Individual Scale Scores Research Articles

Functional outcome and patient satisfaction after laser in situ keratomileusis for correction of myopia and myopic astigmatism.

Purpose:The purpose was to evaluate subjective quality of vision and patient satisfaction after laser in situ keratomileusis (LASIK) for myopia and myopic astigmatism.Patients and Methods:A self-administered patient questionnaire consisting 29 items was prospectively administered to LASIK patients at the Yemen Magrabi Hospital. Seven scales covering specific aspects of the quality of vision were formulated including; global satisfaction; quality of uncorrected and corrected vision; quality of night vision; glare; daytime driving and; night driving. Main outcome measures were responses to individual questions and scale scores and correlations with clinical parameters. The scoring scale ranged from 1 (dissatisfied) to 3 (very satisfied) and was stratified in the following manner: 1-1.65 = dissatisfied; 1.66-2.33 = satisfied and; 2.33-3 = very satisfied. Data at 6 months postoperatively are reported.Results:This study sample was comprised of 200 patients (122 females: 78 males) ranging in age from 18 to 46 years old. The preoperative myopic sphere was − 3.50 ± 1.70 D and myopic astigmatism was 0.90 ± 0.82 D. There were 96% of eyes within ± 1.00 D of the targeted correction. Postoperatively, the uncorrected visual acuity was 20/40 or better in 99% of eyes. The mean score for the overall satisfaction was 2.64 ± 0.8. A total of 98.5% of patients was satisfied or very satisfied with their surgery, 98.5% considered their main goal for surgery was achieved. Satisfaction with uncorrected vision was 2.5 ± 0.50. The main score for glare was 1.98 ± 0.7 at night. Night driving was rated more difficult preoperatively by 6.2%, whereas 79% had less difficulty driving at night.Conclusion:Patient satisfaction with uncorrected vision after LASIK for myopia and myopic astigmatism appears to be excellent and is related to the residual refractive error postoperatively.

Measuring Congregational Vitality: Phase 2 Development of an Outcome Measurement Tool

Since 2009 the Evangelical Lutheran Church in America has worked to develop a survey that can reliably measure qualitative aspects of congregational vitality. This study describes the development of a survey that focuses on key missional outcomes. Congregation members and pastors from 73 congregations were surveyed. Exploratory factor analysis identified important differences in the way pastors and lay people understand concepts like mission resulting in the creation of separate scales for pastors and lay people. These scales describe congregational vitality in five areas. Lay scales describe a congregation's connections with God, each other and the world while pastor scales describe their understanding of the congregation's inner strength and faith in action outside the congregation. For each respondent, individual scale scores were averaged to create congregational scale scores. Congregational scale scores were then compared with each congregation's annual statistics, key informant perceptions, and other items within the survey for validation. The result was a psychometrically sound instrument that helps congregations, synods and the denomination gain a more complete understanding of vitality. Implications for further research are discussed.

Validation of the Suicide Resilience Inventory-25 with American and Chinese college students.

This study is the first to evaluate evidence for measurement invariance and the psychometric properties of the Suicide Resilience Inventory-25 (SRI-25; Osman et al., ) in college-age samples in both the United States and China. We found strong support for full measurement invariance of the three-factor structure of the SRI-25 in the U.S. (113 men and 238 women) and Chinese (121 men and 205 women) samples. In addition, we found that the U.S. sample scored significantly higher than the Chinese sample on all the individual scale scores. Composite scale reliability estimates ranged from moderate (ρ = .83) to high (ρ = .93) across the groups. Although not an aim of the current study, we examined estimates of internal consistency of the SRI-25 scales for men and women within each sample. Differential correlates of the SRI-25 scales were explored further for each sample. These results provide support for the use of the SRI-25 in U.S. and Chinese student samples.

