Development and feasibility testing of the mental status examination scale to assess functional status of young, hospitalized children in Pakistan

Abstract

BackgroundMood, cognitive and physical functioning have been widely studied in hospitalized pediatric patients. They fall under mental status examination (MSE). Even though there are several MSE scales, they need to be adapted to meet the needs of hospitalized children. ObjectiveThe purpose of this study was to describe the development and feasiblity of MSE tool to assess functional status of young children during hospitalization, explore and examine differences of criticalness of illness and age on MSE, before and after play stimulation intervention. MethodsThe Mental Status Examination Scale (MSE-S) was developed in five phases: identification of conceptual framework, item construction, training, testing for feasibility and piloting by trainees. The final tool of MSE-S comprised of a structured observational measure that assessed domains like speech, thought perception, insight, judgement, mood, and interaction. Scores of MSE-S were collected before and after intervention hence, both scores were considered independently (MSE-S Before and MSE-S After). ANOVA and two-way ANOVA was carried out to check the affect of criticalness of illness and age on MSE. Post-hoc analysis of Tukey was carried out to compare pair-wise group differences. Chi-square analysis was done on all the items of MSE-S for criticalness of illness. ResultsThe tool was assessed on 351 children aged between newborn to 6 years. Criticalness of illness was divided into intensive care, special care and acute care units. ANOVA revealed significant group differences before intervention (F (2,510) ​= ​10.0, p ​= ​0.000) and after intervention (F (2, 510) ​= ​12.7, p ​= ​0.000) for criticalness of illness and significant age group differences on MSE-S before intervention (F (2,520) ​= ​9.2, p ​= ​0.000) and MSE-S after intervention (F (2,520) ​= ​9.4, p ​= ​0.000). Two-way ANOVA showed significant difference between the interaction effect of criticalness of disease and age group on MSE-S before (F (8,498) ​= ​2.5, p ​= ​0.010) and MSE-S after (F (8,498) ​= ​3.2, p ​= ​0.002). ConclusionMSE-S can be feasibly used in an inpatient setting with children to make appropriate treatment plans.