A Global Rating Scale and Checklist Instrument for Pediatric Laceration Repair.
Ontology highlight
ABSTRACT:
SUBMITTER: Seo S
PROVIDER: S-EPMC6415009 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:Virtual reality (VR) is an emerging immersive technology with initial documentation of reduction in anxiety and pain when used by children in the hospital setting. The objective of this study was to compare VR to standard of care (SOC) in a pediatric Emergency Department (ED) for pain management and anxiety among children needing a laceration repair procedure. We conducted a prospective randomized controlled trial in a tertiary pediatric ED (NCT03681717) with children 6-16 years of age going through a laceration repair procedure. Intervention was low-cost VR goggles with a free roller coaster application during the procedure or SOC in the ED during the same time (1:1). The primary outcome was post-procedure pain (Faces Pain Scale - Revised (FPS-R)), and secondary outcome was the Venham Situational Anxiety (VSA) score. A total of 32 subjects were in the VR group and 30 in the SOC group. Age, gender, location and length of the laceration, number of sutures needed, use of oral, topical or local anesthetics, time to complete the procedure and time to discharge, were similar between groups. Pain and anxiety as measured after the procedure were very low, and similar between groups. Children rated the VR experience more positively than the SOC (p = 0.01). Using low cost VR system was similar to our tertiary pediatric center SOC comfort level and children enjoyed the VR system more. VR may serve as an additional tool in the armamentarium of ED providers for pain and anxiety reduction during laceration repairs.
| S-EPMC8099939 | biostudies-literature
Project description:BackgroundApathy is usually defined as reduced interest and participation in various activities. It is a frequent consequence of neurological and psychiatric disorders. Although various scoring methods have been proposed, there is a lack of validated, standardised instruments for detecting apathy and assessing its severity.ObjectiveTo develop an apathy rating scale using a structured standardised interview capable of distinguishing between the condition's various features.MethodsThe Lille Apathy Rating Scale (LARS) is based on a structured interview. It includes 33 items, divided into nine domains. Responses are scored on a dichotomous scale. The participants used to validate the scale consisted of 159 patients with probable Parkinson's disease and 58 healthy control subjects. The Marin Apathy Scale, the Montgomery and Asberg Depression Rating Scale, and the Mattis Dementia Rating Scale were also administered.ResultsPrincipal component analysis showed that the LARS probed a single construct which forms the root of an oblique factor structure reflecting four dimensions: intellectual curiosity, self awareness, emotion, and action initiation. The main psychometric properties of the LARS (internal consistency, inter-rater and test-retest reliability) were satisfactory. Concurrent validity was evaluated by reference to the Marin scale and to judgements provided by expert clinicians.ConclusionsStandard validity indices showed that the LARS is sensitive and capable of distinguishing between apathy and depression. As a screening tool, the scale is able to support dichotomous judgements accurately and, when greater measurement sensitivity is required, also determine the severity of apathy within a four category classification.
| S-EPMC2117430 | biostudies-literature
Project description:Police mental health is important because police officers usually encounter stressors that cause high levels of stress. In order to better understand mental health for Chinese police, the Zung Self-Rating Depression Scale (SDS) and Symptom Checklist 90-Revised (SCL-90-R) are commonly used in mainland China. Unfortunately, both the SDS and SCL-90-R lack detailed information on their psychometric properties. More specifically, factor structures of the SDS and SCL-90-R have yet to be confirmed among the police population in mainland China. Therefore, the present study compared several factor structures of the SDS and SCL-90-R proposed by prior research and to determine an appropriate structure for the police population. Utilizing cluster sampling, 1151 traffic police officers (1047 males; mean age = 36.6 years [SD = 6.10]) from 49 traffic police units in Jiangxi Province (China) participated in this study. Confirmatory factor analysis (CFA) with Akaike information criterion (AIC) was used to decide the best fit structure. In the SDS, the three-factor model (first posited by Kitamura et al.) had the smallest AIC and outperformed other models. In the SCL-90-R, the eight-factor model had the smallest AIC and outperformed the one-factor and nine-factor models. CFA fit indices also showed that both the three-factor model in the SDS and the eight-factor model in the SCL-90-R had satisfactory fit. The present study's results support the use of both SDS and SCL-90-R for police officers in mainland China.
