Mean Total Scale Score Research Articles

The effect of pain, stress, and cortisol during labor on breastfeeding success.

The aim of the study is to identify and compare the effect of pain, stress, and cortisol level during labor on breastfeeding success. The study was conducted with 51 pregnant women in the delivery room of Nenehatun Maternity Hospital between 15 August and 30 December 2016. The data were collected using the personal information form, visual analog scale (VAS), verbal category scale (VCS), perceived stress scale (PSS) and Breastfeeding Diagnostic and Assessment Scale (LATCH). It was determined that the total mean score of the mothers for the LATCH breastfeeding success scale was 6.56±1.64, the perceived stress scale total mean score was 48.13±4.09 in their active phase, and the perceived stress scale total mean score was 41.41±5.78 in their postpartum period. A negative moderate significant correlation was observed between the LATCH breastfeeding success scale mean scores and the cortisol levels in the active phase and postpartum period. It was found that the LATCH had a significant correlation with the perceived stress and cortisol in the postpartum period. It was determined that the mothers had more stress in the active phase and this stress affected negatively the lactation and sucking behavior of the infant.

Reliability and validity of the Thai version of the Pediatric Quality of Life inventory\u2122 3.0 Duchenne Muscular Dystrophy module in Thai children with Duchenne Muscular Dystrophy

BackgroundDuchenne Muscular Dystrophy (DMD) is the most common genetic neuromuscular disorder in children. This chronic illness may impact the physical, family, social and school life of affected children and their families. These impacts can be assessed using a disease-specific measure of health-related quality of life (HRQOL). The Pediatric Quality of Life Inventory™ (PedsQL™) 3.0 DMD Module is designed to assess quality of life in children with DMD. This study aimed to evaluate the reliability and validity of the Thai version of the PedsQL™ 3.0 DMD Module in Thai children aged 5–18 years.Method and materialsThe Thai translation of the PedsQL™ 3.0 Duchenne Muscular Dystrophy Module was performed in accordance with established guidelines using forward-back translation and was approved by the creator of the instrument. The Thai version of the scale was administered to children with DMD and their parents at the neuromuscular clinic at Siriraj Hospital and during the annual DMD Day meeting. Psychometric properties were established, and a re-test was performed within 2–4 weeks.ResultsFifty-six children were enrolled. An acceptable level of internal reliability was achieved, as measured by α > 0.7 (total score: child report α = 0.88, parent report α = 0.92). Test-retest reliability showed good agreement, with the following intraclass correlation coefficients (ICCs) for the total score (calculated using all subscales from the child reports and parent reports): child report ICCs = 0.74 and parent report ICCs = 0.88. The mean total scale score was 66.03 for ambulatory children and 55.87 (P = 0.08) for non-ambulatory children according to child self-reports and 70.01 (ambulatory) and 54.29 (non-ambulatory) (P ≤ 0.01) according to parent proxy reports. The child self-reports were in acceptable agreement with the parent proxy reports for most subscales (ICC range 0.49–0.81).ConclusionsThe PedsQL™ 3.0 DMD Module Thai version is a reliable and valid measure of disease-specific health-related quality of life in Thai children with Duchenne muscular dystrophy.

The Relation between spiritual wellbeing and psychological resilience among patients diagnosed with advanced gastrointestinal cancer

