Confidence Scale Research Articles

Key Modifiable Factors in Community Participation Among Adults With Lower Limb Amputation.

The aim of the study is to identify factors that may predict community participation among adults with lower limb amputation. This study is a secondary analysis of a cross-sectional data set, including 126 community-dwelling adults, ≥1 yr after unilateral transfemoral- ( n = 44; mean age = 59 ± 14 yrs) or transtibial-level amputation ( n = 82; mean age = 59 ± 14 yrs) seen in an outpatient limb loss clinic. Participation was assessed with the Community Integration Questionnaire. Factors, that is, demographics, comorbidities, prosthesis use per the Houghton Scale, Socket Comfort Score, assistive device use, falls history, and activity level per General Practice Physical Activity Questionnaire were evaluated. Moreover, balance confidence per the Activities-Specific Balance Confidence Scale, mobility per the Locomotor Capabilities Index, fast and self-selected gait speed per 10-meter walk tests, and functional mobility via Timed Up and Go were also included. Community participation was correlated with several factors ( P ≤ 0.050). Stepwise regression of correlated factors found absence of peripheral neuropathy and greater self-reported physical activity, balance confidence, and prosthesis use, as the strongest correlates, collectively explaining 50.1% of the variance in community participation post-lower limb amputation. Findings identify key modifiable factors for consideration in future prospective research seeking to enhance community reintegration and participation among adults living with a unilateral transfemoral- or transtibial-level amputation.

Development and Evaluation of an Innovative Neurology E-learning Didactic Curriculum for Psychiatry Residents.

This article describes the development, implementation, and piloting of an e-learning neuropsychiatry curriculum for psychiatry residents. The primary outcome of interest was feasibility. Secondary outcomes were interest and confidence caring for patients with neuropsychiatric disorders, and knowledge about neuropsychiatry. The curriculum was designed utilizing Kern's six-step framework. A ten-module, interactive, primarily vignette-based e-learning curriculum was developed focusing on the neurocognitive exam and neurocognitive disorders. The curriculum was piloted in two psychiatry residencies in Brooklyn, NY (n = 80 residents). The curriculum was evaluated using a survey adapted from the General Practitioner Attitudes and Confidence Scale for Dementia (GPACS-D) and a 24-item neuropsychiatry examination prior to the intervention and 1-month post-intervention. Qualitative feedback was acquired through four open-ended items in the post-curriculum survey, which underwent a thematic analysis. Seventy-eight of eighty residents completed the full curriculum. Three of nine attitude items demonstrated significant differences, with residents feeling less frustrated managing dementia (pre-mean = 2.32, post = 2.68, t(2,59) = 2.00, p = 0.004), less frustrated due to not knowing how to effectively treat dementia (pre-mean = 2.05, post = 2.95, t(2,59) = 6.27, p = 0.000), and demonstrating less interest in pursuing further training in neuropsychiatry (pre-mean = 1.95, post = 2.18, t(2,59) = 1.70, p = 0.047), though still overall showing interest. There was no change in confidence ratings. There was a small but significant improvement in total number of knowledge items answered correctly. This study demonstrated the feasibility of implementing an e-learning neuropsychiatry curriculum. It also demonstrated an improvement in resident responses to two attitude items and an increase in neuropsychiatry knowledge.

Stigma, confidence, attitudes, barriers and incentive factors in pharmaceutical care of patiens with depression in Lithuania: a protocol for a prospective 3 years follow-up study