| S-EPMC7215956 | biostudies-literature
Project description:Pain intensity and patients' impression of global improvement are widely used patient-reported outcome measures (PROMs) in clinical practice and research. They are commonly assessed using the Numerical Pain Rating Scale (NPRS) and Global Rating of Change (GROC) questionnaires. The GROC is essential as an anchor for evaluating the psychometric properties of PROMs. Both of these PROMs are translated to many languages and have shown excellent psychometric properties. Their availability in Nepali would facilitate pain research and cross-cultural comparison of research findings. Therefore, the objectives of this study were to translate and cross-culturally adapt the NPRS and GROC into Nepali and to assess the psychometric properties of the Nepali version of the NPRS (NPRS-NP).After translating and cross-culturally adapting the NPRS and GROC into Nepali using recommended guidelines, NPRS-NP was administered to 104 individuals with musculoskeletal pain twice. The Nepali version of the GROC (GROC-NP) was administered at the follow-up for anchor-based assessment. (1) Test-retest reliability and minimum detectable change (MDC) among the stable group, (2) construct validity (by single sample t-test within the improved group and independent sample t-test between groups), and (3) concurrent validity were assessed. Receiver operating characteristic (ROC) curves were plotted to determine the responsiveness of the NPRS-NP using the area under the curve (AUC), and minimum important changes (MIC) for small, medium and large improvements.Significant cultural adaptations were required to obtain relevant Nepali versions of both the NPRS and GROC. The NPRS-NP showed excellent test-retest reliability and a MDC of 1.13 points. NPRS-NP demonstrated a good construct validity by significant within-group difference in mean of NPRS score- t(63)= 7.57, P?<?0.001 and statistically significant difference of mean score- t(98)= -4.24, P?<?.001 between the stable and improved groups. It demonstrated moderate concurrent correlation with the GROC-NP; r?=?0.43, P?<?0.01. Responsiveness of the NPRS-NP was shown at three levels with AUC?=?0.68-0.82, and MIC?=?1.17-1.33.The NPRS and GROC were successfully translated and culturally adapted into Nepali. The NPRS-NP demonstrated good reliability, validity and responsiveness in assessing musculoskeletal pain intensity in a Nepali population.
| S-EPMC5715544 | biostudies-literature
Project description:OBJECTIVE:To develop and validate the Baby Pediatric Symptom Checklist (BPSC), a brief social/emotional screening instrument for children less than 18 months. The BPSC is modeled after the Pediatric Symptom Checklist (PSC) and is part of the Survey of Wellbeing of Young Children, a comprehensive, freely available screening instrument designed for use in pediatric primary care. METHOD:BPSC items were developed by a team of experts who reviewed existing assessment instruments and relevant research literature. Scale construction and initial validation were conducted with 205 families from pediatric primary care sites and 54 families from referral clinics. A replication sample of 146 additional families were enrolled from an independent set of primary care practices. RESULTS:Exploratory factor analysis revealed 3 dimensions of the BPSC: irritability, inflexibility, and difficulty with routines. Factor structure was confirmed in the replication sample. Retest reliability and internal reliability were adequate (intraclass correlation coefficient >0.70) across subscales, with the exception of the "irritability" subscale's internal reliability in the replication sample. Construct validity of the "irritability" and the "difficulty with routines" subscales is supported by correlations with the Parenting Stress Index and the Ages & Stages Questionnaire: Social/Emotional, but the "inflexibility" subscale seems to be distinct from performance on these instruments. Tests of differential item functioning revealed no significant effects for race/ethnicity, child gender, parent education, or family income. Age-based normative data were calculated for each subscale. CONCLUSION:The BPSC assesses 3 domains of behavior for very young children and shows promise as a social/emotional screening instrument for pediatric primary care.
