攀枝花市某医院医护人员营养知识问卷调查

目的了解医护人员营养知识现状,为临床营养学科建设和发展提供依据。方法随机抽取攀枝花市某三级甲等医院临床及医技人员180人进行问卷调查,用SPSS 11.0统计软件进行统计分析,2个均数的比较用t检验,多个均数的比较用方差分析,两两比较用LSD法。结果该院医护人员营养知识平均得分为75.46±9.66,不同职称、学历、职务、职业、性别之间差异无统计学意义;但不同科室间有差异,经两两比较内科得分高于外科、妇产科和其他科室,儿科得分也高于外科和妇产科,其他科室得分低于内科而高于妇产科。基础营养知识平均得分(87.14±7.85)显著高于临床营养知识平均得分(59.76±15.10)。得分合格率分布不均衡,基础营养知识及格率占98.69%,临床营养知识及格率仅占52.29%。结论该院临床及医技人员营养知识尚停留在学历教育阶段,临床营养知识普遍缺乏,已明显滞后于该学科发展的需要。     

Congress On Spinal Cord Medicine and Rehabilitation September 23-26, 2009 Sheraton Dallas Hotel Dallas,Texas Platform Abstracts

Abstract

Objective

To examine the psychometric properties of the Community Integration Questionnaire (CIQ) in large samples of individuals with spinal cord injury (SCI).

Design

Longitudinal 12-month survey study.

Setting

Nation-wide, community dwelling.

Participants

Adults with SCI: 627 at Time 1, 494 at Time 2.

Interventions

Not applicable.

Outcome measures

The CIQ is a 15-item measure developed to measure three domains of community integration in individuals with traumatic brain injury: home integration, social integration, and productive activity. SCI consumer input suggested the need for two additional items assessing socializing at home and internet/email activity.

Results

Exploratory factor analyses at Time 1 indicated three factors. Time 2 confirmatory factor analysis did not show a good fit of the 3-factor model. CIQ scores were normally distributed and only the Productive subscale demonstrated problems with high (25%) ceiling effects. Internal reliability was acceptable for the Total and Home scales, but low for the Social and Productive activity scales. Validity of the CIQ is suggested by significant differences by sex, age, and wheelchair use.

Conclusions

The factor structure of the CIQ was not stable over time. The CIQ may be most useful for assessing home integration, as this is the subscale with the most scale stability and internal reliability. The CIQ may be improved for use in SCI by including items that reflect higher levels of productive functioning, integration across the life span, and home- and internet-based social functioning.     

Reliability and validity of the Japanese version of the Biological Rhythms Interview of assessment in neuropsychiatry-self report for delayed sleep-wake phase disorder

ObjectiveThe Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) might be applicable for assessing delayed sleep-wake phase disorder (DSWPD). We aimed to investigate the reliability and validity of the Japanese version of the BRIAN self-report (J-BRIAN-SR) in DSWPD patients and determine a cutoff score to identify the presence of the disorder.MethodsWe enrolled 60 newly diagnosed DSWPD outpatients and 64 age-matched healthy controls. We used Cronbach's alpha for internal reliability to evaluate J-BRIAN-SR. We confirmed the reliability of the A test and re-test using Pearson's correlation coefficient in the controls. We used confirmatory factor analysis to evaluate the factor structure of J-BRIAN-SR and referenced the Morningness-Eveningness Questionnaire (MEQ) to check concurrent validity. We analyzed the receiver operating characteristic curve (ROC) to determine the J-BRIAN-SR cutoff point for the presence of DSWPD.ResultsThe 18-component scores of the J-BRIAN-SR had an overall reliability coefficient (Cronbach's alpha) of 0.82. We confirmed a high test-retest reliability using an intraclass correlation coefficient (r = 0.84). The correlation between J-BRIAN-SR and MEQ was 0.38 (p = 0.003). The J-BRIAN-SR that we extracted by exploratory factor analysis consisted of three factors. A score of 40 points provided a sensitivity of 80.0% and a specificity of 75.6% for the positivity of DSWPD.ConclusionsThe results of the present study revealed that J-BRIAN-SR is a valid and reliable instrument for screening and evaluating the severity of DSWPD. Our findings will be useful to physicians and patients in Japan and those in clinical settings.     

