Dichotomous Scale Research Articles

Predicting Physics Students’ Achievement Using In-Class Assessment Data: A Comparison of Two Machine Learning Models

Data is the primary source to scaffold physics teaching and learning for teachers and students, mainly reported through in-class assessment. Machine learning (ML) is an axis of artificial intelligence (AI) study that immensely attracts the development of physics education research (PER). ML is built to predict students’ learning that can support students’ success in an effective physics achievement. In this paper, two ML algorithms, logistic regression and random forest, were trained and compared to predict students’ achievement in high school physics (N = 197). Data on students’ achievement was harvested from in-class assessments administered by a physics teacher regarding knowledge (cognitive) and psychomotor during the 2020/2021 academic year. Three assessment points of knowledge and psychomotor were employed to predict students’ achievement on a dichotomous scale on the final term examination. Combining in-class assessment of knowledge and psychomotor, we could discover the plausible performance of students’ achievement prediction using the two algorithms. Knowledge assessment was a determinant in predicting high school physics students’ achievement. Findings reported by this paper recommended open room for the implementation of ML for educational practice and its potential contribution to supporting physics teaching and learning.

Subspecialized breast pathologists have suboptimal interobserver agreement in Ki-67 evaluation using 20% as the cutoff.

Ki-67 expression levels in breast cancer have prognostic and predictive significance. Therefore, accurate Ki-67 evaluation is important for optimal patient care. Although an algorithm developed by the International Ki-67 in Breast Cancer Working Group (IKWG) improves interobserver variability, it is tedious and time-consuming. In this study, we simplify IKWG algorithm and evaluate its interobserver agreement among breast pathologists in Ki-67 evaluation. Six subspecialized breast pathologists (4 juniors, 2 seniors) assessed the percentage of positive cells in 5% increments in 57 immunostained Ki-67 slides. The time spent on each slide was recorded. Two rounds of ring study (R1, R2) were performed before and after training with the modified IKWG algorithm (eyeballing method at 400× instead of counting 100 tumor nuclei per area). Concordance was assessed using Kendall's and Kappa coefficients. Analysis of ordinal scale ratings for all categories with 5% increments showed almost perfect agreement in R1 (0.821) and substantial in R2 (0.793); Seniors and juniors had substantial agreement in R1 (0.718 vs. 0.649) and R2 (0.756 vs. 0.658). In dichotomous scale analysis using 20% as the cutoff, the overall agreement was moderate in R1 (0.437) and R2 (0.479), among seniors (R1: 0.436; R2: 0.437) and juniors (R1: 0.445; R2: 0.505). Average scoring time per case was higher in R2 (71 vs. 37s). The modified IKWG algorithm does not significantly improve interobserver agreement. A better algorithm or assistance from digital image analysis is needed to improve interobserver variability in Ki-67 evaluation.

Aplikasi Teknologi Augmented Reality untuk Media Pembelajaran Olahraga Renang

Swimming is a popular water sport, but the current learning process still relies on traditional printed books. To enhance the learning experience of this sport, this study aims to create and develop learning materials that use augmented reality technology. The research applies the waterfall software engineering method, which includes analysis, system design, implementation, and testing. During the analysis stage, observational data and questionnaires are collected to determine the application's scope. The system design stage includes conceptual design in the form of use cases and physical design in interface design. The design implementation phase is carried out using Unity 3D. The testing phase involves testing the feasibility of media and products using dichotomous scales and black box testing. Our research shows that augmented reality technology can be used as a tool for learning swimming sports. Our tests showed that the product feasibility is 94.7% and media feasibility is 95%. This proves that the application is highly feasible according to media experts and user respondents. The results of black box testing also show that the functionality of the system has been responsive, accurate, compatible, and successful to run all menus and features. Thus, this application can be distributed to be used as a medium for learning swimming sports.

