Cancer-specific administrative data–based comorbidity indices provided valid alternative to Charlson and National Cancer Institute Indices

ObjectiveWe aimed to develop and validate administrative data–based comorbidity indices for a range of cancer types that included all relevant concomitant conditions.Study Design and SettingsPatients diagnosed with colorectal, breast, gynecological, upper gastrointestinal, or urological cancers identified from the National Cancer Registry between July 1, 2006 and June 30, 2008 for the development cohort (n = 14,096) and July 1, 2008 to December 31, 2009 for the validation cohort (n = 11,014) were identified. A total of 50 conditions were identified using hospital discharge data before cancer diagnosis. Five site-specific indices and a combined site index were developed, with conditions weighted according to their log hazard ratios from age- and stage-adjusted Cox regression models with noncancer death as the outcome. We compared the performance of these indices (the C3 indices) with the Charlson and National Cancer Institute (NCI) comorbidity indices.ResultsThe correlation between the Charlson and C3 index scores ranged between 0.61 and 0.78. The C3 index outperformed the Charlson and NCI indices for all sites combined, colorectal, and upper gastrointestinal cancer, performing similarly for urological, breast, and gynecological cancers.ConclusionThe C3 indices provide a valid alternative to measuring comorbidity in cancer populations, in some cases providing a modest improvement over other indices.     

临床护士整体人文关怀感知量表的编制及信效度检验

目的 编制临床护士整体人文关怀感知量表,并检验其信效度。方法 在文献分析和半结构式访谈的基础上,通过德尔菲法构建量表初稿。2022年4月在武汉市某三级甲等医院选取20名临床护士进行预调查,检验量表可读性。2022年4月—5月选取咸宁市和泰安市2所医院的501名临床护士作为调查对象,对量表进行项目分析和信效度检验。结果临床护士整体人文关怀感知量表包括6个维度、40个条目。探索性因子分析共提取6个公因子,累计方差贡献率为79.05%;验证性因子分析结果显示,量表结构模型的拟合指数良好。量表水平的内容效度指数为0.94,条目水平的内容效度指数为0.78～1.00;量表总的Cronbach’s α系数为0.98,重测信度为0.87。结论 临床护士整体人文关怀感知量表信效度良好,可用于测量护士感知的整体人文关怀情况。     

起搏器植入术后患者康复训练依从性量表的编制及信效度检验

目的：构建起搏器植入术后患者康复训练依从性的评估工具。方法：通过文献回顾法结合小组讨论形成起搏器植入术后患者康复训练依从性初始量表,进行2轮专家咨询后,选取2019年3月至7月安徽某三级甲等医院心血管内科接受永久起搏器植入术的患者250例进行问卷调查,以评估量表的信效度。结果：探索性因子分析结果显示,康复训练依从性量表包含3个维度10个条目,累积方差贡献率为66.945%;量表的各条目内容效度(item-level content validity index, I-CVI)为0.856～1.000,总量表的内容效度（scalelevel content validity index, S-CVI）为0.945,总量表的Cronbach’s α系数为0.795,折半信度为0.814,重测信度为0.822。结论：起搏器植入术后患者康复训练依从性量表具有较好的信效度,可用于评估起搏器术后患者康复训练的依从性。     

简体中文版事件相关反刍性沉思问卷在意外创伤者中应用的信效度分析

目的 分析简体中文版事件相关反刍性沉思问卷(C-ERRI)在意外创伤者中的信效度.方法 选取130例意外创伤者作为样本一,使用C-ERRI对其施测以行项目分析和探索性因素分析;另调查320例意外创伤者作为样本二,使用中文版创伤后成长问卷和C-ERRI对其施测,对数据行验证性因素分析、信度分析及效标效度分析.结果 C-ERRI的内在一致性信度:总量表为0.92,侵入性反刍性沉思维度为0.93,目的性反刍性沉思维度为0.85,问卷的两维度共解释56.13％的总方差;验证性因素分析:GFI=0.931,AGFI=0.904,CFI=0.906,NFI=0.915,RMSE=0.046,模型拟合良好.侵入性反刍性沉思反向预测创伤后成长(β=-o.13,P=0.02),目的性反刍性沉思正向预测创伤后成长(β=0.47,P＜0.001).结论 C-ERRI的心理测量学特征较好,适合评估意外创伤者的创伤后认知加工并预测其创伤后成长.     

Validity of reported data in the Swedish Cardiac Arrest Register in selected parts in Sweden

Aim

To describe differences and similarities between reported and non-reported data in the Swedish Cardiac Arrest Register in selected parts in Sweden.

Methods

Prospective and retrospective data for treated OHCA patients in Sweden, 2008–2010, were compared in the Swedish Cardiac Arrest Register. Data were investigated in three Swedish counties, which represented one third of the population. The recording models varied. Prospective data are those reported by the emergency medical service (EMS) crews, while retrospective data are those missed by the EMS crews but discovered afterwards by cross-checking with the local ambulance register.

Result

In 2008–2010, the number of prospectively (n = 2398) and retrospectively (n = 800) reported OHCA cases was n = 3198, which indicates a 25% missing rate.When comparing the two groups, the mean age was higher in patients who were reported retrospectively (69 years vs. 67 years; p = 0.003). There was no difference between groups with regard to gender, time of day and year of OHCA, witnessed status or initial rhythm. Bystander cardiopulmonary resuscitation (CPR) was more frequent among patients who were reported prospectively (65% vs. 60%; p = 0.023), whereas survival to one month was higher among patients who were reported retrospectively (9.2% vs. 11.9%; p = 0.035).