IntroductionAccording to the WHO, approximately 280 million people in the world have depression. It is known that pharmacists are in an ideal position to offer proactive interventions to people with depression or depressive symptoms. However, pharmacists’ stigmatizing attitudes towards depression and patients with mental illness may decrease the quality of pharmaceutical care services provided to those patients. No research has been conducted on pharmaceutical care and pharmacists attitudes towards patients with depression in Lithuania.ObjectivesThe aim of the study is to evaluate stigma, confidence, attitudes, barriers and incentive factors in providing pharmaceutical care to patients with depression in Lithuania.MethodsThe prospective 3 years follow-up study will be carried out among the pharmacists in Lithuania. The sample size of 269 respondents is calculated. First of all, pharmacists will be provided with a training lecture by trained investigator (M.Z.) about depression and its pharmaceutical care. At the same day, after the lecture, pharmacists‘ stigma, confidendence, attitudes, barries and incentive factors in providing pharmaceutical care to patients with depression will be evaluated by 5 questionnaires:1.Participants will be asked to provide sociodemographic information included age, gender, years of practice, etc;2.The pharmacists’ stigma of patients with depression will be evaluated using eight likert-scale items that measure how patients with depression are perceived;3.Pharmacists’ attitudes toward depression will be evaluated using Depression Attitude Questionnaire;4.Pharmacists’ confidence in medication consultation for patients with depression will be evaluated using The Pharmacists’ Confidence scale about Medication Consultation for Depressive patients (PCMCD);5.A list of possible barries and incentive factors identified in the literature will be provided to pharmacists and they will be asked to choose as many barriers and incentive factors as they think are relevant.Next trainings lectures will be performed repeatedly at the month 6, 12, 18, 24, 30 and at the end of the study - month 36. Also, pharmacists‘ position will be re-evaluated after each training lecture by the same 5 questionnaires.The Lithuanian Bioethics Commitee approval is going to be received after the training program is confirmed (estimated time – the 1st quarter of 2023).ResultsStigma, confidence, attitudes, barriers and incentive factors in providing pharmaceutical care to patients with depression in Lithuania will be evaluated.ConclusionsConclusions will be drawn on stigma, confidence, attitudes, barriers and incentive factors in pharmaceutical care of patiens with depression in Lithuania. Also, practical recommendations will be introduced to The Ministry of Health of The Republic of Lithuania.Disclosure of InterestNone Declared

Teaching conflict management: An approach to increasing students' value, confidence, and ability

IntroductionThe primary aim was to explore how to effectively teach conflict management. We focused on three aspects of conflict management: (1) the value students place on conflict management, (2) their confidence in their ability to manage conflict, and (3) their skill in navigating conflict scenarios. MethodsThis approach to teaching conflict management included a consistent educational approach applied by three different instructors at two universities. The class session, provided to second-year student pharmacists, was designed to address ACPE Standards focused on students' conflict management skills. A Likert-style survey, administered pre- and post-classroom intervention, assessed three aspects of conflict management: value, confidence, and ability. The survey also included open-ended questions to explore students' perceptions of conflict management. ResultsAnalysis of pre- and post-intervention surveys found that 76 out of 83 students completed both surveys (91.5% response rate). Cronbach's alphas of the value, confidence, and ability scales were 0.82, 0.86, and 0.78, respectively, at pretest and 0.93, 0.86, and 0.90, respectively, at posttest. ConclusionsChanges in student beliefs regarding the value of conflict management, as well as their confidence in and ability to engage in a crucial conversation, were statistically significant after one classroom session.

TEST COMPLETION TIME, SUBJECT SCORES AND ACADEMIC SELF-EFFICACY. HOW DO THEY RELATE?

<p>Educators always endeavor to unravel the myriad of unexplained variables in learning environments. Examination taking is one such variable. Given the importance attached to examination results, educators seek answers as to why some students have shorter completion time than others and whether they end up scoring better than those who finish later. Is this phenomenon related to their levels of academic self-efficacy? This study set out to investigate the relationship between academic behavior confidence, test scores and test completion time. It was grounded on the self-efficacy theory by Albert Bandura. In an exam-taking situation, twenty-five early finishers and twenty-five late finishers were identified in a common unit examination in a public university in Kenya. They later filled out the Academic Behavior Confidence scale developed by Sander & Sanders (2019). The relationships between the completion time, the test scores on the common unit and their Academic Behavior Confidence scores were investigated using non-parametric approaches, specifically the Spearman’s rho and Mann-Whitney U test. Results show a significant difference between completion time and test scores. Paradoxically, there is no significant difference between completion time and ABC scores. However, there is a positive relationship between test scores and Academic Behavior Confidence scores. It is recommended that educators should use mastery experiences, verbal persuasion and vicarious experiences to enhance Academic Self-efficacy, which may, in turn, improve test scores.</p>.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0028/a.php" alt="Hit counter" /></p>

