Fatigue in the General Korean Population: Application and Normative Data of the Brief Fatigue Inventory

The purpose of this study was to provide normative data for the Brief Fatigue Inventory (BFI) in the general Korean population so that the results for the general population could be compared with those for patients. We constructed a questionnaire that included the BFI and items on demographic characteristics and conducted a population-based, cross-sectional survey in 1,000 individuals. We used multivariate logistic analysis to investigate factors associated with “usual” and “worst” fatigue. The internal consistency was very high (Cronbach's alpha = 0.96) and construct validity was confirmed by factor analysis. All patients had a mean ± SD BFI score of 4.33 ± 2.48 for “worst” fatigue and of 4.07 ± 2.27 for “usual” fatigue, and the global BFI score was 3.44 ± 2.05. The prevalence of each moderate-to-severe fatigue type was similar in severity of fatigue, with 55.2% in “usual” fatigue, and 57.3% in “worst” fatigue. Among the types of fatigue, the prevalence of severe fatigue was lowest for “usual” fatigue (16.5%). In multivariate analyses, the group aged 40–59 years had greater levels of “usual” and “worst” fatigue compared with the group aged 20–29 years. Poor general health and the presence of comorbidities were also associated with increased “usual” and “worst” fatigue. Regular physical activity was associated with reduced levels of “worst” fatigue. The normal values of BFI with proper psychometric properties may help us to better understand the correlates of fatigue in the general population and patients. Our findings indicate that comorbidities should be considered when comparing fatigue data from the general population with data from patients.     

疲劳量表在癌症患者应用中内在一致性和重测信度的研究

目的探讨中文版简明疲劳量表在癌症患者应用中的内在一致性和重测信度。方法50例癌症患者参与本研究。在上午和下午由护士各自独立地应用中文版简明疲劳量表对患者进行调查,以检验简明疲劳量表的内在一致性和重测信度。结果内在一致性统计分析结果显示,在前后两次调查中简明疲劳量表的Cronbach’s α系数均为0．944;简明疲劳量表的9个项目Cronbach’s α系数范围为0．929～0．944。重测信度统计分析结果显示,简明疲劳量表9个项目的ICC值范围为0．742-0．869。结论中文版简明疲劳量表具有良好的内在一致性和重测信度,本研究为癌症患者应用中文版简明疲劳量表提供了参考依据。     

Rasch Analysis of the Edmonton Symptom Assessment System

Context

The Edmonton Symptom Assessment System (ESAS) is a widely used multisymptom assessment tool in cancer and palliative care settings, but its psychometric properties have not been widely tested using modern psychometric methods such as Rasch analysis.

Reliability and validity of a modified Brief Pain Inventory short form in patients with osteoarthritis.

The Brief Pain Inventory short form (BPI-sf) is a validated, widely used, self-administered questionnaire developed to assess the severity of pain and the impact of pain on daily functions. A modified version was used daily in randomised control trials of patients with arthritis undergoing treatment with cyclooxygenase-2 specific inhibitors and non-steroidal anti-inflammatory drugs. Results indicate that the modified BPI-sf, much like the original scale, was internally reliable, consistent over time, and had good construct, as well as convergent and predictive validity in assessment of patients suffering from conditions of chronic pain. Each scale and individual pain intensity item refers to changes in osteoarthritis pain associated with medication use. The modified BPI-sf, like the parent scale, is a valid and reliable tool for situations in which pain is assessed daily and minimises the burden placed on patients to record information necessary for scientific investigations.     

