Assessment Schedule Research Articles

Structural Model of Personality Traits and Illness Perception with Functional Disability in Functional Somatic Syndromes in Patients with Coronary Artery Disease Based on the Mediating Role of Self-Care Behavior

Objective: Heart diseases, including coronary artery disease, are among the three main causes of death alongside cancer and stroke in most countries. The current study aimed to predict functional disability in functional somatic syndromes in patients with coronary artery disease based on personality traits and illness perception, considering the mediating role of self-care behavior. Methods and Materials: This study, with applied objectives and a correlational research design, was conducted using the structural equation modeling approach. The statistical population included all patients with coronary artery disease in the city of Amol in the year 2022, from which 250 individuals were purposefully selected. Data collection tools included the World Health Organization Disability Assessment Schedule (2014), the McCrae and Costa Personality Traits Questionnaire (1985), the Illness Perception Questionnaire (2006), and the Self-Care Questionnaire (2003). The statistical technique used was structural equation modeling with full latent variables. SPSS version 26, AMOS version 24, and R version 4.2.0 software were used for statistical data analysis. Findings: The results showed that all five personality dimensions, illness perception, and self-care significantly explain the variance in functional disability (P<0.01). Additionally, the mediating role of self-care behavior was significant in the relationship between functional disability and four personality dimensions: extraversion, openness to experience, agreeableness, conscientiousness, and illness perception (P<0.01). Conclusion: It can be concluded that functional disability in functional somatic syndromes in patients with coronary artery disease can be predicted based on their personality traits and illness perception, taking into account the mediating role of self-care behavior.

HEART Rate Variability Biofeedback for LOng COVID Dysautonomia (HEARTLOC): Results of a Feasibility Study.

Post-COVID-19 syndrome, or Long Covid (LC) refers to symptoms persisting 12 weeks after the COVID-19 infection. LC comprises a wide range of dysautonomia symptoms, including fatigue, breathlessness, palpitations, dizziness, pain and brain fog. This study tested the feasibility and estimated the efficacy, of a Heart Rate Variability Biofeedback (HRV-B) programme via a standardised slow diaphragmatic breathing technique in individuals with LC. LC patients underwent a 4-week HRV-B intervention for 10 minutes twice daily for 4 weeks using the Polar H10 ECG (Electrocardiogram) chest strap and Elite HRV phone application. Outcome measures C19-YRSm (Yorkshire Rehabilitation Scale modified), Composite Autonomic Symptom Score (COMPASS-31), WHO Disability Assessment Schedule (WHODAS), EQ5D-5L (EuroQol 5 Dimensions) and Root Mean Square of Successive Differences between heartbeats (RMSSD) using a Fitbit device were recorded before and after the intervention. The study was pre-registered at clinicaltrials.gov NCT05228665. A total of 13 participants (54% female, 46% male) completed the study with high levels of independent use of technology, data completeness and intervention adherence. There was a statistically significant improvement in C19YRS-m (P = .001), COMPASS-31 (P = .007), RMSSD (P = .047), WHODAS (P = .02) and EQ5D Global Health Score (P = .009). Qualitative feedback suggested participants could use it independently, were satisfied with the intervention and reported beneficial effects from the intervention. HRV-B using diaphragmatic breathing is a feasible intervention for LC. The small sample size limits generalisability. HRV-B in LC warrants further exploration in a larger randomised controlled study.