Predictors for exacerbation/improvement of postpartum depression—A focus on anxiety, the mothers' experiences of being cared for by their parents in childhood and borderline personality: A perspective study in Japan

ObjectiveTo investigate the course and influencing factors of postpartum depression in women during the child rearing period. MethodsData were collected during 0-year-old baby check-ups and a follow-up investigation. 262 participants were included in the analysis. Both surveys employed the Zung Self-Rating Depression Scale (ZSDS). The first also comprised the State Trait Anxiety Inventory, Parental Bonding Instrument (PBI), and Borderline Scale Index, enabling sub-division of participating subjects into healthy/pathological groups. ZSDS group and survey scores were compared using the t-test. ResultsThe average ages of the children and the ZSDS scores in both surveys were 7.0±3.2 and 21.8±2.4 months, 40.6±7.9 and 40.1±8.7, respectively, with no significant differences among depression scores. When subjects were divided according to individual scale scores, and survey scores compared, depression significantly improved in the high trait/state anxiety group, high PBI maternal care score group, nonborderline personality (BP) trait group, and breast feeding group, whereas depression was significantly exacerbated in the low PBI maternal care score group. DiscussionPostpartum depression characterized by strong anxiety and a depressive state in mothers with favorable psychological backgrounds showed gradual improvement. We noted an exacerbation of depression during the separation period in mothers who had received poor maternal care. We assume that the feeling of abandonment induced by individuation of their children is a major factor. LimitationsThere is concern that some depressive women may have dropped out due to a performance bias. ConclusionsSharing our findings about exacerbation/improvement of depression among medical staff may be beneficial for postpartum mothers.

Mind Your Words

Mindfulness, a construct that entails moment-to-moment effort to be aware of present experiences and positive attitudinal features, has become integrated into the sciences. The Five Facet Mindfulness Questionnaire (FFMQ), one popular measure of mindfulness, exhibits different responses to positively and negatively worded items in nonmeditating groups. The current study employed confirmatory factor analysis with a large undergraduate sample to examine the validity of a hierarchical mindfulness model and whether response patterns related to item wording arose from method effects. Results indicated that a correlated facets model better explained the data and that negative and positive wording constituted substantive method effects. This study suggests that the FFMQ measures components that may relate to, but do not seem to directly reflect, a latent variable of mindfulness. The authors recommend against the use of an FFMQ total score, favoring individual scale scores, and further examination of method effects in mindfulness scales.

Through the eyes of the novice teacher: perceptions of mentoring support

This study examined the perceptions of elementary school beginning teachers (n = 136) across a Rocky Mountain state in the US regarding the mentoring support they received during their first year teaching. Beginning teachers were asked to report the types of mentoring support they received and to rate the helpfulness of this support on the Mentoring Support Survey. Individual item scores and scale scores are reported. An analysis of variance was then used to compare the scale scores of teachers with the administrator-facilitated mentoring supports of common planning time with their mentors and/or release time to observe other teachers. Results indicate that beginning teachers who received both common planning time with a mentor and release time to observe other teachers rated the mentoring experiences they had as significantly more helpful than beginning teachers who were not provided these mentoring supports. Of the two, provision of common planning time was the most important type of administrator-facilitated support.

A before and after study on personality assessment in adolescents exposed to the 2009 earthquake in L'Aquila, Italy: influence of sports practice

ObjectiveTo assess and estimate the personality changes that occurred before and after the 2009 earthquake in L'Aquila and to model the ways that the earthquake affected adolescents according to gender...

International Placements Increase the Cultural Sensitivity and Competency of Professional Health Students: A Quantitative and Qualitative Study