A non-randomized, controlled, interventional study to investigate the effects of community pharmacists’ cognitive behavioral therapy–based interventions on medication adherence and relevant indicators in patients with depression

BackgroundThe prevalence of depression is increasing in Japan. Pharmacists play an important role in helping patients use medicines effectively. Several studies had investigated the impact of community pharmacists on patient adherence to antidepressant therapy, and their results indicated that further study was warranted.MethodsThis study was conducted from June 2019 to May 2020 using a cluster non-randomized, open-label, parallel-group design. Four community pharmacy stores in Osaka and Hyogo Prefectures, Japan, participated in the study, and enrolled patients with unipolar depression. In the intervention group (IG), patients received cognitive behavioral therapy (CBT)-based medication support, and their medication adherence and adverse drug reactions were monitored by telephone. In the control group (CG), the pharmacists engaged in routine interactions with the study participants. Before participating in this study, the intervention-group pharmacists attended a 5-hour training session on CBT-based medication support. The primary outcome of this study was medication adherence, assessed using the Drug Attitude Inventory (DAI)-10. Secondary outcomes included the changes from baseline at 6 months in the following variables: the Patient Health Questionnaire (PHQ)-9 total score, the EQ-5D-5 L (Euro-QOL 5 dimensions 5 levels) score, patient satisfaction, and the Pharmacists’ Confidence Scale about Medication Consultation for Depressive Patients (PCMCD) score.ResultsFour pharmacies (two in IG and two in CG) completed the intervention period. Results were obtained from 19 patients in the IG and 12 patients in the CG. In the IG, the mean DAI-10 score increased from 4.941 at baseline to 6.105, the mean PHQ-9 score decreased from 9.263 to 8.625, and the mean patient satisfaction score increased from 39.947 to 42.211. In the CG, the mean DAI-10 score decreased from 6.333 to 4.167, the mean PHQ-9 score increased from 9.333 to 12.923, and the mean patient satisfaction score decreased from 38.929 to 38.167.ConclusionCBT-based medication support provided by community pharmacists may improve patient medication adherence to antidepressant therapy and symptoms. Such support can be expected to facilitate better treatment of depressed patients and may also allow the duration of treatment to be shortened.Trial registrationUMIN000037954, Date of first registration: 17/06/2019.

Psychometric properties of the Chinese (Cantonese) version of the Upper Extremity Functional Index in people with chronic stroke.

To culturally adapt and examine the psychometric properties of the Chinese (Cantonese) version of the Upper Extremity Functional Index (C-UEFI) in people with chronic stroke. Cross-sectional study. University-affiliated neurorehabilitation research laboratory. The participants (N = 151) were people with chronic stroke (N = 101) and healthy controls (n = 50). We assessed the C-UEFI, Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT), Six-Minute Walk Test (6MWT), Motor Activity Log (MAL), Activity-Specific Balance Confidence (ABC) scale, Lawton Instrumental Activities of Daily Living (IADL) scale, Survey of Activities and Fear of Falling in the Elderly (SAFFE), Stroke Impact Scale (SIS) and Community Integration Measure (CIM) as outcome measures. The C-UEFI items demonstrated good test-retest reliability (intraclass correlation coefficient [ICC]3, 1 = 0.872) and excellent internal consistency (Cronbach's α = 0.922). People with chronic stroke had poorer C-UEFI scores than the healthy controls. The overall C-UEFI mean score of 101 people with stroke was significantly correlated with the mean scores of the FMA-UE, WMFT, MAL, ABC scale, IADL scale, SAFFE, SIS and CIM and the distance covered in the 6MWT. The C-UEFI cut-off score to distinguish between people with chronic stroke and healthy older adults according to upper extremity function was 57.5 out of 59 (sensitivity: 88.1%; specificity: 84%). The C-UEFI had good content validity, with an acceptable fit to the two-factor structure model. The C-UEFI is reliable and valid for assessing functional recovery of upper extremity activity in Chinese people with chronic stroke.