Research Progress in the Study of the World Health Organization Disability Assessment Schedule 2.0 for Perioperative Applications

Research Progress in the Study of the World Health Organization Disability Assessment Schedule 2.0 for Perioperative Applications

Pharmacotherapy guideline concordance for major depressive disorder and its link to functioning via symptom change

Abstract Introduction: Alleviation of symptom severity for major depressive disorder (MDD) is known to be associated with a lagged improvement of functioning. Pharmacotherapy guidelines support algorithms for MDD treatment. However, it is currently unclear whether concordance with guidelines influences functional recovery. A guideline concordance algorithm (GCA-8) was used to measure this pathway in a naturalistic clinical setting. Methods: Data from 1403 adults (67% female, 84% non-Hispanic/Latino White, mean age of 43 years) with nonpsychotic MDD from the Penn State Psychiatry Clinical Assessment and Rating Evaluation System registry (visits from 02/01/2015 to 04/13/2021) were evaluated. Multivariable linear regression measured associations between GCA-8 and World Health Organization Disability Assessment Schedule 2.0 (WHODAS) scores. Mediation by MDD symptom severity using the Patient Health Questionnaire depression module (PHQ-9) was also evaluated. Results: This study found a statistically significant improvement in WHODAS scores (functioning) between baseline and final measures (−2 points, P < .001) within one year. A one standard deviation increase in the GCA-8 score was associated with a 0.48-point reduction in mean disability score (total effect; P = .02) with significant mediation by the change in MDD symptom severity (coefficient = −0.51, P < .001) and a nonsignificant natural direct effect of the GCA-8 independent of PHQ-9 change (coefficient = −0.02, P = .92). Conclusions: Higher pharmacotherapy guideline concordance is associated with better functioning for MDD patients; this association likely occurs through improvement in MDD symptom severity rather than directly.

Integrated Psychological Rehabilitation Program on Neurocognition, Social Skill, and Functional Disability in Persons with Schizophrenia: A Pilot Study

Abstract Introduction: Schizophrenia, a chronic and severe mental disorder, is characterized by disruptions in thinking, perception, emotions, and behavior. These disturbances are accompanied by significant cognitive and social skill deficits that affect their functional outcomes encompassing employment, independent living, social interactions, and community integration. To address these issues, the development of psychological rehabilitation programs addressing cognitive and social skill deficits becomes pivotal in schizophrenia care. Objective: The study was designed to develop modules for the integrated psychological rehabilitation program (IPRP) that focus on neurocognitive functions, social skills, and functional disability and evaluate its feasibility among schizophrenia patients. Materials and Methods: The present study made use of a pre- and posttest research design and used purposive sampling to recruit patients diagnosed with schizophrenia. Twelve participants completed the 1-month IPRP along with the pre- and posttest evaluations encompassing cognitive functions, social skills, and disability using the Bender Gestalt Test, Social Skills Assessment Screening Scale, NIMHANS neuropsychology battery, Postgraduate Institute Memory Scale, and WHO Disability Assessment Schedule II. IPRP consisted of psychoeducation, cognitive retraining, and social skills training. Results: The majority of the participants were college educated (91.7%), unemployed (83.3%), single (75%), males (75%), residing in urban areas (66.7%), and living in joint family (66.7%). Wilcoxon signed-rank test was used to compare pre- and posttest means. The results found significant improvements in various cognitive domains, including visuospatial ability (Z = 2.43, P = 0.015), remote (Z = 2.12, P = 0.034) and immediate memory (Z = 2.04, P = 0.042), verbal retention for similar (Z = 2.26, P = 0.024) and dissimilar pairs (Z = 2.82, P = 0.005), recognition (Z = 2.14, P = 0.032), total memory (Z = 3.06, P = 0.002), mental speed in terms of time taken (Z = 2.98, P = 0.003) and errors made (Z = 2.26, P = 0.024) on the digit symbol substitution test, comprehension (Z = 2.84, P = 0.004), social skills (Z = 2.807, P = 0.005), and overall disability (Z = 2.94, P = 0.003). Conclusion: The findings from the study underscore the potential of the IPRP in mitigating cognitive deficits, enhancing social skills, and reducing overall disability among schizophrenia patients.