Background and Purpose. Effective health care requires cultural and cultural competency, which are vital aspects of a health professional's background. The purpose of this study was to investigate if a difference occurs in cultural pre- and post-international clinical placement. Participants. Seventeen final-year health professions students were recruited from Curtin University of Technology for this study. Methods. Participants attended a 4-week placement in China or India. Social demographic information included previous intercultural experience, prior language study, and intercultural friendship. The Intercultural Development Inventory (IDI) measured cultural pre-and post-placement and was analysed using the paired sample t test. Experiences and reflections of participants were obtained using a guided learning journal; qualitative data were analysed using a phenomenological approach. Results. Overall IDI developmental scores (mean -4.31, 95% CI -9.55 to 0.93) and individual scale scores increased but did not reach statistical significance except for the Acceptance/Adaptation scale (mean -0.34, 95% CI -0.63 to -0.04). Five themes emerged from qualitative analysis suggesting development of cultural sensitivity: increased vigilance and adaptation to environment, uncertainty and anticipation, grappling with supremacy, recognizing and appreciating differences, and cultural immersion and development. Discussion and Conclusion. International placements increase the cultural and competency of health professions students. Future studies should explore variables that will further enhance these cultural attributes in health professionals. Key Words: International Education, Clinical Education, Cultural Competence. BACKGROUND AND PURPOSE Cross-cultural interactions are an inevitable and integral part of clinical practice in a globalised health care environment.1 Government policies including A First Class Service: Quality in the NHS2 in the United Kingdom and National Action Agenda3 in the United States have been implemented to ensure provision of high-quality service by the health care sector to all patients. The Australian Department of Health and Ageing also has in its vision better health for all Australians, with priorities including a move towards health equality in indigenous and non-indigenous populations.4 The resulting focus on the ability of health care professionals to care for a culturally diverse patient population1,5 is driving the assessment of professional competency to encompass not only discipline-specific skills, but also generic cultural competency. This challenges health care professionals, as the diverse groups possess unique notions of illness and health beliefs that influence the delivery and receptivity of care.6 Cultural biases also exist in interpreting communication cues such as body language, facial expression, and tone of voice.7 Therefore, a lack of cultural understanding can compromise the quality of health care services.8,9 To provide effective health care, cultural and cultural competency are vital aspects of a health professionals background.6,10,11 Despite widespread usage and acceptance of the phrases, these concepts are not definitive. Bhawuk and Brislin12 defined cultural as sensitivity to cultural differences and to the points of view of people in other cultures.(p414) This develops as one begins to appreciate, respect and value diversity13 and is essential to facilitate cross-cultural interactions.6,10 Burchum13 identifies cultural as an integral component of cultural competency, which is a broader concept encompassing 6 attributes: cultural awareness, knowledge, understanding, sensitivity, skill, and interaction. Cultural competency is a dynamic process built on the ongoing development of these component attributes.14,15 Previous studies have revealed that students are less competent in handling cross-cultural encounters in the absence of appropriate teaching. …

Characterizing Sources of Uncertainty in Item Response Theory Scale Scores

Traditional estimators of item response theory (IRT) scale scores ignore uncertainty carried over from the item calibration process, which can lead to incorrect estimates of standard errors of measurement (SEM). Here, we review a variety of approaches that have been applied to this problem and compare them on the basis of their statistical methods and goals. We then elaborate on the particular flexibility and usefulness of a Multiple Imputation (MI) based approach, which can be easily applied to tests with mixed item types and multiple underlying dimensions. This proposed method obtains corrected estimates of individual scale scores, as well as their SEM. Furthermore, this approach enables a more complete characterization of the impact of parameter uncertainty by generating confidence envelopes (intervals) for item tracelines, test information functions, conditional SEM curves, and the marginal reliability coefficient. The MI based approach is illustrated through the analysis of an artificial data set, then applied to data from a large educational assessment. A simulation study was also conducted to examine the relative contribution of item parameter uncertainty to the variability in score estimates under various conditions. We found that the impact of item parameter uncertainty is generally quite small, though there are some conditions under which the uncertainty carried over from item calibration contributes substantially to variability in the scores. This may be the case when the calibration sample is small relative to the number of item parameters to be estimated, or when the IRT model fit to the data is multidimensional.

Using growth models to monitor school performance: comparing the effect of the metric and the assessment

This paper investigates whether inferences about school performance based on longitudinal models are consistent when different assessments and metrics are used as the basis for analysis. Using norm-referenced (NRT) and standards-based (SBT) assessment results from panel data of a large heterogeneous school district, we examine inferences based on vertically equated scale scores, normal curve equivalents (NCEs), and nonvertically equated scale scores. The results indicate that the effect of the metric depends upon the evaluation objective. NCEs significantly underestimate absolute individual growth, but NCEs and scale scores yield highly correlated (r >.90) school-level results based on mean initial status and growth estimates. SBT and NRT results are highly correlated for status but only moderately correlated for growth. We also find that as few as 30 students per school provide consistent results and that mobility tends to affect inferences based on status but not growth – irrespective of the assessment or metric used.