The purpose of this study is to determine the relation between spiritual wellbeing and psychological resilience among patients diagnosed with advanced gastrointestinal cancer. The study was performed as a descriptive correlational study, with the participation of patients hospitalized in the oncology clinics of three university hospital. The study population comprised 1318 patients aged 18 or older who were admitted to the two oncology clinics and policlinics of the university hospital. The sample size was determined as 297, the significance level of 0.05, the effect size of 0.08, and the ability to represent the population of 0.95 by the power analysis performed to determine the sample of the study. The study was completed with 302 patients. The Patient Introduction Form prepared by the researcher, FACIT Spiritual Well-Being Scale (FACIT–Sp), and The Brief Resilience Scale (BRS) were used to collect data. In the study, the minimum score obtained by the patients participating in the study from the FACIT-Sp was 15; whereas, their maximum score was 41; the total mean score of the scale was 31.41 ± 4.83. For the BRS scale, their minimum score was 6, their maximum score was 30, and the scale total mean score was 19.17 ± 4.89. When examining FACIT-Sp and BRS mean scores of the patients, it was found that their spiritual wellbeing levels were high and their psychological resilience was moderate A statistically positive correlation was found between the FACIT -Sp and BRS total mean scores of the patients in the study (p = 0.00). With increasing spiritual levels of in advanced gastrointestinal cancer patients, their psychological resilience also increased in the study. Cancer not only affects the patients physically, but also spiritually. It can be recommended for nurses, who take significant roles in the patient care, to approach patients holistically by involving their spiritual side into care.

Individuals’ health literacy level and their knowledge and practices with respect to rational drug use

This descriptive study aimed to identify individuals’ health literacy level and their knowledge and practices with respect to rational drug use. The study was conducted with 405 individuals aged 18 and above who applied to a hospital. Data were collected by using an introductory information form and the Adult Health Literacy Scale (AHLS). Data were analyzed by using the Mann–Whitney U test for comparing two groups and the Kruskal–Wallis H test for comparing the mean total scale scores of more than two groups. We found that participants’ average age was 34.25 ± 14.8; 55.5% of them were female; 50.5% had university education or higher; 51% were married. Their mean AHLS score was 14.03 ± 4.32 over 23. Our study found that individuals that used non-prescribed drugs had a lower mean AHLS score (12.16 ± 4.00), and the individuals that read the drug prospectus (p = 0.000) and expiry date (p = 0.000) had higher mean AHLS scores. For those who changed the drug dose prescribed by a doctor (p = 0.001) and those who stopped medication when the disease symptoms were gone (p = 0.031), the mean AHLS scores were lower at a statistically significant level. We found that participants had a moderate level health literacy and there was a negatively significant relation between age and health literacy scores. The study results indicated that there was a significant relation between their knowledge and practices with respect to rational drug use and health literacy level. Our suggestion is to assess individuals’ health literacy and to plan initiatives for increasing their awareness regarding rational drug use and health literacy.

Effect of parental depression level on children's quality of life after haematopoietic stem cell transplantation.

This descriptive cross-sectional study aimed to determine the impact of parental depression level on children's quality of life after haematopoietic stem cell transplantation (HSCT). This study was conducted in a bone marrow transplantation unit of a children's hospital in Ankara, Turkey. The research sample consisted of 82 parents. Children aged 2-18 years and monitored in polyclinics 100 days after HSCT were included in the study. A sociodemographic data form, parent forms of the Pediatric Quality of Life Inventory, and the Beck Depression Inventory (BDI) were used. Forty (48%) mothers and 42 (51.2%) fathers participated in the study. Of the children, 30 (36.6%) were female and 52 (63.4%) were male, and their mean age was 10.68 [standard deviation (SD) 4.80] years. Twenty-six children (31.7%) had been diagnosed with thalassaemia, and 29 children (35.4%) had undergone HSCT in the previous 25-36 months. The mean total scale score on the Pediatric Quality of Life Inventory was 61.37 (SD 21.85), and the mean parental BDI Score was 14.57 (SD 11.03). Fourteen (17.1%) parents had severe depression and 10 (12.2%) parents had moderate depression. Low statistical correlation was found between the parental BDI score and the total scale score on the Pediatric Quality of Life (r=-0.281; P=0.011). Parental depression level affects children's quality of life after HSCT. Following transplantation, it is important to evaluate parental depression level and provide support.