School Nurse Confidence with Diabetes Devices in Relation to Diabetes Knowledge and Prior Training: A Study of Convergent Validity.

The Diabetes Device Confidence Scale (DDCS) is a new scale designed to evaluate school nurse confidence with diabetes devices. We hypothesized that DDCS score would be associated with related constructs of school nurse diabetes knowledge, experience, and training. In a cross-sectional study, we co-administered the DDCS and Diabetes Knowledge Test 2 (DKT2) questionnaires to school nurses in Pennsylvania. We summarized DDCS scores (range 1-5) descriptively. We evaluated the relationship between DKT2 percent score and DDCS mean score with the Spearman correlation coefficient. Simple linear regression examined school nurse characteristics as predictors of DDCS score. A total of 271 completed surveys were received. Mean DDCS score was 3.16±0.94, indicating moderate confidence with devices overall. School nurses frequently reported low confidence in items representing specific skills, including suspending insulin delivery (40%), giving a manual bolus (42%), knowing when to calibrate a continuous glucose monitor (48%), changing an insulin pump site (54%), and setting a temporary basal rate (58%). Mean DKT2 score was 89.5±0.1%, which was weakly but not significantly correlated with DDCS score (r=0.12, p=0.06). Formal device training (p<0.001), assisting ≥5 students with diabetes devices in the past 5 years (p<0.01), and a student caseload between 1000-1500 students (p<0.001) were associated with higher mean DDCS score. DDCS score is related to prior training and experience, providing evidence for the scale's convergent validity. The DDCS may be a useful tool for assessing school nurse readiness to use devices and identify areas to enhance knowledge and practical skills.

Mobility related confidence level in chronic stroke patients through task oriented walking intervention

Introduction&#x0D; Stroke is a neurological insufficiency caused by cerebrovascular injury resulting in major motor deficits in lower limbs. Different therapeutic interventions are being used for stroke rehabilitation. Task oriented walking intervention is a unique approach used for stroke rehabilitation. This research work was planned to study the effects of Task-Oriented walking Interventions on improving the mobility related confidence level in chronic stroke patients.&#x0D; Method&#x0D; This randomized control trial study was conducted on 48 stroke patients in hospital settings. Informed consent was taken from all the study participants before inclusion in the study population and the data from the study subjects was collected through a specially designed questionnaire, 06 minutes-walk test (6MWT), Timed "Up and Go" test (TUG), and Activity-specific Balance Confidence (ABC) Scale. The study population was randomly divided into two groups as experimental group and control group. Experimental group received Task-Oriented Walking Interventions and conventional treatment while control group received conventional interventions only.&#x0D; Results&#x0D; On statistical analysis, significant improvement in mobility related confidence level for all the three scales TUG, ABC and 6MWT was observed on experimental group as compared to the control group after six weeks of interventions.&#x0D; Conclusion&#x0D; The study concluded that task oriented walking interventions is an effective approach for improving mobility related confidence level in post stroke patients.&#x0D; Keywords: Task oriented training, Mobility related confidence, Stroke, Activity-specific Balance Confidence Scale

Contrast-enhanced Mammography-guided Biopsy: Initial Trial and Experience.