Parent‐proxy report of their children's health‐related quality of life: an analysis of 13 878 parents' reliability and validity across age subgroups using the PedsQL 4.0 Generic Core Scales

. Varni J. W., Limbers C. A. & Burwinkle T. M. ( 2007 ) , 5 , 2 . DOI:10.1186/1477‐7525‐5‐2. Background Health‐related quality of life (HRQOL) measurement has emerged as an important health outcome in clinical trials, clinical practice improvement strategies, and healthcare services research and evaluation. While paediatric patient self‐report should be considered the standard for measuring perceived HRQOL, there are circumstances when children are too young, too cognitively impaired, too ill or fatigued to complete an HRQOL instrument, and reliable and valid parent‐proxy report instruments are needed in such cases. Further, it is typically parents' perceptions of their children's HRQOL that influences healthcare utilization. Data from the PedsQL DatabaseSM were utilized to test the reliability and validity of parent‐proxy report at the individual age subgroup level for ages 2–16 years as recommended by recent Food and Drug Administration (FDA) guidelines.Methods The sample analysed represents parent‐proxy report age data on 13 878 children ages 2–16 years from the PedsQL 4.0 Generic Core Scales DatabaseSM. Parents were recruited from general paediatric clinics, sub‐specialty clinics and hospitals in which their children were being seen for well‐child checks, mild acute illness or chronic illness care (n = 3,718, 26.8%), and from a State Children's Health Insurance Program in California (n = 10 160, 73.2%).Results The percentage of missing item responses for the parent‐proxy report sample as a whole was 2.1%, supporting feasibility. The majority of the parent‐proxy report scales across the age subgroups exceeded the minimum internal consistency reliability standard of 0.70 required for group comparisons, while the total scale scores across the age subgroups approached or exceeded the reliability criterion of 0.90 recommended for analysing individual patient scale scores. Construct validity was demonstrated utilizing the known groups approach. For each PedsQL scale and summary score, across age subgroups, healthy children demonstrated a statistically significant difference in HRQOL (better HRQOL) than children with a known chronic health condition, with most effect sizes in the medium‐to‐large effect size range.Conclusion The results demonstrate the feasibility, reliability and validity of parent‐proxy report at the individual age subgroup for ages 2–16 years. These analyses are consistent with recent FDA guidelines which require instrument development and validation testing for children and adolescents within fairly narrow age groupings and which determine the lower age limit at which reliable and valid responses across age categories are achievable. Even as paediatric patient self‐report is advocated, there remains a fundamental role for parent‐proxy report in paediatric clinical trials and health services research.

Parent proxy-report of their children's health-related quality of life: an analysis of 13,878 parents' reliability and validity across age subgroups using the PedsQL 4.0 Generic Core Scales.

BackgroundHealth-related quality of life (HRQOL) measurement has emerged as an important health outcome in clinical trials, clinical practice improvement strategies, and healthcare services research and evaluation. While pediatric patient self-report should be considered the standard for measuring perceived HRQOL, there are circumstances when children are too young, too cognitively impaired, too ill or fatigued to complete a HRQOL instrument, and reliable and valid parent proxy-report instruments are needed in such cases. Further, it is typically parents' perceptions of their children's HRQOL that influences healthcare utilization. Data from the PedsQL™ DatabaseSM were utilized to test the reliability and validity of parent proxy-report at the individual age subgroup level for ages 2–16 years as recommended by recent FDA guidelines.MethodsThe sample analyzed represents parent proxy-report age data on 13,878 children ages 2 to 16 years from the PedsQL™ 4.0 Generic Core Scales DatabaseSM. Parents were recruited from general pediatric clinics, subspecialty clinics, and hospitals in which their children were being seen for well-child checks, mild acute illness, or chronic illness care (n = 3,718, 26.8%), and from a State Children's Health Insurance Program (SCHIP) in California (n = 10,160, 73.2%).ResultsThe percentage of missing item responses for the parent proxy-report sample as a whole was 2.1%, supporting feasibility. The majority of the parent proxy-report scales across the age subgroups exceeded the minimum internal consistency reliability standard of 0.70 required for group comparisons, while the Total Scale Scores across the age subgroups approached or exceeded the reliability criterion of 0.90 recommended for analyzing individual patient scale scores. Construct validity was demonstrated utilizing the known groups approach. For each PedsQL™ scale and summary score, across age subgroups, healthy children demonstrated a statistically significant difference in HRQOL (better HRQOL) than children with a known chronic health condition, with most effect sizes in the medium to large effect size range.ConclusionThe results demonstrate the feasibility, reliability, and validity of parent proxy-report at the individual age subgroup for ages 2–16 years. These analyses are consistent with recent FDA guidelines which require instrument development and validation testing for children and adolescents within fairly narrow age groupings and which determine the lower age limit at which reliable and valid responses across age categories are achievable. Even as pediatric patient self-report is advocated, there remains a fundamental role for parent proxy-report in pediatric clinical trials and health services research.