A Rasch analysis of a questionnaire designed to evaluate psychiatric patient attitudes and knowledge after attending a pharmacist-led patient medication education group

BackgroundThere are many barriers that prevent persons with mental health disorders from achieving remission, including medication nonadherence. Research on the impact of pharmacist-led patient medication education groups on patient attitudes, knowledge and adherence is limited.ObjectiveTo evaluate the reliability and validity of the Medication Attitudes and Knowledge Questionnaire (MAKQ).MethodsA retrospective pre-post questionnaire was distributed to patients. Variables collected included: patient self-reported medication knowledge and attitudes, patient demographics, number of previous psychiatric hospitalizations, whether the patient attended the whole meeting or only a portion, and outpatient pharmacist relationships. Knowledge and attitude items were measured on a 4-point scale with a range of options from “Agree” to “Disagree.” Rasch analysis was conducted to ensure all items measured the same construct and to assess scale and item reliability and validity. Additionally, the Rasch technique evaluated the change in each person's self-perceived attitudes, knowledge, and confidence in self-managing medications from pre- to post-intervention if the data fit the model. A z-test was used to evaluate gaps in content validity.ResultsSixty patients responded to the MAKQ over the 16-week data collection period. Analysis showed that the 4-point rating scale was not useful and that negatively worded items should be eliminated. Gaps identified in instrument item content were not statistically significant (p > 0.05), indicating comprehensive content validity.ConclusionsMedication attitudes and knowledge items on the retrospective pre-post questionnaire were valid and reliable.     

Reducing questionnaire length did not improve physician response rate: a randomized trial

ObjectivesTo examine the effect of reducing questionnaire length on the response rate in a physician survey.Study Design and SettingA postal four double-page questionnaire on end-of-life decision making was sent to a random sample of 1,100 general practitioners, 400 elderly care physicians, and 500 medical specialists. Another random sample of 500 medical specialists received a shorter questionnaire of two double pages. After 3 months and one reminder, all nonresponding physicians received an even shorter questionnaire of one double page.ResultsTotal response was 64% (1,456 of 2,269 eligible respondents). Response rate of medical specialists for the four double-page questionnaire was equal to that of the two double-page questionnaire (190 and 191 questionnaires were returned, respectively). The total response rate increased from 53% to 64% after sending a short one double-page questionnaire (1,203–1,456 respondents).ConclusionThe results of our study suggest that reducing the length of a long questionnaire in a physician survey does not necessarily improve response rate. To improve response rate and gather more information, researchers could decide to send a drastically shortened version of the questionnaire to nonresponders.     

Usefulness of the Model of Human Occupation in the Hong Kong Chinese Context

Questions have been raised about the applicability of Western theory in an Eastern context. Two case studies are used to illustrate how the Model of Human Occupation (MOHO) is useful in problem identification and intervention planning in Hong Kong. The cases illustrate that MOHO provides useful insights to how Chinese culture influences participation of persons with disabilities.     

Association of tobacco dependence and quit attempt duration with Rasch-modeled withdrawal sensitivity using retrospective measures

Aim   To examine whether Rasch modeling would yield a unidimensional withdrawal sensitivity measure correlating with factors associated with successful smoking cessation.
Design   The psychometric Rasch modeling approach was applied to estimate an underlying latent construct (withdrawal sensitivity) in retrospective responses from 1644 smokers who reported quitting for 3 or more months at least once.
Setting   Web-based, passcode-controlled self-administered computerized questionnaire.
Participants   Randomly selected convenience sample of 1644 adult members of an e-mail invitation-only web panel drawn from consumer databases.
Measurements   Lifetime Tobacco Use Questionnaire, assessing tobacco use across the life-span, including demographics and respondent ratings of the severity of withdrawal symptoms experienced in respondents' first and most recent quit attempts lasting 3 or more months.
Findings   Rasch-modeled withdrawal sensitivity was generally unidimensional and was associated with longer periods of smoking cessation. One latent variable accounted for 74% of the variability in symptom scores. Rasch modeling with a single latent factor fitted withdrawal symptoms well, except for increased appetite, for which the fit was marginal. Demographic variables of education, gender and ethnicity were not related to changes in sensitivity. Correlates of greater withdrawal sensitivity in cessation attempts of at least 3 months included younger age at first quit attempt and indicators of tobacco dependence.
Conclusion   The relationship between tobacco dependence symptoms and Rasch-model withdrawal sensitivity defines further the relationship between sensitivity and dependence. The findings demonstrate the utility of modeling to create an individual-specific sensitivity measure as a tool for exploring the relationships among sensitivity, dependence and cessation.     

Beliefs about hydroxyurea in youth with sickle cell disease

Background

Hydroxyurea reduces complications and improves health-related quality of life (HRQOL) in sickle cell disease (SCD) patients, however adherence remains suboptimal. Understanding patients’ views of hydroxyurea is critical to optimize adherence, particularly in adolescents and young adults (AYA). Study objectives were to assess beliefs about hydroxyurea using the Beliefs about Medicines Questionnaire (BMQ), and to examine the relationship of patients’ beliefs to their hydroxyurea adherence and HRQOL.