Validity of the Utrecht Scale for Evaluation of Rehabilitation-Participation

Purpose: There is still a need for a generic participation instrument that measures both objective and subjective participation in adults living in the community and that is feasible for use in rehabilitation practice. The Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) was developed to satisfy this need, comprising 31 items in three scales: Frequency, Restrictions and Satisfaction. The aim of this study was to examine the validity of this measure. Methods: Cross-sectional study involving former rehabilitation outpatients from five rehabilitation facilities in the Netherlands (n?=?395). The Frenchay Activities Index (FAI), the participation subtotal score of the ICF Measure of Participation and Activities Screener (IMPACT-SP) and the Participation Scale were included as reference measures. Results: Internal consistency of the USER-Participation scales was satisfactory (α 0.70–0.91). Spearman correlations between these scales were between 0.36 and 0.52. Concurrent validity was shown by strong correlations between the Frequency scale and the FAI (0.59), the Restrictions scale and the IMPACT-SP (0.75) and the Satisfaction scale and the Participation Scale (?0.73). Discriminant validity was shown by significant differences in USER-Participation scores between participants with different levels of independence and between participants with different health conditions. Conclusion: The USER-Participation appears to be a valid measure to rate objective and subjective participation in persons with physical disabilities.

Implications for Rehabilitation

• The Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) is a new brief generic instrument to rate objective and subjective participation.

• The USER-Participation comprises 31 items in three scales: Frequency, Restrictions and Satisfaction.

• The USER-Participation appears to be a valid measure to rate objective and subjective participation in persons with physical disabilities.

     

Comparison of the Utrecht Scale for Evaluation of Rehabilitation-Participation With the ICF Measure of Participation and Activities Screener and the WHO Disability Assessment Schedule II in Persons With Spinal Cord Injury

Objective

To validate the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) in persons with spinal cord injury (SCI) using 2 International Classification of Functioning, Disability and Health (ICF)-based instruments: the ICF Measure of Participation and Activities-Screener (IMPACT-S) and the World Health Organization Disability Assessment Schedule II (WHODAS II).

Design

Validation study. Score distributions, internal consistency, and concurrent and discriminant validity were evaluated.

Setting

The community.

Participants

Convenience sample of persons (N=157) with long-term SCI living in The Netherlands.

Interventions

Not applicable.

Main Outcome Measures

USER-Participation, IMPACT-S, and WHODAS II.

Results

No instruments showed floor effects, and 3 out of 6 WHODAS II domains showed ceiling effects. Most scores showed adequate internal consistency (α≥.70), except for the USER-Participation frequency scale (.51) and 2 WHODAS II domains (.58–.60). Spearman correlation coefficients between the segregate USER-Participation scales were <.60 (range, .39–.46), showing that they cover separate aspects of participation. Concurrent validity of the USER-Participation was shown because >75% (83.3%) of the 24 hypotheses (Spearman correlation coefficients above or below .60) with the other measurement instruments were confirmed. Concurrent validity between the IMPACT-S and WHODAS II was not shown (53.8% of 13 hypotheses confirmed). All scores except 4 WHODAS II domains showed significant differences in participation between persons with paraplegia and tetraplegia.

Conclusions

The USER-Participation showed generally satisfactory psychometric properties in Dutch persons with long-term SCI living in the community. The IMPACT-S showed the best psychometric properties, and the WHODAS II showed less favorable results. Future research on the USER-Participation should focus on validation in other languages and different diagnostic groups.     

Measuring Participation After Stroke in Africa: Development of the Participation Measurement Scale

Objective

To develop a valid stroke-specific tool, named the Participation Measurement Scale (PM-Scale), for the measurement of participation after stroke.

Proactive Coping Poststroke: Psychometric Properties of the Utrecht Proactive Coping Competence Scale

Objective

To examine psychometric properties of the Utrecht Proactive Coping Competence scale (UPCC) and explore relations of proactive coping with health-related quality of life (HRQOL) and characteristics of patients with stroke.

Design

Cross-sectional study. Reliability and convergent validity, and associations with HRQOL and characteristics of patients with stroke were examined.

Setting

Inpatient and outpatient settings of hospitals and rehabilitation centers in The Netherlands.

Participants

Patients with stroke (N=55; mean age, 58.7±12.8y; mean months since stroke, 25.0± 38.5).

Interventions

Not applicable.

Main Outcome Measures

UPCC, Utrecht Coping List (UCL), and the short Stroke Specific Quality of Life scale (SS-QOL-12).

Results

The UPCC showed excellent reliability (Cronbach's α=.95) without floor/ceiling effects or skewed score distribution. Convergent validity was shown by moderate positive relations with the UCL subscale active problem solving (r=.38) and moderate negative relations with the UCL subscales passive reactions (r=−.50), avoidance (r=−.40), and expression of emotions (r=−.42). Correlations between the UPCC and HRQOL domains were moderate to strong (r=.48–.61) and stronger than those between UCL subscales and HRQOL domains. The only characteristic of patients with stroke associated with proactive coping was time after stroke (r=−.52).