Development and Item Analysis of a Self-Reporting Instrument to Capture Children's Knowledge and Behaviours on Zoonotic-Related Diseases from Household Pets

Zoonotic infections, which can develop into life-threatening conditions, should not be taken lightly. Despite the rising number of pet owners, knowledge of zoonotic diseases and children's behaviour when associating with pets at home remains limited. In Malaysia, few studies have investigated children's knowledge of zoonotic diseases and personal hygiene practices while caring for pets at home. Therefore, this focused on item development, validation, and analysis to assess content validity, acceptability, and contribution to internal consistency for age appropriateness among children. A pre-validation questionnaire was validated on two primary domains, knowledge, and behaviour, by subject matter experts (SME) specialising in zoonoses. A total of 66 children were selected to answer 14 dichotomous scale questions, with the responses subjected to further analysis. The post-validation process was performed by assessing the item suitability for the target group. Several items in the instrument should be modified. Meanwhile, some items should be retained due to the significance in evaluating the knowledge of disease transmission among children. The rationale underlying this modification stemmed from prior research findings and expert feedback. The final self-reporting instrument, Cognitive Affective Behaviours – Institute for Health Behavioural Research- Zoonoses Children-01 (CAB-IHBR-Zoonoses C-01), includes 10 items with adequate content coverage, acceptable qualities, and favourable expert reviews.

Translation and validation study of the Indonesian version of the practice environment scale of the nursing work index

ObjectivesThis study aimed to translate and validate the Practice Environment Scale - Nursing Work Index (PES-NWI) among nurses in Indonesia. MethodsA scale translation and cross-sectional validation study was conducted. The English version was translated into Indonesian, which involved five steps: forward translation, compare the translation, backward translation, compare the translation, and pilot testing with a dichotomous scale (clear or unclear). Thirty inpatient department nurses were involved in checking readability and understandability. A cross-sectional study was conducted from August to October 2022 at 17 hospitals across Indonesia, involving 350 nursing professionals. The validity test included structural validity and convergent validity. The internal consistency reliability was tested by Cronbach’s α coefficient, item-total correlation, and composite reliability. ResultsConfirmatory factor analysis (CFA) showed an acceptable fit. The correlation of all dimensions was between 0.70 and 0.88, and all items had item loading higher than 0.6. Convergent validity of each dimension ranged from 0.61 to 0.74, internal consistencies with Cronbach’s α coefficient was 0.97, corrected item-to-total correlation ranged from 0.62 to 0.85, and composite reliability of each dimension was higher than 0.89. ConclusionsGood homogeneity and construct validity have been demonstrated for the Indonesian version of the PES-NWI, nursing management can use it to measure the work environment.

Competitiveness of Fruits' and Vegetables' Exports from India

"The study aims to evaluate the competitiveness of selected fruits and vegetables in India by using four revealed comparative advantage (RCA) indices from 2001 to 2019 based on International Trade Centre (INTRACEN) database. The results revealed that out of 25 selected fruits and vegetable products, only seven product groups namely onion fresh, cucumber & gherkin, dried vegetables, cooked or uncooked vegetables, cashewnut shelled, guava & mango and tamarind showed comparative advantage in all the RCA indices. While other fruits and vegetables exhibited comparative disadvantage in a few RCA indices. To measure the consistency across different measures of RCAs, the study used three consistency tests, namely, cardinal, ordinal, and dichotomous tests. The findings indicate that the four indices exhibit greater consistency when measured as an ordinal scale, while showing less consistency when measured as cardinal or dichotomous scales. Moreover, stability of these indices was also revealed in the analysis. The study also suggested specific strategies to boost fruits and vegetables products’ exports."

Validated checklist for assessing communication skills in undergraduate medical students: bridging the gap for effective doctor-patient interactions.

