Reliability and responsiveness of a prostate cancer questionnaire for radiotherapy-induced side effects

Few self-assessment cancer-specific questionnaires/modules have yet been developed for radiotherapy-induced side effects. The aim of the present study was to test the reliability and responsiveness of a prostate cancer (PC)-specific questionnaire. Thirty-one patients with PC graded their urinary and intestinal symptoms and their sexual function on the questionnaire. A doctor and a nurse performed a structured interview and graded the patient's symptoms with the same questions. The procedure was performed at both the start and the end of the treatment. A high concordance regarding symptom detection was seen between the patient, nurse and the doctor. The inter-rater test shows intraclass correlation coefficient (ICC) values above 0.60 in all scales. The internal reliability exceeded the lower limit (Cronbach a >0.70) for all scales. The test-retest gave acceptable reliability for all scales (ICC > or = 0.60). All scales indicated increased problems during radiotherapy. The questionnaire was proven to be valid for the evaluations of urinary and intestinal problems and for sexual function in PC patients.     

Invited lecture: American Board of Surgery Maintenance of Certification explained

The American Board of Surgery Maintenance of Certification program requires more effort on the part of individual diplomates, but the principle is to create a better way of documenting the approach to maintenance of certification. The Maintenance of Certification program was designed to document that American Board of Surgery diplomates are maintaining the necessary competencies to provide quality care.     

Lack of correlation between the mean tender point score and self-reported pain in fibromyalgia

Objectives . To study the validity and nature of self-assessed symptoms among patients with fibromyalgia syndrome (FMS) and to compare our data with findings reported in the US. To determine whether tender point scores correlate with self-reported pain and other symptoms and to study the influence of disease duration. Methods . Tender point scores were assessed in 113 consecutive patients with FMS. All patients completed 2 self-assessment questionnaires (an extended Campbell list, the Enschede Fibromyalgia Questionnaire, and the Dutch Arthritis Impact Measurement Scales). Results . The self-assessed symptoms of the Dutch FMS patients seem to be valid and are comparable with those of American patients. No association between disease duration and number of self-reported symptoms was found. An association between self-reported pain and mean tender point score was lacking for patients with disease of shorter duration and was weak for patients with disease of longer duration. Conclusions . The use of a self-report questionnaire for patients with FMS is feasible and appears to be valid. Tender point scores and self-reported pain represent very different aspects of pain in FMS.     

商洛市大学生主观幸福感及其影响因素

目的:了解商洛市大学生主观幸福感现况及影响因素并有针对性地提出对策。方法:自编一般资料调查表和幸福感指数量表对140名大学生进行问卷调查。结果:大学生平均幸福感指数为(11.82±1.89),与其他地区院校相比,该地区大学生幸福感指数较高。多元线性回归分析显示,大学生主观幸福感的影响因素为学习压力(β=-0.946,t=-3.974,P=0.000)、压力应对(β=1.818,t=2.968,P=0.004)、自我评价健康状况(β=0.75,t=2.587,P=0.011)、兴趣爱好(β=0.612,t=2.108,P=0.037)。结论:大学生主观幸福感状况应引起学校和大学生自身的重视,根据影响因素采取培养策略,从而提高学生的主观幸福感。     

Partners' self-perceptions of the use of different communication strategies during total communication intervention

Background: Collaboration between people with aphasia and their communication partners is needed to achieve success in communication. Some of the partners change their own behaviour spontaneously and start to use different strategies to ensure that conversations are successful, but many require training to do so.

Aims: The aim of the present study was to examine to what extent communication partners perceive they use different strategies to support the conversation and if they perceive changes in the use of these strategies during an intervention concentrating on total communication.

Methods & Procedures: The data were collected during regular rehabilitation courses, which were carried out in two parts (8?+?4 days) with a 3-month interval. People with aphasia participated in the whole course and the partners joined in for the last 2 days of the first part and the whole of the second part (2?+?4 days). The aim of the intervention was to encourage people with aphasia to use total communication and to guide the communication partners to facilitate the use of total communication and to support the conversation. A total of 43 communication partners participated in the present study: 33 participated in a course with their aphasic partners, but 10 did not and formed the control group. Before the first and second parts of the course and 6 months after the course the partners completed a questionnaire comprising 20 questions concerning different communication strategies.

Outcomes & Results: Before the intervention both the participating partners and the control group perceived that they quite often used different strategies to support the conversation. The means of the 20 questions were 62.9/100 and 58.9/100 respectively. Both groups perceived an increase in the use of different strategies after the first part of the course but the change was statistically significant only in the participating group, F(1, 32)?=?8.025, p?=?.016. The participating group perceived a significant increase in the use of strategies supporting verbal comprehension and production after the first part of the course, F(1, 32)?=?6.925, p?=?.026, but perceived a decrease in the use of them when measured 6 months after the course.