Conclusions

The UPCC appears reliable and valid for patients with stroke. Moreover, we found positive associations between proactive coping and HRQOL. Future research is recommended to confirm our results and to explore ways to enhance proactive coping in patients with stroke.     

A confirmatory factor analysis of the Utrecht Work Engagement Scale for Students in a Chinese sample

BackgroundEducational institutions play an important role in encouraging students' engagement with course work. Educators are finding instruments to measure students' engagement in order to develop strategies to improve it. Little is known about the factor structure of the Utrecht Work Engagement Scale for Students among Chinese nursing students.ObjectivesThe aim of this research was to examine the factor structure of the Utrecht Work Engagement Scale for Students via confirmatory factor analysis.Design and MethodsThe study used a cross-sectional design. A sample of 480 students from a nursing school in one Chinese university completed the Utrecht Work Engagement Scale for Students. Factor analysis was used to analyze the resulting data.ResultsThe overall results of internal consistency reliability and confirmatory factor analysis provided evidence supporting the reliability and three-factor structure of the Utrecht Work Engagement Scale for Students. The total internal consistency reliability coefficients were 0.91. Model comparison tests indicated that an oblique factors model that permitted correlations between pairs of error terms fitted the data better than other first-order models. In addition, due to the three strongly intercorrelated factors, a second-order model was found to fit the data well, providing support for the factorial structure of the Utrecht Work Engagement Scale for Students.ConclusionsThe findings of confirmatory factor analysis provided evidence supporting the reliability and three-factor structure of the Utrecht Work Engagement Scale for Students when evaluated with a Chinese nursing student sample in this study. Thus, it is appropriate to use The Utrecht Work Engagement Scale for Students in for assessing the engagement among Chinese nursing students.     

帕金森病患者不同程度抑郁在汉密尔顿抑郁量表的结构差异

目的 探讨帕金森病不同程度抑郁患者汉密尔顿抑郁量表(HAMD)各因子分的差异及变化趋势。     

From Social Avoidance to Substance Use: Working Memory and Negative Affectivity Predict Maladaptive Regulatory Behaviors in Daily Life Across Diagnostic Groups

Cognitive Therapy and Research - We identified common maladaptive regulatory behaviors including substance use, binge eating, and social avoidance, across healthy adults and those diagnosed with...     

Rasch Analyses of the Wheelchair Use Confidence Scale for Power Wheelchair Users

Objectives

To examine the dimensionality of the Wheelchair Use Confidence Scale for power wheelchair users (WheelCon-P), to identify items that do not fit the Rasch rating scale model as well as redundant items for elimination, and to determine the SEMs and reliability estimates for the entire range of measurements.

Evaluation of Antiplatelet Agents for Secondary Prevention of Stroke Using Mixed Treatment Comparison Meta-analysis

Background

The current guidelines recommend various antiplatelet agents used alone or in combination for secondary prevention of noncardioembolic stroke.

Objective

The purpose of this study was to conduct a mixed treatment comparison meta-analysis to determine which antiplatelet or combination of antiplatelet agents is most efficacious and tolerable in patients with prior stroke.

Methods

A comprehensive literature search was conducted in MEDLINE (1945 through March 2012), EMBASE (1974 through March 2012), and the Cochrane Controlled Trials Registry (1975 through April 2012) to identify randomized trials evaluating the role of various antiplatelet agents and combinations for the secondary prevention of stroke. Key articles were cross-referenced for additional studies. Data were screened and evaluated to generate direct and indirect comparisons for recurrent stroke and overall hemorrhagic events. Data were reported as rate ratios (RRs) and 95% CIs.

Results

A total of 24 articles were included in the analysis. Eleven antiplatelet regimens were compared in >88,000 patients. The combination of acetylsalicylic acid (ASA) plus dipyridamole (DP) was more protective against recurrent stroke than ASA alone (RR = 0.78; 95% CI, 0.64–0.93), and no differences were found in all other direct and indirect comparisons with active treatment. ASA plus DP was associated with more overall hemorrhagic events than DP (RR = 1.83; 95% CI, 1.17–2.81), cilostazol (RR = 2.12; 95% CI, 1.21–3.48), and triflusal (RR = 1.67; 95% CI, 1.05–2.78) but fewer events than the combination of ASA plus clopidogrel (RR = 0.38; 95% CI, 0.25–0.56). The combination of ASA plus clopidogrel was associated with an excess of overall hemorrhagic events compared with clopidogrel (RR = 2.81; 95% CI, 1.96–4.10), cilostazol (RR = 5.56; 95% CI, 3.03–9.66), DP (RR = 4.78; 95% CI, 2.80–8.21), sarpogrelate (RR = 3.59; 95% CI, 1.96–6.45), terutroban (RR = 2.13; 95% CI, 1.21–3.61), ticlopidine (RR = 2.80; 95% CI, 1.69–5.00), and triflusal (RR = 4.36; 95% CI, 2.62–7.81).