Communication skills are fundamental in healthcare, but assessing them among medical students presents challenges. In the Indian context, the lack of a specific assessment tool further compounds the issue. Thus this study aimed to develop and validate an observation-based communication skills checklist tailored to Phase I Bachelor of Medicine and Bachelor of Surgery (MBBS) students. The checklist was developed using both inductive and deductive approaches and underwent rigorous testing to ensure its reliability and validity. After piloting, the finalized version was administered to 84 Phase I MBBS students. Results indicated a critical content validity ratio of 0.78, face validity of 0.80, and an impressive Cronbach's alpha of 0.91, indicating good internal consistency and reliability of the checklist. The students scored over 80% in all checklist domains, except for empathy (73%) and support (74%), highlighting areas for potential improvement. Nonetheless, about 75% of students expressed satisfaction with the checklist's communication skills assessment. The feedback from faculty members was positive, as they found the checklist was easy to use, quick, and effective for evaluating communication skills. Consequently, the checklist's introduction has been well received by both students and faculty. In conclusion, the developed checklist proves to be an effective and valid instrument for assessing communication skills in Phase I MBBS students. By integrating this tool into observed station clinical examinations, medical educators can comprehensively evaluate students' communication behaviors. Moreover, the checklist serves as a valuable resource for bridging the gap between theoretical knowledge and practical application, enabling future physicians to excel in doctor-patient interactions, a crucial aspect of patient-centered care.NEW & NOTEWORTHY This article presents a highly unique and novel approach by introducing a structured checklist for communication skill assessment in medical students. Its rigorous validation process ensures reliability and effectiveness, while its adaptation to sociocultural norms highlights its relevance and applicability. The user-friendly design with a single-page layout and dichotomous scale further enhances its practicality in objective structured clinical examinations. The developed checklist equips educators with a valuable resource to assess and improve students' communication abilities.

Predictive Value of In-Program Academic Variables for Future Clinical Education Performance in Physical Therapist Education: An Exploratory Study

Introduction. The purposes of this study were to (1) explore the relationship of preclinical assessment outcomes and grade point averages (GPAs) with full-time clinical education experience (CEE) performance and (2) determine the predictive value of associated variables to full-time CEE performance. Review of Literature. In-program academic variables such as performance tests, comprehensive examinations, and GPAs reflect a measure of student performance before clinical education. Limited and conflicting physical therapist education research exists examining the relationship between preclinical in-program academic variables and CEE performance. Subjects. A retrospective convenience sample of 130 graduated PT student academic records with expected graduation years of 2018, 2019, and 2020. Methods. Academic records related to performance test outcomes, cumulative program GPAs, utilization of a practical retake appeal policy, and comprehensive examination performance were correlated with CEE performance. A dichotomous ordinal rating scale quantified CEE performance per full-time experience based on the presence of a learning contract. Overall CEE performance was defined as the percentage from the combined CEE performance scores across all experiences. Data analyses included Pearson's correlation coefficient, Spearman's rho, and a multiple linear regression analysis. Results. Ten of 25 course-specific performance tests had significant associations with CEE performance. Cumulative GPA and the practical retake appeal were significantly associated with the CEE III score and overall CEE performance. The practical retake appeal was a significant contributor to clinical performance, explaining 5.3% of the variance (β = 0.24, P = .01, 95% CI 0.01 to 0.09, part correlation = 0.23, tolerance = 0.91). Discussion and Conclusion. These findings support the use of performance tests as an effective assessment strategy before CEEs but only represent one aspect of the full picture of readiness to practice. Academic progression policies can offer a mechanism for early identification to support at-risk students before the CEEs.

A mindfulness-oriented psycho-behavioral intervention for patients with acute coronary syndrome: A pilot study