Interplay of Chronic Diseases, Disability, and Depression Among Saudi Arabian Patients: A Cross-sectional Analysis

Chronic diseases are a leading cause of disability and mental health issues globally, with significant implications for healthcare systems and patient well-being. In Saudi Arabia, the prevalence of chronic conditions is rising, but the comprehensive interplay between chronic diseases, disability, and depression remains underexplored. This study aims to examine the relationships between chronic diseases, disability, and depression among Saudi Arabian patients, providing insights that can inform healthcare policies and interventions to improve patient outcomes. A cross-sectional survey was conducted in Riyadh, Saudi Arabia, from March to May 2024. The study included 381 patients with one or more chronic diseases. Data were collected using standardized questionnaires that assessed the number of chronic diseases, level of disability (measured using the World Health Organization Disability Assessment Schedule), and depression (assessed using the Patient Health Questionnaire-9). Regression analysis was used to evaluate the factors contributing to depression and to establish the correlation between chronic diseases, disability, and depression. The analysis revealed a direct association between the number of chronic diseases and the level of disability experienced by the participants (P < 0.01). Patients with multiple chronic conditions (P = 0.000; Beta = 0.456; 95% confidence interval = 0.272-0.422) reported higher levels of disability, significantly impacting their daily functioning. The Pearson correlation analysis revealed a significant positive correlation between the number of chronic illnesses and the severity of disability (P < 0.01). Additionally, our study identified a significant correlation (P < 0.05) between increased depression and higher levels of disability among participants. Patients with higher disability scores exhibited more severe depressive symptoms, indicating a compounded effect on mental health. This study provides critical insights into the significant impact of chronic diseases on disability and mental health among Saudi Arabian patients. The findings highlight the compounded challenges faced by patients with multiple chronic conditions and underscore the intertwined nature of physical and mental health. Addressing the complex interplay of sociodemographic and health-related factors can enable healthcare systems to better meet the needs of this vulnerable population, ultimately improving their quality of life and health outcomes.

Effectiveness of group problem management plus in distressed Syrian refugees in Türkiye: a randomized controlled trial.

Despite high levels of psychological distress, mental health service use among Syrian refugees in urban settings is low. To address the mental healthcare gap, the World Health Organization developed group problem management plus (gPM+), a scalable psychological intervention delivered by non-specialist peer facilitators. The study aimed to evaluate the effectiveness of gPM+ in reducing symptoms of depression and anxiety among Syrian refugees in Istanbul, Türkiye. A randomized controlled trial was conducted among 368 distressed (Kessler Psychological Distress Scale, K10 > 15) adult Syrian refugees with impaired functioning (World Health Organization Disability Assessment Schedule, WHODAS 2.0 > 16). Participants were recruited between August 2019 and September 2020 through a non-governmental organization providing services to refugees. Participants were randomly allocated to gPM+ and enhanced care as usual (gPM+/E-CAU) (184 participants) or E-CAU only (184 participants). Primary outcomes were symptoms of depression and anxiety (Hopkins Symptom Checklist (HSCL-25)) at 3-month follow-up. Secondary outcomes were post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5; PCL-5), functional impairment (WHODAS 2.0), and self-identified problems (psychological outcome profiles). Intent-to-treat analyses showed no significant effect of gPM+ on symptoms of anxiety, depression, PTSD and self-identified problems. Yet, there was a significant reduction in functional impairment in gPM+/E-CAU compared to E-CAU at 3-month follow-up (adjusted mean difference 1.66, 95 % CI 0.04, 3.27, p = 0.045, d = 0.19). Post-hoc subgroup analyses among participants with probable baseline depression or anxiety showed that there was a small but significant reduction in depression (adjusted mean difference -0.17, 95 % CI -0.32, -0.02, p = 0.028, d = 0.27) and anxiety (adjusted mean difference -0.21, 95 % CI -0.37, -0.05, p = 0.009, d = 0.30) symptoms comparing gPM+/E-CAU to E-CAU only at 1-week post assessment, but not at 3-month follow-up. There was a significant difference between conditions on functional impairment at 3-month follow-up, favouring gPM+/E-CAU condition (adjusted mean difference -1.98, 95 % CI -3.93, -0.02, p = 0.048, d = 0.26). In this study in an urban setting in Türkiye, gPM+ did not alleviate symptoms of depression and anxiety among Syrian refugees experiencing psychological distress and daily living difficulties. However, participants with higher distress at baseline seemed to benefit from gPM+, but treatment gains disappeared in the long term. Current findings highlight the potential benefit of tailored psychosocial interventions for highly distressed refugees in volatile low-resource settings.