Conclusion

We found that ASA plus DP was more protective than ASA alone for preventing recurrent stroke; however, no difference was found between most direct and indirect comparisons of antiplatelet agents and combinations. More overall hemorrhagic events seemed to occur with the combination of ASA and clopidogrel than with other treatments. Selection of antiplatelet therapy for the secondary prevention of stroke must be individualized according to patient comorbidities, including risk of stroke recurrence and bleeding.     

Using research for practice: a UK experience of the BARRIERS Scale

It is generally recognized that the majority of health care has been largely based upon opinion rather than research evidence of clinical effectiveness. Attempts to rectify this have been initiated by increasing emphasis on the dissemination of findings. For example, in the UK this had been supported via the Cochran Collaboration and the Centre for Dissemination and Reviews. Dissemination does not, however, guarantee implementation. The complex nature of research utilization has been studied and obstacles identified that can influence the uptake of research by practising nurses. Sandra Funk and colleagues developed the BARRIERS Scale using this research and literature on research utilization. The scale may be helpful for identifying and measuring the barriers to research utilization perceived by nurses working within the UK and has formed the basis of the present study. A convenience sample of 316 comprising a broad spectrum of nurses working in the UK provided the data. Comparison is made with North American nurses from the studies used in the scale's development. The results suggest there are items which are consistently perceived as either strong or negligible barriers by both groups of nurses. Differences, however, did emerge between nurses from the UK and North America on several items. These included the confindence in evaluating research and the perception of the nurse's authority to change patient procedures. Psychometric evaluation was also done. These findings are presented and discussed.     

QUADAS评价:一种用于诊断性研究的质量评价工具(修订版)

背景 QUADAS是一种新近发展起来的诊断性研究的质量评价工具。虽然已有系统评价采用了QUADAS,但尚未得以正式确证。本研究的目的是评价QUADAS的有效性和实用性。方法3位评价者采用QUADAS独立评价30项研究的质量。比较每位评价者的评分与最终结论之间的意见一致度。这主要是通过比较所有QUADAS条目的总分和每个单项的得分来实现的。20位曾在其系统评价中使用过QUADAS的评价者就其使用经验完成一份简短的问卷。结果就所有条目而言,每位评价者的评分与最终结论之间的意见一致度分别达到了91%、90%和85%。就单项QUADAS条目而言,一致度在50%至100%之间,中位值是90%。与难以解释的试验结果和退出病例相关的条目,评分结果差异最大。有关QUADAS内容的反馈意见普遍较好,仅少数评价者提出了有关QUADAS涵盖面、使用便利性、评分说明的清晰度及有效性方面的问题。结论QUADAS内容本身无需作大的修改。评价过程的主要困难出现在难以解释的试验结果和退出病例这2个条目的评分上。对这些条目的评分指南提出了修改意见。评价者必需根据其系统评价制定相应的评分指南,并确保所有评价者都清楚如何评分。评价者还应考虑是否所有的QUADAS条目都与其系统评价相关,以及其他质量条目是否应作为其系统评价的评价部分。     

The Prevalence and Balance of Care for Intellectual Disability: Secondary Analyses of the OPCS Disability Surveys

Government policy continues to emphasise the commissioning and needs-assessment role of health authorities, local authorities and — to a greater extent — general practitioners. To date, much available information for this purpose has been based on service utilisation data or from registers based on case finding from service contacts. As an alternative, we conducted secondary analyses of the national Surveys of Disability of Children and Adults by the Office of Population Censuses and Surveys. The prevalence of intellectual disability for people who had ‘mental handicap’ reported as an underlying health problem was 3.5 per 1000 in the overall population. Rates rose from 1.7 per 1000 among those aged 4 and under, reaching a peak of 6.3 per 1000 among 16–19 year olds and falling to 2.8 per 1000 among people aged 75 or more. Residence in a communal establishment increased markedly with age. People in households had high levels of disability and consequently problems with personal care. Furthermore, behaviour problems were commonplace. Consequently, carers spent long hours caring and often reported adverse effects on their health.     

国内斑点免疫金胶体渗滤法检测结核抗体诊断结核病的文献质量评价

目的评价国内斑点免疫金胶体渗滤法检测结核抗体诊断结核病的献质量。 方法计算机检索中国生物医学献数据库（CBM，1978～2006）和中科技期刊全数据库（VIP，1994～2006），纳入斑点免疫金胶体渗滤法检测结核抗体诊断结核病的所有诊断性研究献，按QUADAS质量评价标准评估，由两位研究独立进行献质量评估。若遇分歧，讨论解决。 结果共检索到38篇相关献，质量评价结果显示，大多数献与QUADAS质量评价标准的符合率不高。多数献采用回顾性病例对照研究设计，其中31篇未清楚描述研究对象的选择标准，18篇不能确定是否所有研究对象均经金标准核实，36篇不清楚诊断试验结果的解释是否采用盲法，37篇未描述是否有难以解释的结果，34篇未描述是否有退出病例。 结论国内斑点免疫金胶体渗滤法检测结核抗体诊断结核病的诊断性研究质量还有待提高。[编按]