BackgroundPeople frequently experience physical and psychological challenges (e.g., depression and anxiety) and high risk of poor prognosis after an acute coronary event. Mindfulness-based intervention holds promise as an effective approach to promoting health and well-being. ObjectivesTo explore the feasibility, acceptability, and potential effects on psychological distress, cardiovascular risk factors and health-related quality of life of a mindfulness-oriented psycho-behavioral intervention for patients with acute coronary syndrome. MethodsWe conducted a pilot randomized controlled trial to test the feasibility, acceptability and potential effects of the intervention in 50 patients with acute coronary syndrome. The intervention included six weekly sessions, including one face-to-face session and five WeChat-delivered sessions that incorporated mindfulness training with health education and lifestyle modification. Eligible patients were recruited in two public hospitals in China and randomly allocated into the intervention group (n = 25) or control group (n = 25). ResultsIntervention feasibility was supported by a relatively high recruitment rate (66.7%) and retention rate (84%) and a smooth and brief data collection procedure (15 to 25 min) of the pilot study. Positive responses of the acceptability dichotomous scale ranged from 81% to 100%, suggesting the intervention was generally acceptable. The intervention had a significant group × time effect on dietary behavior (B = 0.31,95% CI: 0.08, 0.54, P = 0.008) with an effect size (Cohen's d) of -0.72. ConclusionsThe mindfulness-oriented psycho-behavioral intervention appears to be feasible and acceptable and have a promising effect on dietary behavior in patients with acute coronary syndrome. A fully powered randomized controlled trial is warranted to further assess the efficacy of the intervention. Trial registration: Chinese Clinical Trial Registry, No., ChiCTR2000033526.

Patient-reported outcomes for bone regenerative procedures.

Evidence-based dentistry used for decision-making and assessment of treatment includes three components: evidence from the literature, clinical expertise, and patient expectations. Patient satisfaction embraces affability, availability, and ability and can be examined using questionnaires or structured questions to the patient to evaluate patient perception of the treatment. The questions can be quantified using dichotomous, point, or visual analog scales. This would be a straightforward patient-reported outcome measure (PROM). Validated and specific oral health-related quality of life (OHRQoL) questionnaires such as the oral health impact profile (OHIP), oral impact on daily performance (OIDP), or the dental impact on daily living (DIDL) can be used as PROMs, and these measures are appropriate for population studies, where you can measure changes over time and differences between treatment groups. PROMs have shown to enhance patient engagement when integrated into clinical care. PROMs for bone regenerative procedures are mainly used as secondary outcome and are concentrating on the prosthetic outcome more than the pain, discomfort, anxiety, and cost of the surgical procedures. Surprisingly, most patients are satisfied and willing to have the procedures performed again. Whether this is recall bias or not and how the information's from the dentist and the team influence the patients answers to PROMs questionnaires are discussed. The importance of patient perspectives in bone regeneration procedures is obvious and combined with clinical outcome measures, it increases our ability to provide better care. Studies using PROMs as a primary outcome variable are required.

Social media use for medicine information seeking behaviour among undergraduate students via the prism of the innovation decision process

Purpose: To assess the level of adoption of social media for medical information-seeking behaviour (MISB) among students of Obafemi Awolowo University, Nigeria based on the prism of Roger’s innovation-decision process theory.
 Methods: The study was a cross-sectional survey of 429 students. Primary data were collected with a set of questionnaires comprising two main sections which sought to elicit information, first, on the adoption level of social media for medicine information employing a Likert-type scale with five alternative responses and weighting scores of 1 - 5, and second, on use of social media for MISB on a dichotomous (yes/no) scale. Collected data were analysed with descriptive and inferential statistics at 5 % level of significance.
 Results: The results show that adoption of social media tools for sourcing medicine information among the students was at a persuasion level (MWA 2.10) and correlates with the finding on the dichotomous scale that they were barely (28.7 %) using the tools.
 Conclusion: Social media for medicine information-seeking among students of OAU have not been effectively adopted and their use is infrequent. Furthermore, studies on the use of social media may be better assessed using the innovation-decision theory process model rather than a simple dichotomous scale.