A Preliminary Investigation into the Utility of the Adult Behavior Checklist in the Assessment of Psychopathology in People with Low IQ

Background Achenbach & Rescorla (2003) recently developed the Adult Behavior Checklist (ABCL) to assess psychopathology in the general population. The ABCL should be completed by a proxy informant. The use of proxy informants, instead of self‐reporting, makes the ABCL potentially suitable for the assessment of psychopathology in adults with intellectual disability. The aim of the present study was to examine reliability and validity of the ABCL in 124 adults with mild intellectual disability or low IQ, and severe challenging behaviour referred for residential treatment. Methods The ABCL was completed by two independent informants to assess inter‐rater reliability. To examine the validity of the ABCL, its relationship with three measures of functioning was assessed. Furthermore, association between scales of the ABCL and DSM‐IV axis I disorders was examined. Results The ABCL was reliable in terms of internal consistency of its scales, and inter‐rater reliability. Relationships between clusters of axis I DSM‐IV disorders and scales of the ABCL were found as expected. Moreover, ABCL scales predicted different measures of functioning. Conclusions The ABCL appears to be a reliable and valid measure to assess psychopathology in persons with mild intellectual disabilities or low IQ, admitted for treatment in facilities for adults with mild intellectual disability and severe challenging behaviour.     

癌症患者的症状群调查研究

目的了解癌症患者疾病发展和治疗过程中的相关症状,探讨其症状群种类和数量.方法使用中文版安德森症状评估量表对155例住院癌症患者进行调查,采用探索性因子分析法统计症状群.结果癌症患者发生率高的症状依次是疲乏、口干、睡眠不安.严重程度症状依次为食欲下降、呕吐、疲乏和睡眠不安.Spearman相关分析显示,除气短与食欲下降、呕吐之间相关性无统计学意义(P>0.05)之外,其余各症状之间相关性均具有统计学意义且均存在正相关关系(P<0.05).探索性因子分析得出3个症状群,分别为疾病行为症状群、上消化道症状群、心理症状群.各症状群的Cronbach’sα系数分别为0.69、0.83、0.75.结论癌症患者存在多种症状群,对癌症患者应探索以症状群为基础的干预模式,以求能够产生更好的临床效果,提高癌症患者的生存质量.     

Concurrent validity of the modified Edmonton Symptom Assessment System with the Rotterdam Symptom Checklist and the Brief Pain Inventory

As part of a longitudinal prospective study we sought a self-completed instrument of symptom assessment suitable for a population of cancer patients who were receiving palliative therapy. The modified Edmonton Symptom Assessment System (ESAS) is such an instrument, but it required validation for this population. This study represents a validation of the modified ESAS with the Rotterdam Symptom Checklist and the Brief Pain Inventory – two instruments widely used in patients receiving palliative therapy for cancer. We conclude that the modified ESAS is a valid, self-administered instrument to assess symptoms for patients from differing palliative care settings.     

Measuring melancholy: a critique of the Beck Depression Inventory and its use in mental health nursing

The Beck Depression Inventory (BDI) is one of the most commonly used depression measurement instruments. Mental health nurses often utilize the BDI to assess the level of depression in clients, and to monitor the effectiveness of treatments such as antidepressants and electroconvulsive therapy. Despite the widespread use of the BDI in both clinical practice and research, there is surprisingly little nursing literature critically examining the BDI or its use by mental health nurses. This paper reviews the origins, purpose, and format of the BDI, discusses some of the strengths and limitations of the BDI, and concludes with some implications for mental health nursing.     

冠状动脉支架植入患者的心理评估

目的调查冠状动脉支架植入患者的心理健康状况。方法采用症状自评量表(SCL-90)对218例冠状动脉支架植入患者进行心理健康状况评估。结果症状自评量表评定发现,患者心理健康状况好48例(22.02%),良好56例(25.69%),一般82例(37.61%),较差32例(14.68%)。因子评分除人际、敌对和精神病性外,其余6项因子总平均分>2分。在躯体化、忧郁、焦虑和恐怖因子评分中有50%以上的人员因子分>3,阳性项目平均数>43项。结论冠状动脉支架植入患者存在许多心理问题。     