Evaluate lesion visibility and radiologist confidence during contrast-enhanced mammography (CEM)-guided biopsy. Women with BI-RADS ≥4A enhancing breast lesions were prospectively recruited for 9-g vacuum-assisted CEM-guided biopsy. Breast density, background parenchymal enhancement (BPE), lesion characteristics (enhancement and conspicuity), radiologist confidence (scale 1-5), and acquisition times were collected. Signal intensities in specimens were analyzed. Patient surveys were collected. A cohort of 28 women aged 40-81 years (average 57) had 28 enhancing lesions (7/28, 25% malignant). Breast tissue was scattered (10/28, 36%) or heterogeneously dense (18/28, 64%) with minimal (12/28, 43%), mild (7/28, 25%), or moderate (9/28, 32%) BPE on CEM. Twelve non-mass enhancements, 11 masses, 3 architectural distortions, and 2 calcification groups demonstrated weak (12/28, 43%), moderate (14/28, 50%), or strong (2/28, 7%) enhancement. Specimen radiography demonstrated lesion enhancement in 27/28 (96%). Radiologists reported complete lesion removal on specimen radiography in 8/28 (29%). Average time from contrast injection to specimen radiography was 18 minutes (SD = 5) and, to post-procedure mammogram (PPM), 34 minutes (SD = 10). Contrast-enhanced mammography PPM was performed in 27/28 cases; 13/19 (68%) of incompletely removed lesions on specimen radiography showed residual enhancement; 6/19 (32%) did not. Across all time points, average confidence was 2.2 (SD = 1.2). Signal intensities of enhancing lesions were similar to iodine. Patients had an overall positive assessment. Lesion enhancement persisted through PPM and was visible on low energy specimen radiography, with an average "confident" score. Contrast-enhanced mammography-guided breast biopsy is easily implemented clinically. Its availability will encourage adoption of CEM.

Cross sectional study on the competence and confidence of dental students and graduates in the management of medically compromised patients and acute medical emergencies.

A rapidly aging population means many people have multiple health issues leading to an increased risk of acute medical emergencies. The objective of this study was to evaluate how essential experiential learning is in developing dental graduates' ability to manage medically compromised patients. Three hundred and twenty-seven students and graduates were invited to participate in an online survey to rate their confidence in managing medically compromised patients and acute medical emergencies using a 5-point Likert scale. Competence of knowledge was evaluated using 30 multiple choice questions (MCQs) across six domains. The respondents were also asked whether a theory-only training adequately prepared them to manage medically compromised patients, or whether it must be supplemented with clinical training. Two-hundred and sixty-four responses were collected from 75 undergraduates (UG), 96 junior dental officers (JDO) and 93 senior dental officers (SDO). The UG reported that they infrequently managed medically compromised patients, whereas both the JDO and SDO reported having frequent encounters with these patients. The mean confidence scale in the management of medically compromised patients were 2.62, 3.50 and 3.69 (out of 5), respectively. In contrast, their confidence scale in the management of acute medical emergencies was 2.05, 2.33 and 2.50 (out of 5), respectively. The MCQ scores were 25.51, 26.44 and 26.86 out of 30, respectively. The outcomes of the JDO and SDO were significantly better than the UG (t-tests, p<0.05). All three groups responded that a theory-only training in dental school did not adequately prepare them to manage medically compromised patients. Both the JDO and SDO felt that their clinical work experience better prepared them to manage these patients. Experiential learning from "real-life" clinical experience is an essential component in developing graduates' confidence and competence in the management of medically compromised patients. A dental curriculum with theory-only training in this aspect is inadequate.

Modifying the five-time sit-to-stand test to allow use of the upper limbs: Assessing initial evidence of construct validity among lower limb prosthesis users.