The Geometry of Misinformation: Embedding Twitter Networks of Users Who Spread Fake News in Geometrical Opinion Spaces

To understand why internet users spread fake news online, many studies have focused on individual drivers, such as cognitive skills, media literacy, or demographics. Recent findings have also shown the role of complex socio-political dynamics, highlighting that political polarization and ideologies are closely linked to a propensity to participate in the dissemination of fake news. Most of the existing empirical studies have focused on the US example by exploiting the self-reported or solicited positioning of users on a dichotomous scale opposing liberals with conservatives. Yet, left-right polarization alone is insufficient to study socio-political dynamics when considering non binary and multi-dimensional party systems, in which relevant ideological stances must be characterized in additional dimensions, relating for example to opposition to elites, government, political parties or mainstream media. In this article we leverage ideological embeddings of Twitter networks in France in multi-dimensional opinions spaces, where dimensions stand for attitudes towards different issues, and we trace the positions of users who shared articles that were rated as misinformation by fact-checkers. In multi-dimensional settings, and in contrast with the US, opinion dimensions capturing attitudes towards elites are more predictive of whether a user shares misinformation. Most users sharing misinformation hold salient anti-elite sentiments and, among them, more so those with radical left- and right-leaning stances. Our results reinforce the importance of enriching one-dimensional left-right analyses, showing that other ideological dimensions, such as anti-elite sentiment, are critical when characterizing users who spread fake news. This lends support to emerging accounts of social drivers of misinformation through political polarization, but also stresses the role of the entanglement between fake news, anti-elite polarization, and the role of scientific authorities in public debate.

Developing and Psychometric Testing a Health Care Transition Service Measure in the National Survey of Children’s Health

ObjectiveAccess to health care transition (HCT) services has been included in national surveys for 20 years. While dozens of studies have assessed HCT, no study has examined the model fit of the HCT questions or psychometric properties of the measure. We utilized National Survey of Children’s Health (NSCH) data to develop and test a comprehensive HCT measure. MethodsWe utilized NSCH data (2016–19) to examine the model fit of 9 HCT questions. The new measure’s psychometric properties were assessed by comparing it to theoretically similar and divergent variables including receiving care coordination/help, shared-decision making, satisfaction with communication, preventative dental care, and volunteer experience. ResultsAn exploratory factor analysis and item culling yielded 8 items addressing 3 subscales. A confirmatory factor analysis on separate data confirmed the identified subscales. A dichotomous and continuous scale was created with subscales including Guidance Toward Independence, Adequate Clinic Visit, and Continuity of Care Discussions. Model fit was excellent with an Eigenvalue of 1.08% and 89% variance explained in exploratory factor analysis and a Goodness of Fit index of 0.97 in confirmatory factor analysis. Examination of initial reliability and content and criterion validity indicated high reliability and validity for the scale and subscales. ConclusionsThis was the first study to examine the psychometric properties of the HCT measure in the NSCH. The HCT measure identified in this study assesses providers’ use of care plans, promotion of independence, clinic visit quality, and transfer assistance. This measure will be a useful tool in clinics, intervention development, and research for adolescents with and without special health care needs.retain-->

Exploring the Knowledge Regarding Mucormycosis and Its Management Among a Cohort of Dental Undergraduates in India: A Cross-Sectional Survey.

Mucormycosis is an angioinvasive fungal infection associated with a high mortality rate in both low- and middle-income countries. A dentist plays a crucial role and first line in the diagnosis and treatment of mucormycosis since the majority of the site of infection is the rhino cerebral or rhino maxillary area. The present study was designed to ascertain knowledge about mucormycosis and its management among a sample of dental undergraduates in India. A self-administered questionnaire covering demographic details, knowledge relating to underlying disease and risk factors (10 items), clinical features and diagnosis (8 items), and management of mucormycosis (six items) was employed. Responses were recorded on a dichotomous scale. Data analysis was done using SPSS 20 (SPSS Inc., Chicago, IL, USA). The mean and standard deviation for correct answers and knowledge levels were determined. A total of 437 respondents were included. Classification of participants based on the level of correct knowledge demonstrated that the majority of students had good knowledge (232, 53.1%). Comparison of the same based on the college type showed significant differences for only clinical features, diagnosis (p=0.002), and management (p=0.035) whereas no significance was seen for gender. Correlation by Karl's Pearson correlation coefficient revealed a significant positive correlation between the entire knowledge scores. The study portrays adequate knowledge among dental interns that can be used to modify preventive care measures to lessen the public health emergency. Stakeholders can take the necessary action to spread knowledge about mucormycosis through training workshops and continuing dental education programs to combat the health crisis.