Conclusion

Among 3198 cases of OHCA in three counties in Sweden, 800 (25%) were not reported prospectively by the EMS crews but were discovered retrospectively as missing cases. Patients who were reported retrospectively differed from prospectively reported cases by being older, having less frequently received bystander CPR but having a higher survival rate. Our data suggest that reports on OHCA from national quality registers which are based on prospectively recorded data may be influenced by selection bias.     

Reliability and validity of perceived self-efficacy in wheeled mobility scale among elite wheelchair-dependent athletes with a spinal cord injury

Purpose: To study the reliability and validity of the perceived self-efficacy in wheeled mobility scale among elite athletes with a spinal cord injury (SCI). Method: During the Beijing Paralympics, 79 participants with SCI completed the SCI Exercise Self-Efficacy Scale (ESES), the revised Self-Efficacy in Wheeled Mobility scale (SEWM) and the perceived wheeled mobility (WM) at present Visual Analog Scale (VAS). Sample included athletes from 18 countries and subcategorized by gender, lesion level/completeness and type of sports. Reliability and concurrent validity were determined. Results: SEWM Cronbach’s α was 0.905. High internal consistency was confirmed in Split-half correlation coefficient (r = 0.87). Validity was supported by significant correlations between SWEM and ESES total scores (r = 0.64, p < 0.05), and between SEWM and WM VAS scores (r = 0.60; p < 0.001). Subgroups analyses showed that athletes with tetraplegia showed significantly lower WM self-efficacy levels than those with paraplegia. There was a significant difference in perceived WM self-efficacy between athletes who participated in dynamic wheelchair sports and those who participated in non-wheelchair sports (p < 0.03). Conclusions: The SEWM is a reliable and valid scale among Paralympic athletes with SCI. Findings confirmed a significantly higher perception of self-efficacy in WM among athletes who participated in dynamic wheelchair sports.

Implications for Rehabilitation

• Increased self-efficacy in wheeled mobility (WM) may encourage wheelchair users with spinal cord injury (SCI) to approach, persist, and persevere at WM related tasks that were previously avoided.

• The perceived self-efficacy in WM scale (SEWM), which is available on-line in five different languages, may find clinical applications for people with SCI in different countries.

• The SEWM can be applied to the assessment of progress in WM levels during the acute rehabilitation phase, and also in structured WM workshops conducted after discharge from the hospital.

     

The validity,reliability, and responsiveness of the modified Iowa Level of Assistance scale in hospitalized older adults in subacute care

Abstract

Objective: The objective of this study was to investigate the psychometric properties of the Modified Iowa Level of Assistance scale in hospitalized older adults in subacute care.

Design: A cohort, measurement-focused study.

Participants and setting: Fifty-eight older adults, aged 65?years and older, were recruited from a subacute rehabilitation hospital.

Methods: Inter-rater reliability was established by having two physiotherapists independently assess each participant within 24-h of each other. Construct validity was established using “known-groups” validity, while concurrent validity was also examined by correlating modified Iowa Level of Assistance scores with the Elderly Mobility Scale. Responsiveness was assessed by examining the difference in modified Iowa Level of Assistance scores from admission to discharge.

Results: The mean age of participants was 82.8?years (SD 7.5; range 68–97). The modified Iowa Level of Assistance scale was found to be reliable, valid, and responsive in this sample of hospitalized older adults. It had excellent inter-rater reliability (intraclass correlation coefficient [2,1] 0.96; 95% confidence intervals (CI) 0.93, 0.98) and no systematic differences across the range of scores. The scale displayed a mean difference between two known groups of 11.4 points and correlated significantly and negatively with the Elderly Mobility Scale (Spearman’s rho???0.90). The modified Iowa Level of Assistance score also changed significantly over the course of the hospital admission with an effect size of 1.2.

Conclusions: The modified Iowa Level of Assistance scale is a valid measure with excellent inter-rater reliability in hospitalized older adults. It is responsive to functional change during hospital admission and may be useful for routine outcome assessment for hospitalized older adults in subacute care.

• Implications for Rehabilitation

• The mILOA scale is a valid, reliable, and responsive outcome measure that can be used to quantify the gait and mobility impairments in hospitalized older adults in subacute care.

• For optimal reliability and responsiveness, consistent administration of the mILOA scale will be required particularly for higher level mobility tasks such as negotiating a step.

     

眼内填充术后强迫体位患者生活质量量表的研制

目的制定眼内填充术后强迫体位患者生活质量评定量表。方法查阅国内外文献,建立专家组,拟定眼内填充术后强迫体位患者生活质量初始量表。应用初始量表对138例眼内填充术后强迫体位患者和37例非眼内填充术后患者进行生活质量测评。对资料进行条目分析和筛选,再进行探索性因子分析,确定量表测试版为社会交往、日常生活能力、自我管理、情绪活动、进食质量和社会支持6个维度,含37条目。检验测试版量表的信度和效度。结果量表的Cron-bach’sα系数为0.929,分半信度为0.856;各条目与因子间的相关系数为0.391～0.886,各因子间的相关系数在0.068～0.642,各因子与总量表的相关系数在0.342～0.842,与SF-36的相关系数为0.806。结论制定的眼内填充术后强迫体位患者生活质量量表具有较高的信度和效度,能敏感反映强迫体位患者的生活质量。