| S-EPMC3763819 | biostudies-literature
Project description:IntroductionDeclining rates of operative vaginal deliveries and routine episiotomy in obstetric practice, along with rising cesarean section rates, have decreased OB/GYN resident experience with episiotomy repair and obstetric anal sphincter injuries (OASIS). Simulation models are valuable educational tools in procedural training. Several models have been reported, each with its own limitations and benefits.MethodsWe developed a 1-hour workshop to teach novice OB/GYN residents perineal laceration repair skills on a modified beef tongue model. The model required 5-10 minutes to assemble following written and video instruction, and learners had 30-50 minutes to practice using learner instructions. Learners were evaluated using a procedure checklist and global objective structured assessment of technical skills. To evaluate the session, we surveyed current faculty and residents, as well as residency graduates.ResultsBetween 2008 and 2017, an estimated 82 OB/GYN residents participated in this activity, and 95 participants and facilitators received the survey. Forty-one (59%) respondents agreed that this model was similar to repairing OASIS in clinical practice. Our trainees reported that the optimal time for simulated OASIS repair was the R2 and R3 years; however, 90% of respondents felt residents should be offered this simulation yearly.DiscussionBased on our survey of trainees, graduates, and faculty, we created a realistic simulated OASIS repair training, despite the limitation that the model lacked a rectum. Learners reported an interest in repeating the simulation frequently during residency to augment their clinical experience and increase perceived competence in third- and fourth-degree laceration repair by their graduation.
| S-EPMC7062543 | biostudies-literature
Project description:We previously developed a reliable and valid method for classifying the intensity of pediatric cancer treatment. The Intensity of Treatment Rating Scale (ITR-2.0) 1 classifies treatments into four operationally defined levels of intensity and is completed by pediatric oncology specialists based on diagnosis, stage, and treatment data from the medical record. Experience with the ITR-2.0 and recent changes in treatment protocols indicated the need for a minor revision and revalidation.Five criterion raters reviewed the prior items, independently proposing additions and/or changes in the classification of diseases/treatments. Subsequent to a group discussion of the proposed changes, a revised 43-item ITR was evaluated. Pediatric oncologists (n = 47) completed a two-part online questionnaire. Validity of the classifications was determined by the oncologists classifying each disease/treatment into one of the four levels of intensity. Inter-rater reliability was calculated by having each oncologist classify the treatments of 12 sample patients using the new version which we call the ITR-3.Agreement between median ratings of the 43 items for the pediatric oncologists and the criterion raters was high (r = 0.88). The median of the raters was either identical (81%) with the criterion ratings or discrepant by one level. Inter-rater reliability was very high when using the ITR-3 to classify 12 sample patients, with a median agreement of 0.90 and an intraclass correlation coefficient (r(ICC) = 0.86).With these minor modifications and updates, the ITR-3 remains a reliable and valid method for classifying pediatric oncology treatment protocols.
| S-EPMC3223269 | biostudies-literature
Project description:The aim of this study is to adapt and validate the global deterioration scale (GDS) for the systematic tracking of Alzheimer's disease (AD) progression in a population with Down syndrome (DS). A retrospective dual-center cohort study was conducted with 83 participants with DS (46.65 ± 5.08 years) who formed the primary diagnosis (PD) group: cognitive stability (n = 48), mild cognitive impairment (n = 24), and Alzheimer's disease (n = 11). The proposed scale for adults with DS (GDS-DS) comprises six stages, from cognitive and/or behavioral stability to advanced AD. Two neuropsychologists placed the participants of the PD group in each stage of the GDS-DS according to cognitive, behavioral and daily living skills data. Inter-rater reliability in staging with the GDS-DS was excellent (ICC = 0.86; CI: 0.80-0.93), and the agreement with the diagnosis categories of the PD group ranged from substantial to excellent with κ values of 0.82 (95% CI: 0.73-0.92) and 0.85 (95% CI: 0.72, 0.99). Performance with regard to the CAMCOG-DS total score and orientation subtest of the Barcelona test for intellectual disability showed a slight progressive decline across all the GDS-DS stages. The GDS-DS scale is a sensitive tool for staging the progression of AD in the DS population, with special relevance in daily clinical practice.