Testing How Reliable and Accurate the Persian Version of the WHO Disability Assessment Schedule II is for People With Mental Health Issues

Testing How Reliable and Accurate the Persian Version of the WHO Disability Assessment Schedule II is for People With Mental Health Issues

To Assess Caregiver Burden of Patients with Dementia: Its Sociodemographic and Clinical Correlates

Background and Aim: To assess the primary caregiver burden in the patients of dementia. Dementia is a chronic neurodegenerative disorder that refers to a disease process marked by progressive cognitive impairment in clear consciousness. The morbidities associated with dementia accounts for the poor quality of life. Equally affected are caregivers of these patients. The study aims to assess the caregiver burden (CGB) and how the care of these patients affect them. This further includes sociodemographic and clinical features of the caregivers. Materials and Methods: The cross-sectional study was conducted from June 2021 to May 2022 in the Department of Psychiatry, MGM medical college, Indore (M.P.) after approval from the institutional ethical committee. The study included 60 patients and 60 caregivers attending Psychiatry outpatient department (OPD). They were assessed using a semi-structured proforma consisting of socio-demographic and clinical variables. Clinical rating scale i.e., burden assessment schedule (BAS) was applied for caregivers and dementia severity rating scale (DSRS) for the patients. Pearson's and Spearman's correlation coefficient was applied with P-value < 0.05 considered as significant. Result: The study finds that the mean age of the caregiver is 55.6 ± 10.01 years and that of patient is 69.81± 0.71 years. The mean BAS score is 68.3 ± 11.77. A negative correlation is established between BAS and income of the caregiver and is statistically significant (P < .001), while a positive correlation between BAS and age, number of hospitalization, total duration of illness, and the mean of time spent with the patient during the day and is statistically significant (P < .001). Factors like low income, advancing age, and time spent with the patients in the caregivers had affected the BAS score, and the score was found to be raised. Factors related to the patients affecting the BAS score was total duration of illness and number of hospitalization. Both factors played a key role in the addressed the overall care burden among the caregivers. Conclusion: Factors such as low income, advancing age, and time spent with the patients in the caregivers had affected the BAS score, and the score was found to be raised. Factors related to the patients affecting the BAS score was the total duration of illness and number of hospitalization. Both factors played a key role in the addressed the overall care burden among the caregivers.

Efficacy of telerehabilitation with digital and robotic tools for the continuity of care of people with chronic neurological disorders: The TELENEURO@REHAB protocol for a randomized controlled trial.

Chronic Neurological Disorders (CNDs) are among the leading causes of disability worldwide, and their contribution to the overall need for rehabilitation is increasing. Therefore, the identification of new digital solutions to ensure early and continuous care is mandatory. This protocol proposes to test the usability, acceptability, safety, and efficacy of Telerehabilitation (TR) protocols with digital and robotic tools in reducing the perceived level of disability in CNDs including Parkinson's Disease (PD), Multiple Sclerosis (MS), and post-stroke patients. This single-blinded, multi-site, randomized, two-treatment arms controlled clinical trial will involve PD (N = 30), MS (N = 30), and post-stroke (N = 30). Each participant will be randomized (1:1) to the experimental group (20 sessions of motor telerehabilitation with digital and robotic tools) or the active control group (20 home-based motor rehabilitation sessions according to the usual care treatment). Primary and secondary outcome measures will be obtained at the baseline (T0), post-intervention (T1, 5 weeks after baseline), and at follow-up (T2, 2 months after treatment). a multifaceted evaluation including quality of life, motor, and clinical/functional measures will be conducted at each time-point of assessment. The primary outcome measures will be the change in the perceived level of disability as measured by the World Health Organization Disability Assessment Schedule 2.0. The implementation of TR protocols will enable a more targeted and effective response to the growing need for rehabilitation linked to CNDs, ensuring accessibility to rehabilitation services from the initial stages of the disease.

