Dataset Information

Carer Appraisal Scale: Second Edition of a Novel Carer-Based Outcome Measure.

ABSTRACT: Carers are known to have valuable information regarding patient functioning. It has been repeatedly cited that failure of communication between mental health services and the carers of patients is related to critical incidents and failures in patient care. Despite this, there are no structured interventions for carers to participate in patient care, let alone assist with measuring patient progress. This study builds upon and expands on a previous pilot study of a similar measure that was developed for a specific old-age population to create one suitable for general adult use. Development of the Carer Appraisal Scale was based on a grounded theory approach, beginning with semi-structured interviews with staff members working in the mental health service of a major tertiary referral center, with intent on refinement by focus groups, carer feedback, and eventual reduction in total number of items via factor analysis in order to create an accessible and brief measure suitable for regular clinical use. It is proposed that this measure provides additional value for services in engaging the carers of patients in a clinically meaningful way that will greatly impact on patient care.

SUBMITTER: Jeyasingam N

PROVIDER: S-EPMC7427367 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Carer Appraisal Scale: Second Edition of a Novel Carer-Based Outcome Measure.

Jeyasingam Neil N Ip Vincent V Alcock Hannah H Choi Sophia Yoon-Young SY Lye Joshua J Perry Rebecca R

Journal of patient experience 20190313 2

Carers are known to have valuable information regarding patient functioning. It has been repeatedly cited that failure of communication between mental health services and the carers of patients is related to critical incidents and failures in patient care. Despite this, there are no structured interventions for carers to participate in patient care, let alone assist with measuring patient progress. This study builds upon and expands on a previous pilot study of a similar measure that was develop ...[more]

PMID: 32851138

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Project description:Background: While the Yale-Brown Obsessive-Compulsive Scale Second Edition (Y-BOCS-II) is the gold-standard for measurement of obsessive-compulsive (OC) symptom severity, its factor structure is still a matter of debate and, most importantly, criterion validity for diagnosis of OC disorder (OCD) has not been tested. This study aimed to clarify factor structure and criterion validity of the Y-BOCS-II. Methods: We first validated and quantified the psychometric properties of a culturally adapted Portuguese translation of the Y-BOCS-II (PY-BOCS-II). The PY-BOCS-II and other psychometric instruments, including the OCD subscale of the Structured Clinical Interview for the DSM-IV, used to define OCD diagnosis, were administered to 187 participants (52 patients with OCD, 18 with other mood and anxiety disorders and 117 healthy subjects). In a subsample of 20 OCD patients and the 18 patients with other diagnoses, PY-BOCS-II was applied by clinicians blinded to diagnosis. Results: PY-BOCS-II had excellent internal consistency (Cronbach's α = 0.96) and very good test-retest reliability (Pearson's r = 0.94). Exploratory factor analysis revealed a two-factor structure with loadings consistent with the Obsessions and Compulsions subscales, and there was good to acceptable convergent and divergent validity. Importantly, the area under the curve (AUC) of the receiver operating characteristic (ROC) curve suggested elevated accuracy in discriminating between patients with OCD and control subjects (AUC = 0.96; 95% confidence interval [CI]: 0.92-0.99), that was retained in comparisons with age, gender and education matched controls (AUC = 0.95; 95% CI: 0.91-0.99), as well as with patients with other mood and anxiety disorders (AUC = 0.93; 95% CI: 0.84-1). Additionally, a cut-off score of 13 had optimal discriminatory ability for the diagnosis of OCD, with sensitivity ranging between 85 and 90%, and specificity between 94 and 97%, respectively when all samples or only the clinical samples were considered. Conclusion: The PY-BOCS-II has excellent psychometric properties to assess the severity of obsessive-compulsive symptoms, reflecting obsessive, and compulsive dimensions, compatible with currently defined subscales. Furthermore, we found that a cut-off of 13 for the Y-BOCS-II total score has good to excellent sensitivity and specificity for the diagnosis of OCD.

Project description:The Indian Autism Screening Questionnaire (IASQ), derived from the Indian Scale for Assessment of Autism ISAA (the mandated tool for autism in India), is an autism screening instrument for use in the general population by minimally trained workers. While ISAA has 40 items with four anchor points, the IASQ is a 10-item questionnaire with yes/no answers. It was initially validated using the ISAA. During its development the ISAA was itself compared to the Childhood Autism Rating Scale version 1 (ISAA Manual). In the present study, we evaluated both the ISAA and the IASQ in relation to the Childhood Autism Rating Scale version 2 (CARS-2).MethodsParticipants were recruited from three settings: a referral clinic for neurodevelopmental conditions run by the Department of Paediatrics of a tertiary care teaching hospital (NDC OPD), the outpatient department of an institute for disability and rehabilitation (NIEPID), and from the community (CGOC). Persons between ages 3-18 were recruited following consent or assent (parent and child/adolescent). The IASQ was administered by a minimally trained administrator. It was followed by ISAA and the CARS-2 (in alternating order, by different evaluators blind to each other) (CARS2 SV (Standard Version) and CARS2 HF (High Functioning) as applicable). Sensitivity, specificity and area under the Receiver Operator Characteristics (ROC) curve were calculated for IASQ and CARS2, as well as for ISAA and CARS2. Concordance between CARS2 and ISAA was calculated using kappa coefficient.ResultsA total of 285 participants (NIEPD n = 124; NDC OPD, n = 4; CGOC n = 157) (a total of 70 with autism and 215 controls) participated. IASQ and CARS2 were administered on 285 participants, while IASQ and ISAA were administered on 264 participants. When IASQ was compared to CARS2, sensitivity was 97%, specificity 81%, PPV 63%, NPV 99% at cut off 1 while these values were 97%, 92%, 79% and 99% respectively at cut off 2. There was high concordance between CARS2 and ISAA (Kappa 0.907, p<0.0001).ConclusionsIASQ has satisfactory sensitivity, specificity and concordance when compared with CARS2; it can be used for screening children with autism in community. The ISAA also showed a high concordance with CARS2, as it had with the older version of CARS.

Dataset Information

Carer Appraisal Scale: Second Edition of a Novel Carer-Based Outcome Measure.

Publications

Carer Appraisal Scale: Second Edition of a Novel Carer-Based Outcome Measure.

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