| S-EPMC10049652 | biostudies-literature
Project description:BackgroundThe Fahn-Tolosa-Marin Clinical Rating Scale for Tremor (FTM) has been used in large trials for essential tremor (ET), but its anchors for ratings from 0 to 4 of upper limb tremor are probably too low for patients with severe tremor (tremor amplitude >4 cm; grade 4). The Essential Tremor Rating Assessment Scale (TETRAS) is a validated clinical scale designed specifically for the assessment of ET severity. TETRAS has anchors that span a larger range of tremor amplitudes (>20 cm = grade 4), making it more suitable for assessing patients with severe ET. However, there is no direct comparison of these scales in any clinical trial.MethodsUpper limb postural and kinetic tremor items from both scales were compared using blinded, video-recorded examinations of patients with moderate-to-severe ET who participated in a trial of focused ultrasound thalamotomy.ResultsFTM ratings of postural and kinetic tremor correlated strongly with those of TETRAS. However, FTM exhibited a ceiling effect for severe tremor. Rest tremor, exclusive to FTM, correlated poorly with postural and kinetic tremor and had very poor test-retest reliability. In contrast, wing-beating postural tremor, exclusive to TETRAS, exhibited excellent test-retest reliability and a strong correlation with kinetic and limbs-extended-forward postural tremor. Test-retest reliabilities of the other TETRAS and FTM ratings were excellent, and both scales had good sensitivity to treatment effect.ConclusionsTETRAS has 2 main advantages over FTM in the assessment of tremor severity: (1) the absence of a ceiling effect in patients with severe ET, and (2) the inclusion of wing-beating tremor.
| S-EPMC6174461 | biostudies-literature
Project description:Researchers are finding limitations of currently available disease-focused questionnaire tools for outcome studies in complementary and alternative medicine/integrative medicine (CAM/IM).Three substudies investigated the new one-item visual analogue Arizona Integrative Outcomes Scale (AIOS), which assesses self-rated global sense of spiritual, social, mental, emotional, and physical well-being over the past 24 hours and the past month. The first study tested the scale's ability to discriminate unhealthy individuals (n = 50) from healthy individuals (n = 50) in a rehabilitation outpatient clinic sample. The second study examined the concurrent validity of the AIOS by comparing ratings of global well-being to degree of psychological distress as measured by the Brief Symptom Inventory (BSI) in undergraduate college students (N = 458). The third study evaluated the relationships between the AIOS and positively- and negatively-valenced tools (Positive and Negative Affect Scale and the Positive States of Mind Scale) in a different sample of undergraduate students (N = 62).Substudy (i) Rehabilitation patients scored significantly lower than the healthy controls on both forms of the AIOS and a current global health rating. The AIOS 24-hours correlated moderately and significantly with global health (patients r = 0.50; controls r = 0.45). AIOS 1-month correlations with global health were stronger within the controls (patients r = 0.36; controls r = 0.50). Controls (r = 0.64) had a higher correlation between the AIOS 24-hour and 1-month forms than did the patients (r = 0.33), which is consistent with the presumptive improvement in the patients' condition over the previous 30 days in rehabilitation. Substudy (ii) In undergraduate students, AIOS scores were inversely related to distress ratings, as measured by the global severity index on the BSI (rAIOS24h = -0.42, rAIOS1month = -0.40). Substudy (iii) AIOS scores were significantly correlated with positive affect (rAIOS24h = 0.56, rAIOS1month = 0.57) and positive states of mind (rAIOS24h = 0.42, rAIOS1month = 0.45), and inversely correlated with negative affect (rAIOS24h = -0.41, rAIOS1month = -0.59).The AIOS is able to distinguish relatively sicker from relatively healthier individuals; and correlates in expected directions with a measure of distress and indicators of positive and negative affect and positive states of mind. The AIOS offers a tool for CAM/IM research that extends beyond a disease emphasis.
| S-EPMC343287 | biostudies-literature