Tool For Individual Assessment Research Articles

Development and Psychometric Evaluation of the Pain Assessment in Advanced Dementia (PAINAD) Scale

<h3>Objectives</h3> To develop a clinically relevant and easy to use pain assessment tool for individuals with advanced dementia that has adequate psychometric properties. <h3>Design</h3> Instrument development study using expert clinicians and behavioral observation methods. Measurement of sensitivity of the instrument to detect the effects of analgesic medications in a quality improvement activity. <h3>Setting</h3> Inpatient dementia special care units in a Veterans Administration Medical Center. <h3>Participants</h3> Nineteen residents with advanced dementia who were aphasic or lacked the ability to report their degree of pain and six professional staff members. Additionally, data from medical records of 25 residents who were receiving pain medications as required (PRN) were collected. <h3>Measurements</h3> Based on the literature review, related assessment tools and consultation with expert clinicians, a five-item observational tool with a range of 0 to 10 was developed. The tool, Pain Assessment in Advanced Dementia (PAINAD), was compared with the Discomfort Scale and two visual analog scales (discomfort and pain) by trained raters/expert clinicians in the development study, and used for detection of analgesic efficacy in a quality improvement activity. <h3>Results</h3> Adequate levels of interrater reliability were achieved between dyads of the principal investigator with each clinical research rater and between two raters. PAINAD had satisfactory reliability by internal consistency with a one factor solution. PAINAD and the Discomfort Scale–Dementia of Alzheimer Type (DS-DAT) were significantly correlated, providing evidence of construct validity. PAINAD detected statistically significant difference between scores obtained before and after receiving a pain medication. <h3>Conclusions</h3> The PAINAD is a simple, valid, and reliable instrument for measurement of pain in noncommunicative patients. Since the patient population used for its development and testing was limited to a relatively small number of males, further research is needed before it can be universally recommended.

Development and Psychometric Evaluation of the Pain Assessment in Advanced Dementia (PAINAD) Scale

To develop a clinically relevant and easy to use pain assessment tool for individuals with advanced dementia that has adequate psychometric properties. Instrument development study using expert clinicians and behavioral observation methods. Measurement of sensitivity of the instrument to detect the effects of analgesic medications in a quality improvement activity. Inpatient dementia special care units in a Veterans Administration Medical Center. Nineteen residents with advanced dementia who were aphasic or lacked the ability to report their degree of pain and six professional staff members. Additionally, data from medical records of 25 residents who were receiving pain medications as required (PRN) were collected. Based on the literature review, related assessment tools and consultation with expert clinicians, a five-item observational tool with a range of 0 to 10 was developed. The tool, Pain Assessment in Advanced Dementia (PAINAD), was compared with the Discomfort Scale and two visual analog scales (discomfort and pain) by trained raters/expert clinicians in the development study, and used for detection of analgesic efficacy in a quality improvement activity. Adequate levels of interrater reliability were achieved between dyads of the principal investigator with each clinical research rater and between two raters. PAINAD had satisfactory reliability by internal consistency with a one factor solution. PAINADthe Discomfort Scale-Dementia of Alzheimer Type (DS-DAT) were significantly correlated, providing evidence of construct validity. PAINAD detected statistically significant difference between scores obtained before and after receiving a pain medication. The PAINAD is a simple, valid, and reliable instrument for measurement of pain in noncommunicative patients. Since the patient population used for its development and testing was limited to a relatively small number of males, further research is needed before it can be universally recommended.

Development and Psychometric Evaluation of the Pain Assessment in Advanced Dementia (PAINAD) Scale

Objectives To develop a clinically relevant and easy to use pain assessment tool for individuals with advanced dementia that has adequate psychometric properties. Design Instrument development study using expert clinicians and behavioral observation methods. Measurement of sensitivity of the instrument to detect the effects of analgesic medications in a quality improvement activity. Setting Inpatient dementia special care units in a Veterans Administration Medical Center. Participants Nineteen residents with advanced dementia who were aphasic or lacked the ability to report their degree of pain and six professional staff members. Additionally, data from medical records of 25 residents who were receiving pain medications as required (PRN) were collected. Measurements Based on the literature review, related assessment tools and consultation with expert clinicians, a five-item observational tool with a range of 0 to 10 was developed. The tool, Pain Assessment in Advanced Dementia (PAINAD), was compared with the Discomfort Scale and two visual analog scales (discomfort and pain) by trained raters/expert clinicians in the development study, and used for detection of analgesic efficacy in a quality improvement activity. Results Adequate levels of interrater reliability were achieved between dyads of the principal investigator with each clinical research rater and between two raters. PAINAD had satisfactory reliability by internal consistency with a one factor solution. PAINAD and the Discomfort Scale–Dementia of Alzheimer Type (DS-DAT) were significantly correlated, providing evidence of construct validity. PAINAD detected statistically significant difference between scores obtained before and after receiving a pain medication. Conclusions The PAINAD is a simple, valid, and reliable instrument for measurement of pain in noncommunicative patients. Since the patient population used for its development and testing was limited to a relatively small number of males, further research is needed before it can be universally recommended. To develop a clinically relevant and easy to use pain assessment tool for individuals with advanced dementia that has adequate psychometric properties. Instrument development study using expert clinicians and behavioral observation methods. Measurement of sensitivity of the instrument to detect the effects of analgesic medications in a quality improvement activity. Inpatient dementia special care units in a Veterans Administration Medical Center. Nineteen residents with advanced dementia who were aphasic or lacked the ability to report their degree of pain and six professional staff members. Additionally, data from medical records of 25 residents who were receiving pain medications as required (PRN) were collected. Based on the literature review, related assessment tools and consultation with expert clinicians, a five-item observational tool with a range of 0 to 10 was developed. The tool, Pain Assessment in Advanced Dementia (PAINAD), was compared with the Discomfort Scale and two visual analog scales (discomfort and pain) by trained raters/expert clinicians in the development study, and used for detection of analgesic efficacy in a quality improvement activity. Adequate levels of interrater reliability were achieved between dyads of the principal investigator with each clinical research rater and between two raters. PAINAD had satisfactory reliability by internal consistency with a one factor solution. PAINAD and the Discomfort Scale–Dementia of Alzheimer Type (DS-DAT) were significantly correlated, providing evidence of construct validity. PAINAD detected statistically significant difference between scores obtained before and after receiving a pain medication. The PAINAD is a simple, valid, and reliable instrument for measurement of pain in noncommunicative patients. Since the patient population used for its development and testing was limited to a relatively small number of males, further research is needed before it can be universally recommended.