Factors Influencing Social and Community Participation of People with Spinal Cord Injury in Karnataka, India.

Social and community participation are major indicators to assess the adequacy of treatment and rehabilitation in patients with spinal cord injury (SCI). This study examined the relationship between functional independence, level of disability, and social and community participation among people with SCI in India. In this cross sectional study, 110 persons with SCI, aged 18 years and above participated in a community setting, in Karnataka, India. Spinal Cord Independence Measure Version III-self-reporting (SCIM III-SR), Craig Handicap Assessment and Reporting Technique (CHART), and WHO Disability Assessment Schedule 2.0 (WHODAS) were the clinical outcome measures. Spearman's correlation and stepwise multiple linear regression were done to determine association and identify the factors determining the community participation of people with SCI. CHART physical independence had a positive correlation with SCIM self-care (R = 0.446) and SCIM mobility (r = 0.434). CHART cognitive independence (R = -0.38) and CHART mobility (R = -0.396) had a weak correlation with WHODAS. SCIM self-care and SCIM mobility (R2 = 0.34) were determinants of CHART cognitive independence. SCIM respiratory and sphincter management and SCIM self-care (R2 = 0.327) were determinants of CHART mobility. Self-care and mobility of people with SCI determine their ability to successfully reintegrate into the community, warranting a comprehensive community rehabilitation program.

Protocol for a comparative cross-sectional study on characterisation of auditory impairment in sickle cell disease and sickle cell trait and its impact on health-related quality of life in Nigeria

IntroductionSickle cell disease (SCD) and sickle cell traits (SCT) are genetically inherited red blood cell disorders common among people of African descent. Nigeria has a high prevalence of SCD, with...

Risk assessment and optimal scheduling of serial projects

The valuation and planning of complex projects are becoming increasingly challenging with rising market uncertainty and the deregulation of many industries, which have also raised the need for efficient risk management. We take the perspective of a private firm interested in sequential capacity expansion of a project and develop a framework for measuring the downside risk of the serial project and optimising the sequence of the stages. Under general distributional assumptions for the duration of each stage, we present an accurate representation of the project’s net present value (NPV) distribution based on a Pearson curve fit, leading to closed-form expressions for the associated risk measures. We then assess the impact of duration variability on the value at risk and demonstrate its role in stochastic project scheduling. We also account for the trade-off between maximising the expected NPV and minimising the risk exposure, and obtain the optimal schedule for risk-averse decision-makers. It becomes obvious that both the duration variability of each stage and the decision-makers’ risk preferences can significantly affect the optimal sequence of the stages and that high duration variability is not always undesirable, even for risk-averse decision-makers.

Validating the COVID Check-In: A co-produced online platform enabling integrated care for people with Long COVID