118例体外受精-胚胎移植助孕患者心理症状分析

目的：对体外受精—胚胎移植助孕患者的心理症状水平和特点进行分析,为制定干预对策提供参考依据。方法采用症状自评量表,对118例进行体外受精—胚胎移植助孕患者进行评估,将量表各因子得分与全国女性常模进行比较分析,比较不同年龄段、不同学历及不孕年限组得分的差异。结果本组患者的躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神病性9项因子分均高于全国女性常模（P<0.05）。结论体外受精—胚胎移植助孕患者在9个心理症状因子存在一定的自觉症状,提示医护人员应从多角度关注其心理健康状况,及早进行心理干预和心理调适,避免心理问题对助孕成功率产生影响。     

Measurement Properties of Visual Analogue Scale,Numeric Rating Scale,and Pain Severity Subscale of the Brief Pain Inventory in Patients With Low Back Pain: A Systematic Review

The Visual Analogue Scale (VAS), Numeric Rating Scale (NRS), and Pain Severity subscale of the Brief Pain Inventory (BPI-PS) are the most frequently used instruments to measure pain intensity in low back pain. However, their measurement properties in this population have not been reviewed systematically. The goal of this study was to provide such systematic evidence synthesis. Six electronic sources (MEDLINE, EMBASE, CINAHL, PsycINFO, SportDiscus, Google Scholar) were searched (July 2017). Studies assessing any measurement property in patients with nonspecific low back pain were included. Two reviewers independently screened articles and assessed risk of bias using the COSMIN checklist. For each measurement property, evidence quality was rated as high, moderate, low, or very low (GRADE approach) and results were classified as sufficient, insufficient, or inconsistent. Ten studies assessed the VAS, 13 the NRS, 4 the BPI-PS. The 3 instruments displayed low or very low quality evidence for content validity. High-quality evidence was only available for NRS insufficient measurement error. Moderate evidence was available for NRS inconsistent responsiveness, BPI-PS sufficient structural validity and internal consistency, and BPI-PS inconsistent construct validity. All VAS measurement properties were underpinned by no, low, or very low quality evidence; likewise, the other measurement properties of NRS and BPI-PS.

Symptom Distress Among Diverse Patients Referred for Community-Based Palliative Care: Sociodemographic and Medical Correlates

Context

Community-based palliative care programs are appearing in the U.S. Many of these programs, particularly those in large cities, serve highly diverse populations. Information about the sources of variation in the conditions that drive illness burden, like symptom distress, may be useful in program planning.

The Utility of Screening in the Design of Trials for Symptom Management in Cancer

Clinical trials that test interventions for symptom management must target patients whose symptoms are severe and can benefit from participation. Screening symptoms for their severity prior to trial entry may be an important element of trial design. This research describes the utility of screening for severity of symptoms prior to entry into clinical trials for symptom management in cancer. To accomplish this, 601 cancer patients undergoing chemotherapy were assessed at screening and at the initial intervention contact, using the 0–10 rating scale for severity of nine symptoms. Post-test probabilities and likelihood ratios (LRs) were estimated across cut-offs in screening severity scores. Areas under receiver operating characteristic curves for reaching threshold of four at the initial intervention contact were estimated by a nonparametric method. It was found that screening severity scores were good predictors for identifying patients who would not reach threshold but did not always accurately predict patients who would. The cut-offs between 2 and 4 on a 0–10 scale could be used to identify patients that might benefit from receipt of interventions. For all symptoms, the LRs were greater than one across possible screening cut-offs. The findings indicate that decision rules based on screening prior to entry into cancer symptom management trials can provide reasonable discriminative accuracy by differentiating among patients who are likely to reach higher levels of severity later in the trial from those who are not. Optimal severity cut-offs can be established based on LRs and desired sensitivity and specificity.     

