1.
Peny-Dahlstrand, Marie, 1953, et al.
(författare)
Patterns of participation in school-related activities and settings in children with spina bifida
2013
Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 35:21, s. 1821-1827
Tidskriftsartikel (refereegranskat) abstract
Purpose: To evaluate how children with spina bifida (SB) participate in school-related activities and to explore if their motor and process skills in task performance were related to their level of active participation in school. Method: Fifty children from a geographical cohort of children with SB (aged 6-14 years) and their teachers rated the children's frequency of participation in school-related activities using a Swedish adaptation of the Availability and Participation Scale. The teachers also rated each child's level of active participation with the School Function Assessment, part one. Each child's motor and process skills were evaluated with the Assessment of Motor and Process Skills. The relation between levels of active participation and motor and process skills was subjected to binary logistic regression analysis. Results: The children participated very frequently in school activities, but their level of active participation was restricted, particularly in the recess/playground setting. There was a highly significant relation between full active participation in most school settings and the children's motor and process skills. Conclusion: Children with SB need support to become more actively involved, particularly in unstructured peer activities. The school staff need to be informed that not only the motor skills but also the process skills have an impact on the children's active participation.
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Kiadaliri, Ali
(författare)
Psychometric properties of the EQ-5D-5L in patients with knee or hip osteoarthritis : confirmatory factor analysis and item response theory
2024
Ingår i: Osteoarthritis and Cartilage. - 1063-4584. ; 32:Suppl 1, s. 196-197
Konferensbidrag (refereegranskat) abstract
Purpose (the aim of the study): There is limited evidence on psychometric properties of EQ-5D-5L among people with osteoarthritis (OA) undertaking non-surgical treatment. The aim of the current study was to evaluate the psychometric properties of the EQ-5D-5L among individuals with knee or hip OA participating in a digitally delivered education and exercise therapy.Methods: Secondary analysis of data obtained from individuals aged 40+ years participating in the digital treatment during the year 2021 with the responses to EQ-5D-5L at enrolment. Confirmatory factor analysis (CFA) with the weighted least square mean and variance adjusted estimator was used to assess dimensionality. Local independency assumption was assessed using residual correlations between item pairs with r>0.2 as violation of the assumption. Monotonicity was evaluated using Mokken analysis. Item response theory was implemented by generalized partial credit model. The item parameters (discrimination and difficulty) were estimated using the maximum marginal likelihood estimation. Targeting was assessed by inspecting the item-person map (the Wright map). Differential item functioning (DIF) by sex, age (≤65 years vs. >65 years) and OA site (knee vs. hip) were assessed and items with a McFadden pseudo-R2 change of ≥0.02 were flagged for potential DIF. All analyses were conducted in RStudio version 2022.02.0.Results: A total of 16,200 individuals with mean (standard deviation) age 64.3 (9.1), 74.0% females and 59.6% with knee OA were included. The included subjects reported 609 of the 3,125 possible health profiles of the EQ-5D-5L with slight or moderate problems with pain/discomfort dimension and no problems on the other dimensions (i.e. profiles “11121” and “11131”) being the first and second most common profiles (9.4% and 4.4% of respondents, respectively). CFA confirmed the unidimensionality of the EQ-5D-5L with factor loading ranged from 0.49 for anxiety/depression to 0.85 for usual activity dimensions, and an average variance extracted of 0.53 suggesting adequate convergent validity. Local independence and monotonicity assumptions were met. The fit statistics suggested an adequate fit of IRT model. Among five dimensions, pain/discomfort was the most affected (least difficult to endorse) while self-care was the least affected (most difficult to endorse). No disordered response thresholds were identified. EQ-5D-5L showed adequate reliability (>0.7) over a wide range of the underlying trait (76.4% of total information were within -1 to 4 standard deviation of average level of poor HRQoL) with an overall reliability of 0.80 (Figure 1). Usual activity and anxiety/depression were the most and least informative items. Inspecting the item-person map (Figure 2) suggested that while EQ-5D-5L covered the full range of HRQoL levels in the sample, it targeted, on average, a poorer HRQoL than experienced by the participants in the study. No DIF (uniform or nonuniform) was detected.Conclusions: The EQ-5D-5L demonstrated acceptable psychometric properties among subjects with hip or knee OA participating in a digital education and exercise therapy. These results support the use of EQ-5D-5L among people with less severe knee or hip OA.
6.
Nilsson, Maria H, et al.
(författare)
Fatigue in Parkinson's Disease: Measurement Properties of a Generic and a Condition-specific Rating Scale.