Technical ultrasonic quality assurance in Danish Radiology Departments

IntroductionIn general, there is a lack of technical quality assurance (TQA) in ultrasound, which threatens patients. This study aimed to map the level of ultrasound quality assurance in Danish Radiology Departments, assess the intra- and interrater reliability of the in-air method for evaluating transducer quality, and determine the prevalence of faulty transducers. MethodsFrom October to November 2021, an anonymous survey focused on the extent of TQA was e-mailed to clinicians (via managers) responsible for ultrasound TQA. The six-item survey included both closed and open-ended questions. In addition, a sample of 63 ultrasound b-mode reverberation images was collected from four Danish Radiological Departments, later rated by two blinded radiographers on a dichotomous scale. ResultsA total of 46 participants responded to the survey. In the survey, 15 respondents reported not having a TQA procedure, while six thought a procedure existed but were uncertain. Various methods were reported for the respondents who answered that TQA was performed (n = 13).Half of the respondents (n = 23, 50%) reported experiencing transducer malfunctions, and seven said they did not find the lack of regular testing problematic.The interrater reliability was κ = 0.75 (95% CI.: 0.61–0.89), and the inter-rater reliability was κ = 0.84 (95% CI.: 0.70–0.98). Based on the agreement between the two raters, 20 out of 50 (40%) transducers were flawed. ConclusionThis study demonstrates the general deficiency of TQA in Danish Radiological Departments, with 21 clinicians responsible for ultrasound TQA responding either not having a TQA procedure or being uncertain if one exists. Furthermore, the study reveals that the in-air method for assessing transducer quality demonstrates moderate to almost perfect reliability and that nearly half of the transducer tested exhibits visual faults.

Identification of Benefits of Participating in Content Mastery Services at SMPN 37 Muaro Jambi

Purpose of the study: The purpose of this study was to identify the benefits of participating in content mastery services in terms of attitudes and study habits, learning techniques/learning methods, and educational planning. Content mastery services in junior high schools are core activities supporting the implementation of the content mastery service process.
 Methodology: The population in this study were all students at SMP Negeri 37 Muaro Jambi with a total of 38 students. This research is a population research because all members of the population are the research samples. Data in this study were collected through a questionnaire with a dichotomous scale and processed using a percentage formula.
 Main Findings: The results of the study showed that (1) Identification of the benefits of participating in content mastery services related to attitudes and study habits at SMP Negeri 37 Muaro Jambi was at good quality (76.9%) meaning that attitudes and study habits were good. (2) Identification of the benefits of participating in content mastery services for indicators of learning techniques / learning methods at SMP Negeri 37 Muaro Jambi that are related to being of good quality (75.6%) meaning that learning techniques / learning methods are good, and (3) Identification of the benefits of participating in services mastery of the related educational planning indicator content at SMP Negeri 37 Muaro Jambi is of good quality (81%) meaning that planning for education is good. The implications of the research results for guidance and counseling services can be carried out in the following steps: (1) Help develop a classroom atmosphere, teacher-student relationships and student-student relationships that support the implementation of guidance and counseling. (2) Providing opportunities and facilities for students who need guidance and counseling services/activities to participate/undergo the intended services/activities. (3) Participate in special activities for handling student problems, such as case conferences, and (4) Assist in gathering information in the context of evaluating guidance and counseling services and follow-up efforts.
 Novelty/Originality of this study: Knowing the benefits of participating in content mastery services in terms of attitudes and study habits, learning techniques/learning methods, and educational planning.

