011; 25; 410–416
Ferrans and Powers’ Quality of life index applied in urinary incontinence research – a pilot study Background: The aim of this study was to explore the usefulness of applying a global, evaluation‐based quality of life (QoL) questionnaire in assessing the impact of urinary incontinence (UI) on women’s lives. Methods: The study population comprised long‐term gynaecological cancer survivors (n = 160) and controls from the general population (n = 493). The presence of UI was assessed by the question ‘Do you leak urine?’ while UI perceived as a problem was assessed on a five‐point scale from ‘No problem’ to ‘A very large problem’. QoL was measured by Ferrans & Powers’ QoL index (QLI), generic version II. Results: UI was distributed equally among women with a history of gynaecological cancer and among women from the general population (34%). UI has a negative impact on overall QLI as well as a wide range of items. Approximately 20% of the incontinent women defined UI as no problem, with QLI scores similar to continent women. Only 5% experienced UI as a large/very large problem; with exceptionally low QLI scores. The psychometric testing of QLI (acceptability, internal consistency reliability and known‐group validity) supports the use of QLI in UI‐studies. Conclusions: The Ferrans & Powers’ QLI is considered an acceptable tool for UI research, but further psychometric testing is required.     

Incontinence: Managed or mismanaged in hospital settings?

This paper reports the results of a survey of inpatients to determine the prevalence of their continence status and the overall management of their incontinence. A survey of 447 hospitalized adults was conducted and an audit of their medical records. Twenty‐two per cent of patients reported urinary incontinence, 10% faecal incontinence, 78% nocturia, 23% urinary urgency and 11% trouble passing urine. Pre‐existing bladder and bowel problems were reported by 34% and 26% of patients respectively. Sixty per cent of patients were using a continence product or device. There was a lack of documentation in the medical records about patients' continence status and about their pre‐admission bowel and bladder status. The findings reveal that the management of incontinence in acute and subacute settings is suboptimal. There is a need to raise clinical awareness about incontinence in hospital settings and to implement a structured approach to its assessment and management. Furthermore, as the costs associated with the management or mismanagement of incontinence in hospital settings are not fully understood, there is a need for further research on this issue.     

基于布里斯托大便分型的结构化管理在ICU失禁患者护理中的应用研究

目的探讨基于布里斯托大便分型的结构化管理在ICU失禁患者中的应用效果。方法选取2019年12月至2020年3月ICU收治的大便失禁患者为对照组,2020年5月至8月ICU收治的大便失禁患者为试验组,每组54例,对照组实施常规的护理方法,试验组在布里斯托大便分型的指导下实施皮肤结构化管理,比较两组患者失禁性皮炎（IAD）的发生率、IAD的发生时间以及IAD的严重程度。结果试验组IAD发生率低于对照组,IAD的发生时间延缓,试验组发生中度和重度IAD的例数少于对照组,差异均具有统计学意义（P＜0.05）。结论基于布里斯托大便分型的结构化管理能有效降低失禁患者IAD的发生率和严重程度,延缓IAD发生的时间,值得临床推广。     

Career success perception and work‐related behaviour of employees in geriatric care – a pilot study in a German geriatric care facility

Scand J Caring Sci; 2011; 25; 45–52
Career success perception and work‐related behaviour of employees in geriatric care – a pilot study in a German geriatric care facility Introduction: One of the job characteristics of geriatric care is the long‐term relationship of the employees to the elderly people they are interacting with. However, these relationships are characterised by the fact that despite of the care provided by the employees, the patients experience physical suffering during the relationship, which often ends with their deaths. Although that is to be expected in this profession, it can be interpreted as personal failure and may be a reason why employees in geriatric care feel exhausted and perceive strain and stress in the job. Aim: The objective of this study was to explore the influence of career success perceptions on geriatric care staffs’ coping and work‐related behaviour. Method: Data were collected in 2008 in a German geriatric care facility using the standardised psychometric questionnaire ‘AVEM’ (Occupational Stress and Coping Inventory) as well as a previously developed ranking of career success dimensions in geriatric care. The 69 employees, who participated were of various age groups, had different work experience and were working in distinct areas of expertise. Results: The results show that men experience higher success at work and have more career ambitions than women. Differences in age with regard to success perception at work could not be identified. However, there is an influence of the intensity of contact between patient and employees on the perception of career success. Also, a correlation between the career success dimension happiness in the job and work experience could be verified. Conclusion: The current results show no impact of subjective career success dimensions on work‐related coping behaviour. At the same time, the results point to differences in the relevance of subjective career success dimensions regarding the demographics of employees in geriatric care. Thus, demographics may be considered as health resources and can have positive health impacts for employees in caring‐professions.     

A Danish version of the MISSCARE survey: Translation and validation

Background

Measuring missed nursing care in clinical settings may serve as an important indicator for improving patient safety and nursing staff retention. Internationally, several tools exist, with the MISSCARE Survey being the most frequently used and validated; however, no tools are available in the Danish language.

Aim

This study aimed at translating the MISSCARE Survey from US English to Danish and evaluate its psychometric properties.

Methods

The translation followed the recommended method, that is forward-and-backward translation, involving clinical experts and a professional, native English-speaking translator. The final version was approved by the survey's original developer. Face validity was tested among 10 nurses and 1 practical nurse. Nursing staff from 34 selected departments at Aarhus University Hospital's (n = 1241) were invited to participate in a pilot test in November 2020. The survey consisted of a demographic section, a section of ‘nursing elements’ (Part A) and section of ‘reasons’ (Part B). Acceptability was assessed on Part A and B. Reliability was tested by Cronbach's alpha, and psychometric properties were investigated using Confirmatory Factor Analysis (Part B).

Results

The face-validity test resulted in minor contextual changes and the addition of a ‘not applicable’ response option in Part A. The pilot test had a 42.6% response rate (n = 529). Acceptability was good, with 1–10 missing responses per item in Part A and 0–20 missing responses in Part B. The numbers of ‘not applicable’ responses ranged from 0 to 81. The overall Cronbach's alpha was 0.81. Factor-loading ranges were 0.62–0.48 for ‘communication’, 0.79–0.39 for ‘materials and resources’, and 0.50–0.35 for ‘labour’, suggesting an acceptable fit with the theoretical model.

Conclusion

The MISSCARE Survey was successfully translated into Danish. The psychometric properties confirmed the questionnaire as a valid and reliable tool for measuring missed nursing care in Danish hospital settings.