2013
Ingår i: Journal of Pain and Symptom Management. - : Elsevier BV. - 1873-6513 .- 0885-3924. ; 46:5, s. 737-746
Tidskriftsartikel (refereegranskat) abstract
CONTEXT: High-quality fatigue rating scales are needed to advance the understanding of fatigue and determine the efficacy of interventions. Several fatigue scales are used in Parkinson's disease, but few have been tested using modern psychometric methodology (Rasch analysis). OBJECTIVES: To examine the measurement properties of the generic Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale and the condition-specific 16-item Parkinson Fatigue Scale (PFS-16) using Rasch analysis. METHODS: Postal survey data (n=150; 47% women; mean age 70 years) were Rasch analyzed. The PFS-16 scores were tested according to both the original polytomous and the suggested alternative dichotomized scoring methods. RESULTS: The PFS-16 showed overall Rasch model fit, whereas the FACIT-F showed signs of misfit, which probably was the result of a sleepiness-related item and mixing of positively/negatively worded items. There was no differential item functioning by disease duration but by fatigue status (greater likelihood of needing to sleep or rest during the day among people classified as nonfatigued) in the PFS-16 and FACIT-F. However, this did not impact total score-based estimated person measures. Targeting and reliability (≥0.86) were good, but the dichotomized PFS-16 showed compromised measurement precision. Polytomous and dichotomized PFS-16 and FACIT-F scores identified six, three, and four statistically distinct sample strata, respectively. CONCLUSION: We found general support for the measurement properties of both scales. However, polytomous PFS-16 scores exhibited advantages compared with dichotomous PFS-16 and FACIT-F scores. Dichotomization of item responses compromises measurement precision and the ability to separate people, and should be avoided.
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Religa, D., et al.
(författare)
SveDem, the Swedish Dementia Registry - A tool for improving the quality of diagnostics, treatment and care of dementia patients in clinical practice
2015
Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:2
Tidskriftsartikel (refereegranskat) abstract
Background: The Swedish Dementia Registry (SveDem) was developed with the aim to improve the quality of diagnostic work-up, treatment and care of patients with dementia disorders in Sweden. Methods: SveDem is an internet based quality registry where several indicators can be followed over time. It includes information about the diagnostic work-up, medical treatment and community support (www.svedem.se). The patients are diagnosed and followed-up yearly in specialist units, primary care centres or in nursing homes. Results: The database was initiated in May 2007 and covers almost all of Sweden. There were 28 722 patients registered with a mean age of 79.3 years during 2007-2012. Each participating unit obtains continuous online statistics from its own registrations and they can be compared with regional and national data. A report from SveDem is published yearly to inform medical and care professionals as well as political and administrative decision-makers about the current quality of diagnostics, treatment and care of patients with dementia disorders in Sweden. Conclusion: SveDem provides knowledge about current dementia care in Sweden and serves as a framework for ensuring the quality of diagnostics, treatment and care across the country. It also reflects changes in quality dementia care over time. Data from SveDem can be used to further develop the national guidelines for dementia and to generate new research hypotheses.
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Smedback, Jonas, et al.
(författare)
Palliative care during the final week of life of older people in nursing homes : A register-based study
2017
Ingår i: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 15:4, s. 417-424
Tidskriftsartikel (refereegranskat) abstract
Objective: Our aim was to explore the presence of symptoms, symptom relief, and other key aspects of palliative care during the final week of life among older people residing in nursing homes. Method: Our study employed data from the Swedish Palliative Care Register on all registered individuals aged 60 and older who had died in nursing homes during the years 2011 and 2012. Variables pertaining to monitoring and treatment of symptoms, end-of-life discussions, circumstances around the death, and the individual characteristics of deceased individuals were explored using descriptive statistics. Results: The most common underlying causes of death among the 49,172 deceased nursing home residents were circulatory diseases (42.2%) and dementia (22.7%). The most prevalent symptom was pain (58.7%), followed by rattles (42.4%), anxiety (33.0%), confusion (21.8%), shortness of breath (14.0%), and nausea (11.1%). Pain was the symptom with the highest degree of total relief (46.3%), whereas shortness of breath and confusion were totally relieved in 6.1 and 4.3% of all individuals, respectively. The use of valid instruments for symptom assessment was reported for pain in 12.3% and for other symptoms in 7.8% of subjects. The most prevalent individual prescriptions for injection PRN (pro re nata, according to circumstances) were for pain treatment (79.5%) and rattles (72.8%). End-of-life discussions were performed with 27.3% of all the deceased individuals and with 53.9% of their relatives. Of all individuals, 82.1% had someone present at death, and 15.8% died alone. Of all the nursing home resident deaths recorded, 45.3% died in their preferred place. Significance of results: There were large variations in degree of relief from different symptoms during the final week of life. Pain was the most prevalent symptom, and it was also the symptom with the highest proportion of total/partial relief. Other symptoms were less prevalent but also less well-relieved. Our results indicate a need for improvement of palliative care in nursing home settings, focusing on management of distressing symptoms and promotion of end-of-life discussions.