Evaluating knowledge and attitudes scales for the care of older adults among nursing students in Ghana

BackgroundUnderstanding nursing students’ knowledge about and attitudes toward older adults’ using context-specific survey instruments can help to identify and design effective learning and teaching materials to improve the care for persons 60 years and above. However, there are no validated instruments to examine nursing students’ knowledge and attitudes toward the care for older adults in the African context. The study aimed to evaluate the items on the Knowledge about Older Patients Quiz and Kogan's Attitudes towards Old People Scale suitable for the African context.MethodsA cross-sectional study was conducted using second-and third-year nursing students from two public Nursing Training Institutions in Ghana. Using Sahin’s rule of sample size estimate of at least 150 participants for unidimensional dichotomous scales, 170 nursing students were recruited to participate after an information session in their classrooms. Data were collected from December 2019—March 2020 using the Knowledge about Older Patients Quiz and Kogan’s Attitudes Towards Old People Scale. Item response theory was employed to evaluate the Knowledge about Older Patients Quiz difficulty level and discrimination indices. Corrected item-to-total correlation analysis was conducted for Kogan's Attitudes towards Old People Scale. The internal consistency for both scales was examined.ResultsOf the 170 participants, 169 returned completed surveys. The mean age of participants was 21 years (SD = 3.7), and (54%) were female. Of the 30-items of the Knowledge about Older Patients Quiz, seven items were very difficult for most students to choose the correct response, and one was easy, as most of the students chose the correct response. Although 22 items demonstrated appropriate difficulty level, discrimination indices were used to select the final 15- items that discriminated moderately between upper and lower 25% performing students. The Kuder-Richardson-20 reliability was. 0.30, which was low. Considering Kogan's Attitudes towards Old People scale, 10-items were removed following negative and low corrected item-to-total correlation and a high Alpha coefficient if items were deleted. The final 22-items had a Cronbach alpha coefficient of 0.65, which was moderately satisfactory.ConclusionEvaluation of the scales demonstrated essential content validity and moderate internal consistency for the context of our study. Further research should focus on ongoing context-specific refinement of the survey instruments to measure nursing students’ knowledge about and attitudes toward caring for older adults in the African context.

Patient Satisfaction with Anaesthesia: Perioperative Questionnaire versus Face-to-face Survey

Introduction: Factors favouring patient satisfaction in anaesthesia are availability of services based on institutional facilities, mutual between with anaesthesiologist and patients, skill of health care experts and patient requirements. When one wishes to improve response rates and raise the calibre of the data captured, face-to-face surveys are among the greatest methods for gathering data. It can be challenging to quantify subject satisfaction in anaesthesia since subjective indications vary by person, culture and background. Patients rating of their own satisfaction can estimate the care given during procedure which cannot be easily assessed in any other way. Aim: To assess patient satisfaction regarding the care provided during anaesthesia and to find out whether dissatisfactions are better elicited through face-to-face interviews or questionnaire. Materials and Methods: This cross-sectional study was conducted on patients undergoing surgery under general or regional anaesthesia at Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India, from November 2021 to February 2022. Estimated sample size was 74. As per American Society of Anaesthesiologist (ASA) grades 1 and 2, adults in the age group of 18–65 years were divided into two groups using chits. In group A, face-to-face interview was done on postoperative day 2 by anaesthesiology resident. In group B, questionnaire was given on postoperative day 2 by anaesthesiology resident. The questions on anaesthesia-related dissatisfaction were posed in a semi dichotomous scale (no/yes-mild, moderate, severe); the questions on satisfaction with anaesthesia care were given on a 4-item scale (extremely satisfied/satisfied/ neutral/dissatisfied). The data was analysed by using Statistical Package for the Social Sciences (SPSS) software version 22.0, and R environment version 3.2.2 and Microsoft word and Excel have been used to generate graphs and tables. Results: Patient population included in study was 74, among which 63 (85.1%) patients were extremely satisfied with the care given by Anaesthesia Department in general, seven (9.5%) were satisfied, four (5.4%) were neutral, and no one were dissatisfied. Among questionnaire group 36 (97.3%) patients were extremely satisfied with anaesthesia care in general while 27 (73%) of face-to-face group were extremely satisfied with anaesthesia care in general. Among anaesthesia related dissatisfactions 65 (87.8%) of patients did not complain of postoperative nausea and vomiting. In this study 52 (70.3%) patients were extremely satisfied with pain relief after surgery. Conclusion: Face-to-face interview identifies more patients who report lower degree of satisfaction with anaesthesia, it can be concluded that interviewing is better suited for detecting quality problems with anaesthesia care than written questionnaire.