Food intake characteristics of hemodialysis patients as obtained by food frequency questionnaire

Objectives: Food frequency questionnaires (FFQ) are frequently used in epidemiologic studies of nutrition and food intake. However, the use of FFQs in patients receiving maintenance dialysis has not been extensively studied. We hypothesize that FFQ is a useful tool to assess the food intake differences between patients receiving dialysis and patients not receiving dialysis. Design: Matched exposed-unexposed study with case-controlled design. Setting: Outpatient dialysis unit affiliated with a tertiary-care community medical center. Patients: From a pool of 102 maintenance hemodialysis (MHD) outpatients in a community dialysis unit, 30 adult MHD outpatients (15 men, 15 women, aged 55.8 ± 14.6 years) were selected randomly as case subjects. They included 16 African Americans, 8 whites, 4 Hispanics, and 2 Asians. Eleven MHD patients took the multivitamin, Nephrovite (R&D Laboratories, Marina del Rey, CA), regularly. From an archive of 1,610 nondialytic individuals with known FFQ data, 30 control subjects were selected randomly to match the age, race, and sex of the case subjects. Intervention: We used Block's FFQ (version 98), an 8-page self-administered questionnaire that has been widely used in epidemiologic studies. A group of trained research assistants supervised the FFQ administration and interviewed those patients who were not able to answer all of the questions without assistance. Student t test was used to compare group means in form of daily dietary intake, and conditional logistic regression was used to calculate odds ratios for predetermined dichotomizing cutoff levels. Main outcome measures: Food intake characteristics of MHD patients as compared with control patients not receiving dialysis. Results: Statistically significant differences between MHD case subjects and nondialytic control subjects were observed between the amounts of daily intake for vitamin C (84 ± 63 mg/d v 127 ± 70 mg/d, P =.01), dietary fiber (12 ± 6 g/d v 18 ± 11 g/d, P =.02), potassium (2,024 ± 1,088 mg/d v 2,701 ± 1,429 mg/d, P =.04), cryptoxanthin (56 ± 88 μg/d v 140 ± 118 μg/d, P =.003), and lycopene (2,052 ± 2,234 μg/d v 4,524 ± 3,979 μg/d, P =.004). These data indicate that MHD patients had a significantly lower intake of vitamin C, dietary fibers, potassium, and 2 of the carotenoid compounds when compared with individuals not receiving dialysis. Moreover, the daily intake of vitamin B6 was significantly higher in MHD patients probably because of the high pyridoxine content in Nephrovite. By using the conditional logistic regression analysis, the odds ratios for lower than predetermined cutoff levels in patients receiving dialysis were significant for vitamin C, potassium, and the 2 previously mentioned carotenoids (odds ratio between 3.50 and 7.50, P <.05). Conclusions: Patients receiving dialysis may consume significantly lower amounts of potassium, vitamin C, and dietary fibers as well as lower amounts of some carotenoids. The FFQ seems to be a useful tool to compare dietary intake of MHD patients with other groups, although it may underestimate the amount of daily protein and energy intake and, hence, may not be an accurate tool for individual assessment of food intake. More studies are required to evaluate the validity of the FFQ in dialysis patients. The lower vitamin C, fiber, and carotenoid intake of MHD patients may be atherogenic. Hence, the hypothesis is proposed that prescribed restrictions in potassium in MHD patients may lead to reduced fruit and vegetable intake, leaving meat and fats as the main source of calories. This may contribute to atherosclerosis and increased cardiovascular morbidity and mortality in these patients. This hypothesis needs to be evaluated in future studies. © 2002 by the National Kidney Foundation, Inc.

The Functional Assessment of Dysphagia

The development of reliable and valid clinical assessment tools for individuals with ingestive skill loss is recognized as being of foremost importance. Yet, the concepts of reliability, validity and re sponsiveness are not widely understood or applied in this domain. The purpose of this review is to describe these concepts with particular em phasis on the selection of an appropriate clinical assessment tool for dysphagia.

An individual assessment technique for group projects in software engineering

Presents the history behind organising and assessing group projects in software engineering at Teesside Polytechnic. The article describes why the initial plan in 1987-88 was seriously deficient in the objective assessment of many of the desirable attributes of a good software engineer. It reviews how the method of setting and monitoring goals was overhauled to create a cost-effective structured learning environment, and how the industrial audit and review procedure was modified to become a tool for individual assessment and performance/learning feedback. Details of the goals and their assessment are given. >

Construction and Development of the Academic Motivations Inventory (AMI

This paper reports the early development of the Academic Motivations Inventory (AMI), a self-report measure of the academic motivations of college students. Content validation procedures and the reliability of items and scales suggest that AMI is at present a promising instrument for group measurement (e.g., to describe the predominant motivations of students in a course) and that it may become, through refinement of the scales, a useful tool for individual assessment.