How young can children reliably and validly self-report their health-related quality of life?: an analysis of 8,591 children across age subgroups with the PedsQL 4.0 Generic Core Scales.

BackgroundThe last decade has evidenced a dramatic increase in the development and utilization of pediatric health-related quality of life (HRQOL) measures in an effort to improve pediatric patient health and well-being and determine the value of healthcare services. The emerging paradigm shift toward patient-reported outcomes (PROs) in clinical trials has provided the opportunity to further emphasize the value and essential need for pediatric patient self-reported outcomes measurement. Data from the PedsQL™ DatabaseSM were utilized to test the hypothesis that children as young as 5 years of age can reliably and validly report their HRQOL.MethodsThe sample analyzed represented child self-report age data on 8,591 children ages 5 to 16 years from the PedsQL™ 4.0 Generic Core Scales DatabaseSM. Participants were recruited from general pediatric clinics, subspecialty clinics, and hospitals in which children were being seen for well-child checks, mild acute illness, or chronic illness care (n = 2,603, 30.3%), and from a State Children's Health Insurance Program (SCHIP) in California (n = 5,988, 69.7%).ResultsItems on the PedsQL™ 4.0 Generic Core Scales had minimal missing responses for children as young as 5 years old, supporting feasibility. The majority of the child self-report scales across the age subgroups, including for children as young as 5 years, exceeded the minimum internal consistency reliability standard of 0.70 required for group comparisons, while the Total Scale Scores across the age subgroups approached or exceeded the reliability criterion of 0.90 recommended for analyzing individual patient scale scores. Construct validity was demonstrated utilizing the known groups approach. For each PedsQL™ scale and summary score, across age subgroups, including children as young as 5 years, healthy children demonstrated a statistically significant difference in HRQOL (better HRQOL) than children with a known chronic health condition, with most effect sizes in the medium to large effect size range.ConclusionThe results demonstrate that children as young as the 5 year old age subgroup can reliably and validly self-report their HRQOL when given the opportunity to do so with an age-appropriate instrument. These analyses are consistent with recent FDA guidelines which require instrument development and validation testing for children and adolescents within fairly narrow age groupings and which determine the lower age limit at which children can provide reliable and valid responses across age categories.

Natalizumab Induction Therapy Results in Improved Quality of Life in Patients with Crohnʼs Disease

Purpose: To investigate quality of life (QoL) outcomes during ENCORE, a phase 3, randomized, double-blind, placebo (pbo)-controlled trial evaluating the efficacy and safety of natalizumab (NAT) induction therapy in patients (pts) with Crohn's disease (CD). Methods: Pts with Crohn's Disease Activity Index (CDAI) scores ≥ 220 and ≤ 450 and C-reactive protein (CRP) levels >2.87 mg/L were randomized 1:1 to receive 300 mg NAT (n = 259) or placebo (pbo) (n = 250) infusions at Weeks (wks) 0, 4, and 8. The Inflammatory Bowel Disease Questionnaire (IBDQ) and Short Form-36 (SF-36) were used to measure QoL at baseline and Wk 12. Higher scores indicate better QoL. Results: Baseline scores were comparable between the 2 groups. Pts in the NAT group had a mean CDAI score of 303.9 and a mean IBDQ total score of 123.6 vs 299.5 and 122.5 respectively, in the pbo group. At Wk 12, improvement in mean total IBDQ score was greater for pts in the NAT group compared to pbo (26.7 vs 15.1, respectively, p < 0.001), as was improvement in all 4 dimensions of the IBDQ (p≤ 0.002). Improvement in 6 of the 8 individual scale scores of the SF-36 (p≤ 0.013), as well as the physical score component (PCS) score (p < 0.001), was greater in pts receiving NAT. Conclusions: Pts receiving NAT induction therapy had significantly greater improvements in QoL than those receiving pbo, as measured by both disease specific (IBDQ) and global (SF-36) measures of QoL. Greater improvements were seen in the total IBDQ, all IBDQ subscale scores, 6 of 8 SF-36 scales, and the PCS scale of the SF-36.Table: QoL Score Change from Baseline to Wk 12-Mean (SD).