The Five-time Sit-to-Stand (5xSTS) Test is a performance-based measure used by clinicians and researchers to assess the body functions needed to accomplish sit-to-stand transitions (e.g., lower limb strength, balance, and trunk control). The current requirements for performance of the 5xSTS Test (i.e., crossing arms over the chest) may not be appropriate for many, if not most lower limb prosthesis (LLP) users. The study aims were to (1) develop a modified five-time sit-to-stand (m5xSTS) Test protocol; (2) to examine initial evidence of known-groups construct validity among LLP users by comparing differences in performance by amputation level, amputation etiology, and functional level; and (3) to assess initial evidence of convergent construct validity by examining the correlations between m5xSTS performance with self-reported mobility (Prosthetic Limb Users Survey of Mobility (PLUS-M)), self-reported balance confidence (Activities-balance Confidence Scale (ABC)) and functional capability (comfortable walking speed). Three-hundred sixty-one LLP users participated in this cross-sectional study. The investigators developed a m5xSTS Test protocol that allows tested individuals to use different assistance strategies (i.e., use of upper limbs to push off thighs, push up from the armrests, or use a walker) when needed to perform the test. The investigators recorded m5xSTS Test times and assistance strategies. Significant differences in m5xSTS Test times were found between those who did and did not use an assistance strategy, as well as between participants grouped by different amputation level, etiology, and functional level. Significant moderate negative correlations were found between m5xSTS Test times and PLUS-M T-score (ρ = -0.42, p<0.001), ABC score (ρ = -0.42, p<0.001), and comfortable walking speed (ρ = -0.64, p<0.001), respectively. The m5xSTS Test allows LLP users to perform sit-to-stand transitions in a manner that accounts for their functional impairments, is consistent with post-amputation training, and is safe for the tested individual. Results from this study provide preliminary evidence of known groups and convergent construct validity for the m5xSTS Test with a large national sample of LLP users.

Reliability and validity of the Arabic version of the modified falls efficacy scale

Purpose The purpose of this study was to adapt Modified Falls Efficacy Scale (MFES) into Arabic and determine the reliability and validity of the instrument. Materials and methods The study was conducted in two phases: (i) translation and adaptation by the systematic approach of the ‘forward-back’ translation method and (ii) psychometric testing of the Arabic version of the Modified Falls Efficacy Scale among 207 community-dwelling older adults (≥ 60 years). Results The Arabic version of the Modified Falls Efficacy Scale demonstrated excellent internal consistency (Cronbach’s alpha = 0.98) and test–retest reliability scores (ICC = 0.96, 95% CI; 0.95–0.97). And also showed strong correlations with both the Falls Efficacy International (r = −0.82) and the activities-specific Balance Confidence Scale (r = 0.87). Sampling adequacy for factor analysis was proven by a Kaiser–Meyer–Olkin value of 0.962. Goodness-of-fit (GFI) statistics for the model were in the acceptable range (Chi-Square/Degree of Freedom (CMIN/DF) = 2.59, Goodness-of-fit index (GFI) = 0.9, Comparative Fit Index (CFI) = 0.97, Root Mean Square Error of Approximation (RMSEA) = 0.79). Conclusion The Arabic version of the Modified Falls Efficacy Scale has demonstrated excellent psychometric qualities to measure the level of fear of falling.

Psychometric evaluation of critical incident video instruments for nursing education

Abstract The Critical Incident Video (CIV) Project is a mixed method longitudinal study that uses CIVs to prepare nursing faculty members to address common teaching challenges. CIVs are short videos that present unresolved teaching challenges. Given the lack of specific instruments for evaluating the usefulness of CIVs, the aim of this phase of the project was to develop and test two instruments measuring the pedagogical effects of CIVs. The CIV Preparation and Confidence Scale (CIVPCS©) and the CIV Simulation Experience Scale (CIVSES©) were assessed for validity and reliability. Using a Delphi method, a convenience sample of 23 nurse educators provided feedback enhancing the validity and clarity of the CIVPCS©. Reliability of the CIVPCS© was determined using Cronbach’s alpha and test-retest method. No changes were recommended for the CIVSES©. Findings from the assessment of these newly developed CIV instruments are reported and implications for faculty development are discussed.

Association between balance confidence and basic walking abilities in people with unilateral transtibial lower-limb amputations: A cross-sectional study.