OSAHS患者症状困扰与生活质量的相关性研究

目的:了解睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea hypopnea Syndrome,OSAHS)患者症状困扰现状,并分析其与生活质量的相关性,为临床护理措施的制定提供一定的理论依据。方法:采用M.D.Anderson症状量表和SF-36生活质量量表对福建医科大学附属第一医院呼吸与危重症医学科的120例OSAHS患者进行调查。结果:OSAHS患者症状困扰发生率为100%,120例患者13项症状评分为41.32±16.19分,6项症状对患者生活的影响程度评分为14.02±8.75分,OSAHS患者生活质量低于四川常模(P0.05);13项症状困扰分别和躯体角色、身体疼痛、总健康、生命力、社会功能、情感角色、心理健康7个维度评分呈负相关,6项症状对患者生活的影响评分和躯体功能、躯体角色、总健康、社会功能、情感角色5个维度评分呈负相关。结论 OSAHS患者均有不同程度的症状困扰,症状困扰程度与生活质量呈正相关;应重视患者症状的评估和管理,降低症状困扰程度,改善患者生活质量。     

高性能战斗机飞行员改装期的心理症状调查

目的 探讨高性能战斗机飞行员的改装期的心理特点及干预对策.方法 采用症状自评量表(Symptom Checklist-90,SCL-90),对318名入院体检改装高性能战斗机的飞行员进行心理测试,并分别与我国地方常模和军人常模进行比较.结果 高性能战斗机飞行员SCL-90测试各因子分均低于中国常模和中国军人常模(P<0.01).为其他部队改装的高性能战斗机飞行员躯体化和焦虑因子分值高于为本部队改装飞行员(P<0.01或P<0.05).结论 高性能战斗机飞行员的心理状态优于我国普通人群和全国各类军事人员.     

Cancer-Related Symptom Assessment in France: Validation of the French M. D. Anderson Symptom Inventory

This multicenter study was intended to validate the French version of the M. D. Anderson Symptom Inventory (MDASI-Fr) in French cancer patients (n = 162) with solid tumors or hematological malignancies. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was used as a part of the validation. Factor analysis showed three underlying constructs for symptom items: general symptoms (pain, fatigue, disturbed sleep, shortness of breath, drowsiness, dry mouth, and numbness or tingling items); emotional and cognitive components (distress, sadness, and remembering items); and a gastrointestinal component (nausea, vomiting, and lack of appetite items), with Cronbach's alphas of 0.79, 0.73, and 0.71, respectively. Convergent validity was established by comparing MDASI-Fr items with the EORTC QLQ-C30 scale and the Brief Pain Inventory (BPI). Overall, the 19-item MDASI-Fr score correlated well with the QLQ-C30 global health status, and the pain item of the MDASI-Fr was highly correlated with the short form of the BPI. The most prevalent symptoms were fatigue, distress, dry mouth, and pain. Twenty-five percent of patients reported moderate or severe pain (numeric rating scale >4 on 0–10 severity ratings). Physician ratings of global change on a second visit were significantly associated with changes in patient ratings on the MDASI-Fr, supporting the sensitivity of the measure. Symptoms interfered most with work and general activity. The MDASI-Fr is a valid and reliable tool for measuring symptom severity and interference in French cancer patients.     

Validation of the Edmonton Symptom Assessment System: Ascites Modification

Context

Few patient-reported outcomes are available to measure the symptoms associated with malignant-related ascites in patient care and clinical research. Although the Edmonton Symptom Assessment System: Ascites Modification (ESAS:AM) is a brief tool to measure symptoms associated with malignant-related ascites, it remains to be fully validated.

重危患者家属需求量表中文修订版的探讨

目的形成重危患者家属需求量表(CCFNI)的中文修订版。方法通过对CCFNI翻译、回译、内在一致性和等同性检验等过程形成中文修订版,进行信效度检验后微调、定版;并应用于小样本人群检验中文修订版信效度及稳定性。结果本量表信度分析显示:支持因子的Cronbach’sα系数最高为0.81,获取信息因子最低,为0.65,说明量表有较好的信度;5个因子的标准关联效度Pearson相关系数均在0.70以上,说明中英版本CCFNI之间相关性较好;区分效度除支持因子外,其他因子得分患者家属和护士的差别都有统计学意义(P<0.01),说明中文版CCFNI可以区分不同人群。结论中文版CCFNI可以在国内ICU等领域应用,但还需要不断修订和完善,解决跨文化等问题,使之更符合国情。