Introduction: ‘Long COVID’ describes the sustained and debilitating symptoms experienced by many people following acute COVID-19 infection. This study builds on previous work by Deakin University and the Western Health COVID-19 Recovery Collaboration (WHCOVRE). In this previous work, a team of 4 health researchers and 6 consumers with Long COVID co-designed the COVID Recovery (or DisCOVeRY) model of care. This model provides a framework for appropriate and effective care by providing an integrated pathway that incorporates existing community supports, tailored to individual consumer need. Consumers receive a comprehensive biopsychosocial assessment using a co-designed patient rated outcome measure (PROM) called the ‘COVID Check-In’ (CCI), the World Health Organisation Disability Assessment Schedule (WHODAS-36), EQ-5D and the 100-point Goal Attainment Scale (GAS). Assessment outcomes determine which clinical stream is offered – self-managed (DisCOVeRY-SM) or intensive rehabilitation (DisCOVeRY-IR).
 Aim: The aim of this project was to validate the automated component of DisCOVeRY-SM for people with Long COVID. Is the CCI a valid, reliable, relevant and accessible Patient Rated Outcome Measure (PROM) for people with Long COVID?
 Methods: A quantitative descriptive approach was adopted, providing a psychometric analysis of the validity of the CCI. The CCI was delivered using “Platform O”; a flexible online research tool developed at Deakin University to meet both end-user and researcher needs. The interactive content builder fully integrates with questionnaire applications, online video platforms, animated content, and third-party interactive applications. “Platform O” also includes engagement tools (e.g., star ratings, personalised reminders) and security features to support user testing, continuous quality improvement and communication between end-users and the project team.
 All Australians meeting the World Health Organisation case description of Long COVID aged over 18 years were eligible to participate. For divergent validity analysis, a separate sample of Australians diagnosed with chronic fatigue syndrome (CFS) aged over 18 years were also eligible to participate. Participants were invited to complete the comprehensive baseline assessment outcome measures only on a single occasion on Platform O. Brief ‘pop’ up questions about the comprehensiveness, relevance and comprehensibility of the CCI were included to evaluate content validity. Correlations between CCI scores, WHODAS-36, EQ-5D and the GAS assessed convergent validity. While Long COVID and chronic fatigue syndrome share some symptoms, they are distinctive syndromes whose differences were used to assess divergent validity.
 Results: The face and construct validity of the CCI was tested in a small sample (n=20) at Western Health. Further validation is currently underway (n=260 consumers) to ensure its quality prior to broader scale up of the DisCOVeRY-SM, and these results will be reported in this conference paper. 
 Conclusion: The CCI is the first co-produced PROM for people with Long COVID, and specifically reflects their needs and priorities. Rigorous validation of this measure will support its broader dissemination both within and outside of Australia, to enable people with this syndrome to receive integrated, high quality and individually tailored care.

THE ASSOCIATION OF URINARY INCONTINENCE AND DISABILITY AMONG A DIVERSE SAMPLE OF MID-LIFE SWAN WOMEN

Abstract Few studies have examined the prospective association between urinary incontinence (UI) and disability in midlife women. We assessed associations between UI type, frequency and amount with reported disablity in a racially/ethnically diverse cohort of community dwelling midlife women. Data was from longitudinal analyses of questionnaires from the multi-center, prospective cohort Study of Women’s Health Across the Nation. We used multivariable ordinal logistic regression to examine if UI type, frequency and amount at the 13th follow-up were associated with the World Health Organization Disability Assessment Schedule (WHODAS) at the 15th follow-up (controlling for other factors, e.g. menopause status, body mass index, lifestyle and psychosocial factors) and disability at Follow-up 13. UI was associated with subsequent reports of disability in participants, particularly in the WHODAS domains of mobility, communication, and societal participation. Associations were strongest for mixed UI type compared to stress UI or urge UI, daily frequency of UI compared to monthly or weekly, and larger amounts of urine leakage compared to drops of leakage. UI appears had a strong association with multiple domains of disability in midlife women after two years of follow-up. It is important for clinicians to address UI earlier in symptom onset. Screening for mixed UI and UI that occurs more frequently and it larger amounts, more specifically, may yield better information regarding a patient’s future disability risk.