Falls are common for people with lower-limb amputations (PLLA). Low balance confidence is also prevalent, is worse in PLLA not reporting walking automaticity, and is known to negatively affect prosthesis use, social engagement, and quality of life. Moreover, walking with a prosthesis requires continuous attention. Low balance confidence may act as a distractor imposing an additional cognitive load on the already cognitively demanding task of walking with a prosthesis. Adults with unilateral, transtibial amputations were recruited. The Activities-specific Balance Confidence (ABC) scale quantified balance confidence. The L Test assessed basic walking abilities under single-task (ST) (usual) and dual-task (DT) (walking while counting backwards) conditions. The relative change in gait and secondary task performance between conditions (ie, DT cost) was calculated. Separate multivariable linear regressions examined the association of balance confidence on the L Test. Forty-four PLLA (56.6 ± 12.6 years) participated. An independent association of the ABC to ST ( P < 0.001, R 2 = 0.56) and DT ( P = 0.008, R 2 = 0.43) L Test performance was observed. A 1% ABC increase was related with a 0.24 (95% confidence interval, 0.35-0.14) and 0.23 (95% confidence interval, 0.39-0.06) second reduction with the ST and DT L Test, respectively. No association to DT cost was observed. Balance confidence influences basic walking abilities yet does not modulate the added cognitive load associated with DT. Interventions that address balance confidence may be beneficial throughout rehabilitation. This research is novel and offers the possibility for alternative avenues for focus in rehabilitation and falls prevention in a population at high risk for falls.

Karitane Parenting Confidence Scale: measuring parenting self-efficacy in Portuguese mothers during the first year postpartum

ABSTRACT Background The Karitane Parenting Confidence Scale (KPCS) was designed to assess parenting self-efficacy in parents of infants during the first year. Objective The aim of this study was to analyse the psychometric characteristics of the KPCS in Portuguese mothers during the first-year postpartum. Methods A sample of 383 mothers were recruited at two public outpatient units in Northern Portugal. Mothers completed the KPCS, a sociodemographic questionnaire, and measures of depressive and anxiety symptoms at least one time between two weeks, three, six and 12 months postpartum. Results Good fit was found for a factor model with three subscales: parenting, support and child development. The KPCS presented good internal consistency. Regarding the criterion validity of the KPCS, significant effects of mother’s age were found on the development subscale and significant associations were found between mother’s depressive and anxiety symptoms and the KPCS total scale and subscales. Optimal clinical cut-offs were suggested. Conclusion Findings provided evidence on the psychometric characteristics of the KPCS which can be used to assess parenting self-efficacy in Portuguese mothers during the first-year postpartum, possibly identifying mothers with low parenting self-efficacy.

Effects of Home-Based Boxing Training on Trunk Performance, Balance, and Enjoyment of Patients With Chronic Stroke.

To investigate the effect of 6 weeks of home-based boxing training on trunk performance, balance, fear of falling, and level of therapy enjoyment in individuals with chronic stroke. Eighteen participants with chronic stroke were randomly divided into boxing and control groups (9 patients per group). The boxing group received home-based boxing training for 25 minutes plus balance and trunk exercise training for 15 minutes, while the control group received only home-based balance and trunk exercise training for 40 minutes, three days a week for 6 weeks. The Trunk Impairment Scale (TIS), Mini-Balance Evaluation Systems Test (Mini-BESTest), Activities-specific Balance Confidence (ABC) scale, and Physical Activity Enjoyment Scale (PACES) were assessed at baseline, and at 2, 4, and 6 weeks post-training. The Wilcoxon signed rank test and Mann-Whitney U-test were used to determine differences between pre- and post-training within and between groups. Statistical significance was set at p<0.05. The TIS scores significantly increased from 13 to 17 points in the boxing group (p<0.05) compared to an increase from 15 to 17 points in the control group (p<0.05). The Mini-BESTest scores significantly increased from 14 to 22 points in the boxing group (p<0.05) compared to an increase from 17 to 20 points in the control group (p<0.05). There were no differences in the TIS, Mini-BESTest, ABC, and PACES scores between the two groups. Home-based boxing training with balance and trunk exercise training had a similar training effect compared to home-based balance and trunk exercise training.