Patient’s Perspective of Preoperative Anxiety and Need for SupportAn Observational Study

Introduction: Majority of the patients undergoing elective surgery generally experience anxiety. Preoperative anxiety causes emotional distress and needs support to cope. Aim: To evaluate the prevalence of preoperative anxiety in patients undergoing elective surgery and to examine association between the intensity of anxiety and need for assistance. Materials and Methods: An observational study was conducted at Sri Devaraj Urs Medical College, Kolar, Karnataka, India on 100 participants. The inclusion criteria were - age >18 years of either sex belonging to American Society of Anaesthesiologists (ASA)- Physical Status (PS) grade I or II and undergoing elective surgery. After obtaining informed consent, a questionnaire including both Amsterdam Preoperative Anxiety Information Scale (APAIS) and Numeric Rating Scale (NRS) to measure anxiety was given to the patients in preanaesthetic evaluation clinic by anaesthesiology resident one day prior to the scheduled surgery. The questionnaire included a semi dichotomous scale (yes/no) for anxiety assessment; to quantify the intensity of anxiety levels the questions on APAIS were given on 5-item scale (not at all/ somewhat/moderate/moderately-high/extremely) and NRS on 4-item scale (no anxiety/mild/moderate/severe). Results: The prevalence of anxiety was 100%.The mean age was 43.3±11.9 years. The majority (53%) were females. According to NRS, majority of patients undergoing major surgeries had higher mean anxiety levels (6.95±1.96). APAIS anxiety about anesthesia was 4.78±2.1 and about surgery was 5.52±1.9. A cut-off of 13 on the APAIS anxiety scale had a sensitivity of 90% and a specificity of 81.1%. A cut-off of 3.5 on the NRS scale had a sensitivity of 72.7% and a specificity of 65.2%. Conclusion: All the patients undergoing elective surgery should be subjected for preoperative anxiety assessment and those with higher anxiety levels requiring support should be addressed to have better postoperative outcomes. Grade of surgery had a significant role in causing anxiety. Hence both Anaesthesiologist and Surgeons should be involved in counselling the patient.

Gastrostomy tube feeding in epidermolysis bullosa: A multi-center assessment of caregiver satisfaction.

Gastrostomy tubes (G-tubes) are a feasible intervention for nutritional support in patients with epidermolysis bullosa (EB) who suffer from gastrointestinal involvement. However, some parents may be apprehensive about this surgical intervention. The purpose of this study is to assess caregiver satisfaction and experiences after G-tube insertion in children with EB. Nine institutions sent an anonymous 89-item online questionnaire to caregivers of patients with EB and active G-tubes during an 8-week study period. The questionnaire consisted of eight sections and was formatted with multiple choice, Likert scales, dichotomous scales (yes/no), and free text. Twenty caregiver surveys were completed. All caregivers were parents (100%). The average age of G-tube placement was 2.7 years (SD: 2.1, range 0-8) and duration of the G-tube utilization was an average of 12.0 years (SD: 7.8, range 1-25). EB subtypes were dystrophic (n=15/20, 75%), junctional (n=3/20, 15%), and simplex (n=2/10, 10%). Almost all caregivers (n=18/20, 90%) reported high levels of satisfaction with G-tube management (scores > 20 on the modified SAGA-8 scale). More than half of caregivers (n=12/20, 60%) reported that, retrospectively, they would have desired earlier adoption of the G-tube. Caregivers rated mealtimes as more enjoyable and easier both for themselves and the individual with EB post-G-tube placement. The survey demonstrates a high rate of satisfaction for G-tube use among caregivers of patients with EB across varying ages and household settings. The free-text responses provide unique insight into caregiver's individual experiences regarding G-tubes to be considered for future studies.