Relationship of life expectancy with quality of life and health-related hope among Japanese patients receiving home medical care: The Zaitaku Evaluative Initiatives and Outcome Study

Spiritual care for patients’ quality of life (QOL) and hope should be included in home medical care for patients with limited life expectancy. This study aimed to analyze the associations between estimated life expectancy, QOL, and hope among patients receiving home medical care in Japan. This multicenter cross-sectional study involved 29 home medical care facilities in Japan. Patients were categorized by estimated life expectancy, as assessed by home medical care physicians. The outcomes were QOL measured via the Quality-of-Life Scale for Elderly Patients Receiving Professional Home Care (QOL-HC: higher score indicates better QOL), the domain scores of health-related hope (“health,” “role and connectedness,” and “something to live for”; higher scores indicate higher levels of hope), and life functioning measured using the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0; higher score indicates worse functioning and disability). QOL-HC scores were significantly higher in patients with shorter life expectancy (< 6 m vs. ≥ 1 y, adjusted mean differences: 0.7 points [95%CI 0.1 to 1.3]). Regarding health-related hope, “something to live for” scores were associated with shorter life expectancy (< 6 m vs. ≥ 1 y, -17.7 points [-34.2 to -1.2]), whereas “role and connectedness” scores did not change remarkably with shorter life expectancy (< 6 m vs. ≥ 1 y, -3.3 points [-16.4 to 9.8]). Furthermore, shorter life expectancy was associated with higher WHODAS 2.0 scores (< 6 m vs. ≥ 1 y, 19.6 points [4.3 to 34.8]). Home medical care physicians who engage in spiritual care should facilitate thoughtful dialogue with their patients by recognizing declines in life functions and hope for fulfilment, which are associated with short life expectancy.

Supplemental Material for Confirmatory Factor Analysis of the 12-Item World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) Within the Clubhouse Model of Psychosocial Rehabilitation for Serious Mental Illness

Supplemental Material for Confirmatory Factor Analysis of the 12-Item World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) Within the Clubhouse Model of Psychosocial Rehabilitation for Serious Mental Illness

Confirmatory factor analysis of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) within the clubhouse model of psychosocial rehabilitation for serious mental illness.

The Clubhouse model (CM) for serious mental illness is a recovery-oriented and member-driven program that aims to facilitate functional recovery. Efficacy evaluation of the CM is limited by lack of uniform functional disability assessment. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) is a widely accepted measure of functional disability, but its psychometric properties have yet to be examined within the CM. This research sought to confirm the generic six-factor structure of the 12-item WHODAS-2.0 using retrospective administrative data from 339 adults with serious mental illness from an accredited Clubhouse. A second-order confirmatory factor analysis was conducted, followed by secondary known-groups analyses to examine whether the WHODAS-2.0 differentiates between subgroups with varying degrees of disability. The WHODAS-2.0 demonstrated good overall reliability. The generic six-factor structure produced nonsignificant loadings due to lack of independence between the "participation" and "getting along" factors. The items of these two factors were combined into a five-factor model, which displayed excellent fit, with all significant paths and adequate-to-strong loadings, and no correlation among errors. The WHODAS-2.0 significantly differentiated members by receipt of public assistance, employment status, and number of medical comorbidities, supporting construct validity. These results provide initial support for the use of the 12-item WHODAS-2.0 as a CM-related outcome measure and encourage future research of the full 36-item version. The intentional community approach of the CM is unique and may require adjustments to the factor structure of the WHODAS-2.0 by merging the "participation" and "getting along" domains. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Investigation of the relationship between oral motor feeding development and gross motor development between preterm and term infants at 10- to 12-month postnatal age