Predictors of incident reversible and potentially reversible cognitive frailty among Taiwanese older adults

BackgroundFew studies emphasize on predictors of incident cognitive frailty (CF) and examine relationships between various gait characteristics and CF. Therefore, we conducted a 2-year prospective study to investigate potential predictors, including gait characteristics, of incident reversible CF (RCF) and potentially RCF (PRCF) among Taiwanese older adults.MethodsEligible participants were individuals aged ≥ 65 years, who could ambulate independently, and did not have RCF/PRCF at the baseline. The baseline assessment collected information on physical frailty and cognitive measures, in addition to sociodemographic and lifestyle characteristics, preexisting comorbidities and medications, gait characteristics, Tinetti’s balance, balance confidence as assessed by Activities-specific Balance Confidence (ABC) scale, and the depressive status as assessed by the Geriatric Depression Scale. The Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale, and Digit Symbol Substitution Test were used to evaluate cognitive functions. Incident RCF and PRCF were ascertained at a 2-year follow-up assessment.ResultsResults of the multinomial logistic regression analysis showed that incident RCF was significantly associated with older age (odds ratio [OR] = 1.05) and lower ABC scores (OR = 0.97). Furthermore, incident PRCF was significantly associated with older age (OR = 1.07), lower ABC scores (OR = 0.96), the presence of depression (OR = 3.61), lower MMSE scores (OR = 0.83), slower gait velocity (OR = 0.97), and greater double-support time variability (OR = 1.09).ConclusionsIncident RCF was independently associated with older age and lower balance confidence while incident PRCF independently associated with older age, reduced global cognition, the presence of depression, slower gait velocity, and greater double-support time variability. Balance confidence was the only modifiable factor associated with both incident RCF and PRCF.

The Dynamic Interplay of Objective and Subjective Balance and Subsequent Task Performance: Implications for Fall Risk in Older Adults

Introduction: Falls occur in daily life when an activity results in a loss of balance that is too great to recover from. Our purpose in this study was to examine how fall risk differentiates the dynamic interplay of objective and subjective balance on a given day and subsequent task performance on that day. Methods: For 30 consecutive days, following a baseline fall risk assessment, 41 older adults (56% female, Age M = 75.22, SD = 6.75) self-assessed balance and task performance using a smartphone. The Activity-specific Balance Confidence scale measured subjective balance. Postural sway and chair-stand performance were measured within a smartphone using accelerometry. Data were analyzed using multilevel random coefficient models. Results: Tests of heterogeneity in level one residuals showed day-to-day variability in balance confidence and postural sway to be greater in individuals with higher fall risk at baseline. Baseline fall risk differentiated how the interplay of balance confidence and postural sway on a given day related to chair-stand performance on that day. For those with higher fall risk, on days that balance confidence was higher, greater postural sway was followed by greater chair-stand performance. Conclusion: Findings indicate that older adults, especially those with higher fall risk, may be unaware of subtle fluctuations in balance, which could lead to engaging in activities that exceed the capacity to maintain balance at that moment. Fall prevention efforts should address older adults’ understanding of and responses to fluctuations of physical function in daily life.

Psychometric Properties of the Short Version of the Activities-Specific Balance Confidence Scale in Vestibular Patients.

This study aimed to analyze the psychometric properties of the Activities-specific Balance Confidence Scale Short Version (ABC-6) in vestibular patients. The sample consisted of 87 subjects aged over 18 years with vestibular pathology. Construct validity, internal consistency, test-retest reliability, concurrent validity, and capacity to discriminate between subjects with or without risk of falling as measured with the ABC-16 standard version were analyzed. The ABC-6 showed a unifactorial structure. Cronbach's alpha was 0.873. The reliability was moderate for each of the items and substantial for the total score (intraclass correlation coefficient = 0.778). The standard error of measurement was 10.24, with a minimum detectable change of 20.07. The ABC-6 version showed a strong correlation with physical and functional measures, moderate correlation with emotional measures, and poor correlation with the Physical Component Summary of SF-12 and retrospective 12-month falls. A cutoff point ≤55 showed a sensitivity = 94.44% and a specificity = 92.75% in differentiating between patients with or without risk of falling measured with the ABC-16 standard version, with an area under the curve = 0.975. The ABC-6 showed acceptable psychometric properties for measuring balance confidence and risk of falling in vestibular patients.