Conclusions: Communication partners perceive that they often use different strategies to support communication. The self-assessment method can make the partners more aware of these strategies. An intervention can increase the partners' awareness of the comprehension problems of their aphasic partners.     

文职护理骨干任职培训效果自我评价研究

目的:研究文职护理骨干对任职培训效果的自我评价,为完善培训体系和培训模式提供参考依据。方法:以方便抽样法,采用自行设计的任职培训效果自我评价调查表,对参加3期全军文职护理骨干培训班共228名文职护士进行调查。结果:8项整体评价均在85.50%以上,其中认为培训班有必要和对培训师资队伍满意2项评价均为100%。任职培训内容31个项目中,提高程度位于前5位的是医疗护理法律知识(78.95%)、伤病员现场一线的病情观察与分类(78.07%)、护士职业生涯规划(77.63%)、护士职业礼仪规范(77.19%)、战创伤救治与护理(76.75%),位于后5位的是护理论文写作(53.07%)、军事训练伤的防护(52.63%)、文献检索能力(52.20%)、军队常见精神障碍的防护(51.32%)、健康教育知识和能力(50.88%)。结论:文职护理骨干对任职培训效果整体评价较好,在人文素养与临床管理、军事护理技能方面部分知识提升较大,培训效果提升较小的均为实践性较强的内容,提示在任职培训中需进一步完善实践教学模式、内容和方法。     

Measuring self-esteem after spinal cord injury: Development,validation and psychometric characteristics of the SCI-QOL Self-esteem item bank and short form

ObjectiveTo describe the development and psychometric properties of the Spinal Cord Injury-Quality of Life (SCI-QOL) Self-esteem item bank.DesignUsing a mixed-methods design, we developed and tested a self-esteem item bank through the use of focus groups with individuals with SCI and clinicians with expertise in SCI, cognitive interviews, and item-response theory- (IRT) based analytic approaches, including tests of model fit, differential item functioning (DIF) and precision.SettingWe tested a pool of 30 items at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital, and the James J. Peters/Bronx Department of Veterans Affairs hospital.ParticipantsA total of 717 individuals with SCI completed the self-esteem items.ResultsA unidimensional model was observed (CFI = 0.946; RMSEA = 0.087) and measurement precision was good (theta range between −2.7 and 0.7). Eleven items were flagged for DIF; however, effect sizes were negligible with little practical impact on score estimates. The final calibrated item bank resulted in 23 retained items.ConclusionThis study indicates that the SCI-QOL Self-esteem item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available.     

疲劳自评量表

疲劳自评量表(fatigue self-assessment scale,FSAS)是在回顾国内外有关疲劳评定研究的基础上,结合中国语言习惯及人文特点编制而成。该量表由23个项目组成,可用于评定有疲劳表现的亚健康与各种疾病人群的疲劳类型、程度(包括躯体疲劳、精神疲劳与疲劳后果3个因子)及特征(包括疲劳对睡眠/休息的反应、疲劳的情境性与疲劳的时间模式3个因子)及疲劳的干预效果。     

What is self-rated health and why does it predict mortality? Towards a unified conceptual model

The association of self-rated health with mortality is well established but poorly understood. This paper provides new insights into self-rated health that help integrate information from different disciplines, both social and biological, into one unified conceptual framework. It proposes, first, a model describing the health assessment process to show how self-rated health can reflect the states of the human body and mind. Here, an analytic distinction is made between the different types of information on which people base their health assessments and the contextual frameworks in which this information is evaluated and summarized. The model helps us understand why self-ratings of health may be modified by age or culture, but still be a valid measure of health status. Second, based on the proposed model, the paper examines the association of self-rated health with mortality. The key question is, what do people know and how do they know what they know that makes self-rated health such an inclusive and universal predictor of the most absolute biological event, death. The focus is on the social and biological pathways that mediate information from the human organism to individual consciousness, thus incorporating that information into self-ratings of health. A unique source of information is provided by the bodily sensations that are directly available only to the individual him- or herself. According to recent findings in human biology, these sensations may reflect important physiological dysregulations, such as inflammatory processes. Third, the paper discusses the advantages and limitations of self-rated health as a measure of health in research and clinical practice. Future research should investigate both the logics that govern people's reasoning about their health and the physiological processes that underlie bodily feelings and sensations. Self-rated health lies at the cross-roads of culture and biology, therefore a collaborative effort between different disciplines can only improve our understanding of this key measure of health status.