BackgroundImmature central nervous system, extended stay in the neonatal intensive care unit, and sensory experience deficiency may contribute to oral and gross motor delay in preterm infants. Current study aimed to investigate oral and motor development in preterm infants.MethodsTwenty-nine preterm infants and 28 term infants were evaluated within the scope of the study. Oral motor feeding development was assessed with the Schedule for Oral Motor Assessment, and motor development was evaluated with the Alberta Infant Motor Scale. All analyses were performed using SPSS 22. The study was approved by the Gazi University Clinical Researches Ethics Committee (no: 25901600–23).ResultsThere was a correlation between the Schedule for Oral Motor Assessment categories (solid, semisolid, cracker, puree, bottle, and cup) and the Alberta Infant Motor Scale score (p < 0.05). There was a significant difference between groups in the Schedule for Oral Motor Assessment’s solid, semisolid, cracker, and puree categories and total score (p < 0.05). There was a significant difference between groups regarding the Alberta Infant Motor Scale score (p < 0.05).ConclusionPreterm infants come behind their term peers in motor and oral motor feeding performance. These two areas of development can influence each other. For this reason, oral motor feeding problems should be emphasized as well as motor problems in physiotherapy rehabilitation evaluations.

Refinement and Validation of the Empowerment Audiology Questionnaire: Rasch Analysis and Traditional Psychometric Evaluation.

Empowerment is the process through which individuals with hearing-related challenges acquire and use knowledge, skills and strategies, and increase self-efficacy, participation, and control of their hearing health care, hearing solutions, and everyday lives. The aim was to refine and validate the Empowerment Audiology Questionnaire (EmpAQ), a hearing-specific measure of empowerment. This was achieved through (1) refinement via Rasch analysis (study 1), and (2) traditional psychometric analysis of the final survey structure (study 2). In study 1, 307 adult hearing aid owners completed the initial empowerment measure (33 items) online. To inform an intended item reduction, Rasch analysis was used to assess a range of psychometric properties for individual items. The psychometric properties included analysis of individual items (e.g., response dependency, fit to the polytomous Rasch model, threshold ordering) and the whole EmpAQ (e.g., dimensionality). Item reduction resulted in a 15-item version (EmpAQ-15) and a short-form 5-item version (EmpAQ-5), validated using modern (Rasch), and traditional (Classical Test Theory) psychometric analysis (study 2). In study 2, 178 adult hearing aid owners completed the EmpAQ-15 and EmpAQ-5, alongside 5 questionnaires to measure related constructs. These included two hearing-specific questionnaires (Social Participation Restrictions Questionnaire and Self-Assessment of Communication), two general health-related questionnaires (Patient Activation Measure and World Health Organization Disability Assessment Schedule 2.0), and a general empowerment questionnaire (Health Care Empowerment Questionnaire). Modern (Rasch) and traditional psychometric analysis techniques (internal consistency, construct validity, and criterion validity) were used to assess the psychometric properties of the EmpAQ-15 and EmpAQ-5. Rasch analysis of the initial 33-item measure of empowerment identified 18 items with high response dependency, poor fit to the Rasch model, and threshold disordering, which were removed, resulting in a long-form (EmpAQ-15) hearing-specific measure of empowerment. A short-form (EmpAQ-5) version was developed for use in the clinic setting. Validation of the two EmpAQ measures using Rasch analysis showed good item fit to the Rasch model, appropriate threshold targeting, and the existence of unidimensionality. Traditional psychometric evaluation showed that both questionnaires had high internal consistency and positive correlations with the hearing-specific questionnaires. However, in contrast with our hypotheses, correlations with general health questionnaires were stronger than with hearing-specific questionnaires; all questionnaires were correlated with the EmpAQ and in the direction hypothesized. Taken together, these findings support the construct validity of the EmpAQ-15 and EmpAQ-5. The EmpAQ-15 and EmpAQ-5 are the first self-report measures to be developed specifically for the measurement of empowerment. The EmpAQ-15 and EmpAQ-5 were found to meet the Rasch model criteria for interval-level measurements. Traditional psychometric evaluation supports the construct validity of both measures. The EmpAQ measures have the potential to be used in both research and clinical practice to evaluate empowerment along the hearing journey. The next stage of this research will be to further validate these measures by assessing their responsiveness, minimal clinically important difference, and clinical interpretability in a clinical population.