Functional outcomes and patient satisfaction after laser in situ keratomileusis for correction of myopia

To determine subjective patient satisfaction and self-perceived quality of vision after laser in situ keratomileusis (LASIK) to correct myopia and myopic astigmatism. Department of Ophthalmology, Academic Hospital Maastricht, Maastricht, The Netherlands. A validated questionnaire consisting of 66 items was self-administered by 142 consecutive patients. Seven scales covering a specific aspect of quality of vision were formulated. Aspects included global satisfaction, quality of uncorrected and corrected vision, quality of night vision, glare, daytime driving, and night driving. Main outcome measures were responses to individual questions and scale scores, and correlations with clinical parameters including refractive outcome, uncorrected visual acuity, best corrected visual acuity, ablation depth, and scotopic pupil-optical zone disparity were obtained. The mean score for the overall satisfaction was 4.1 +/- 0.71 (SD) (scale 0 to 5.0). A total of 92.2% of patients were satisfied or very satisfied with their surgery, 93.6% considered their main goal of surgery achieved, and 92.3% would choose to have LASIK surgery again. Satisfaction with uncorrected vision was 3.03 +/- 0.71. The mean score for glare was 3.0 +/- 0.9. At night, glare from lights was believed to be more important than before surgery by 47.2%. Glare from oncoming car headlights after surgery was reported by 58.4% and was believed to be more bothersome for night driving than before surgery by 52.8%. Night driving was rated more difficult than before surgery by 39.4%, whereas 59.3% had less difficulty driving at night. There was a significant correlation between the uncorrected vision score and the postoperative spherical equivalent (r = 0.245) and postoperative astigmatism (r = 0.265). There was no correlation between the glare or night vision scores and the degree of correction, the amount of ablation depth, or the disparity between the scotopic pupil and the optical zone. Self-perceived uncorrected vision after LASIK surgery for the correction of myopia and myopic astigmatism appears to be very good and is related to the postoperative residual error. Although the majority of patients postoperatively experienced glare, particularly with driving at night, this was not related to the pupil-optical zone disparity or degree of correction.

Identification of subgroups of persons with chronic pain based on profiles on the pain stages of change questionnaire

This study sought to identify reliable subgroups of patients with chronic pain based on profiles of subscale scores on the Pain Stages of Change Questionnaire (PSOCQ), a reliable and valid measure of individuals' readiness to adopt a self-management approach to chronic pain. The PSOCQ was administered to 633 people seeking treatment for chronic pain. Participants were predominantly White, averaged 48 years of age, about half were men, and about half reported back pain as the primary complaint. In a first study, cluster analysis was applied to 250 respondents. Five clusters were identified and named Precontemplation (11.0% of the sample), Contemplation (18.0%), Noncontemplative Action (12.4%), Participation (25%), and Ambivalent (33.6%). Results of a discriminant function analysis (DFA) on this sample, using the solution from the cluster analysis yielded a total error rate of 0.036. In a second study, the results of the first DFA were applied to an independent sample of 383 respondents in order to cross validate the solution from the first study. Cluster assignment proportions were very similar to the first sample and the posterior probability error rate for the second DFA was 13%. As predicted, clusters did not differ on measures of pain, disability, or demographics. Moreover, clusters differed significantly in theoretically consistent directions by scores on the Survey of Pain Attitudes, thus demonstrating criterion related validity for the clusters. Future research should examine the utility of PSOCQ profiles, relative to individual PSOCQ scale scores alone, in predicting response to self-management treatment approaches.

Health-Related Quality of Life in Children and Adolescents Who Have a Diagnosis of Attention-Deficit/Hyperactivity Disorder

Health-Related Quality of Life in Children and Adolescents Who Have a Diagnosis of Attention-Deficit/Hyperactivity Disorder

Short- and Long-Term Outcomes of Adult Audiological Rehabilitation

To examine short- and long-term subjective benefits of providing a counseling-oriented audiological rehabilitation (AR) program as an adjunct to hearing aid intervention for individuals with adult-onset hearing loss. One hundred six veterans (68 men and 38 women), fit binaurally with digitally programmable analog hearing aids, participated. The Communication Profile for the Hearing Impaired (CPHI; ) was administered to all participants before hearing aid fitting. Half the patients were randomly assigned to receive hearing aids alone (i.e., control); the other patients were assigned to participate in a 4-wk group AR program in conjunction with receiving hearing aids (i.e., HA + AR). At the end of the AR program, the CPHI was again administered to all participants to assess short-term benefit and at 6 mo and 1 yr after hearing aid fitting to assess long-term benefit. A separate repeated-measures version of the general linear model was used to examine short- and long-term benefits for the CPHI factor scores (communication importance, communication performance, adjustment, interaction, and reaction) and for individual importance ratings and scale scores. Hearing aid use improved both short- and long-term self-perception of communication performance, with no additional benefits from participation in the AR program. Consistent with the goals of a counseling-oriented AR program, differential short-term treatment effects were found for communication strategy usage, which led to differential short-term benefits for the interaction and reaction factors. Although failing to reach strict criteria for statistical significance, there was an observable difference in short-term outcomes between the two groups for the adjustment factor, with greater improvements occurring for the HA + AR group. Over the course of the year, benefits measured for the HA + AR group remained stable, whereas scores for the control group continued to increase, resulting in no differences in factor scores between groups at 1 yr after intervention. The finding of a short-term differential treatment benefit for AR in terms of interaction and reaction, and possibly for adjustment, was important, as better outcomes in these areas may be important in the decision to keep hearing aids. If this is the case, then the data support the inclusion of a counseling-oriented AR program. Differential treatment effects in interaction and reaction appeared to result from communication strategy use, indicating that the AR program is meeting many of its goals in this area. The lack of long-term differential effects appeared as the result of continued changes in adjustment, interaction, and reaction with continued hearing aid experience.

Underlying Components of Scores Assessing African Americans’ Racial Perspectives

Underlying pro- and anti-Black components accounted for significant variance in various racial scale scores among African Americans (N = 224), Intercorrelations for individual racial scale scores were consistent with theory and accounted for significant variance in psychological distress scores in patterns consistent with their representation of a pro-Black, anti-Black, or mixed perspective.

Health-Related Quality of Life and Postoperative Length of Stay for Patients with Colorectal Cancer

Background. Length of stay (LOS) after surgery is a major determinant of resource utilization for colorectal cancer (CRC). The purpose of this study was to examine the association between pretreatment health-related quality of life (HRQL) scores and postoperative hospital LOS in a cohort of patients undergoing surgery for CRC. Methods. Seventy patients with biopsy-proven CRC were enrolled in an IRB-approved, prospective study. Information was collected concerning standard perioperative variables. Prior to surgery, all patients also completed the CRC-specific module of the Functional Assessment of Cancer Therapy (FACT-C). Perioperative variables and FACT-C scores were compared with LOS in both univariate and multivariate analysis. LOS for those patients scoring in the lowest quartile on FACT-C was compared with LOS for patients scoring in the remaining quartiles. Results. Median length of stay for the entire group was 6 (range 3–25) days. In univariate analysis, surgical complications (10.6 vs 6.6 days; P = 0.001) and with poorer FACT-C individual scale scores for Physical Well-Being (9.1 vs 7.3 days; P = 0.04), Functional Well-Being (9.6 vs 7.1 days; P = 0.006), and Colorectal Cancer Concerns (9.5 vs 7.1 days; P = 0.01) were all significantly associated with increased length of stay. In multivariate analysis, surgical morbidity (OR = 5.6; 95% CI 1.5–21.4), age >72 (OR = 6.0; 95% CI 1.6–23.5), and low FACT-C total score (OR = 4.2; 95% CI 1.1–15.6) were independently associated with increased LOS. Conclusions. Pretreatment HRQL scores as measured by FACT-C may be of benefit in the prediction of LOS. Such information may be an important and currently neglected means of risk-adjusting populations undergoing surgery for colorectal cancer for this outcome.