Yarning about cultural safety in midwifery practice for Aboriginal women

Rates of academic success of Indigenous students compared to other students continues to be significantly lower in many first world countries. Professional development activities for academics can be used to promote teaching, learning and support approaches that value Indigenous worldviews. However, there are few valid and reliable tools that measure the effect of academic development strategies on awareness of cultural safety.To develop and validate a self-report tool that aims to measure nursing and midwifery academics' awareness of cultural safety.This study followed a staged model for tool development. This included: generation of items, content validity testing and expert Indigenous cultural review, administration of items to a convenience sample of academics, and psychometric testing. An online survey consisting of demographic questions, Awareness of Cultural Safety Scale (ACSS), and awareness of racism items was completed by academics undertaking a professional development program on cultural safety.Ratings by experts revealed good content validity with an index score of 0.86. The 12-item scale demonstrated good internal reliability (Cronbach's alpha of 0.87). An evaluation of construct validity through factor analysis generated three factors with sound internal reliability: Factor 1 (Cultural Application, Cronbach's alpha = .85), Factor 2 (Cultural Support, Cronbach's alpha = .70) and Factor 3 (Cultural Acknowledgement, Cronbach's alpha = .85). The mean total scale score was 46.85 (SD 7.05, range 31–59 out of a possible 60). There was a significant correlation between scores on the Awareness of Cultural Safety Scale and awareness of racism scores (r = .461, p = .002).Awareness of cultural safety is underpinned by principles of respect, relationships, and responsibility. Results indicated the ACSS was valid and reliable. Completion of the scale aimed to foster purposeful consideration by nursing and midwifery academics about their perceptions and approaches to teaching in order to improve Indigenous student success.

Development of the Awareness of Cultural Safety Scale: A pilot study with midwifery and nursing academics

BackgroundRates of academic success of Indigenous students compared to other students continues to be significantly lower in many first world countries. Professional development activities for academics can be used to promote teaching, learning and support approaches that value Indigenous worldviews. However, there are few valid and reliable tools that measure the effect of academic development strategies on awareness of cultural safety. ObjectivesTo develop and validate a self-report tool that aims to measure nursing and midwifery academics' awareness of cultural safety. MethodsThis study followed a staged model for tool development. This included: generation of items, content validity testing and expert Indigenous cultural review, administration of items to a convenience sample of academics, and psychometric testing. An online survey consisting of demographic questions, Awareness of Cultural Safety Scale (ACSS), and awareness of racism items was completed by academics undertaking a professional development program on cultural safety. FindingsRatings by experts revealed good content validity with an index score of 0.86. The 12-item scale demonstrated good internal reliability (Cronbach's alpha of 0.87). An evaluation of construct validity through factor analysis generated three factors with sound internal reliability: Factor 1 (Cultural Application, Cronbach's alpha=.85), Factor 2 (Cultural Support, Cronbach's alpha=.70) and Factor 3 (Cultural Acknowledgement, Cronbach's alpha=.85). The mean total scale score was 46.85 (SD 7.05, range 31–59 out of a possible 60). There was a significant correlation between scores on the Awareness of Cultural Safety Scale and awareness of racism scores (r=.461, p=.002). ConclusionAwareness of cultural safety is underpinned by principles of respect, relationships, and responsibility. Results indicated the ACSS was valid and reliable. Completion of the scale aimed to foster purposeful consideration by nursing and midwifery academics about their perceptions and approaches to teaching in order to improve Indigenous student success.

Validation and reliability of Turkish Singing Voice Handicap index

This study aims to constitute a valid and reliable Turkish version of the original Singing Voice Handicap Index. An authorized committee assessed the reliability and validity of the content, scope, and language of the original Singing Voice Handicap Index which underwent a back translation process. The Turkish version of the questionnaire was answered twice with a 7 to 10-day interval by two singing voice groups with or without singing voice problems. The reliability and validity analyses were performed based on these answers. Of a total of 123 individuals (64 females, 59 males; mean age 26.2±7.3 years), 81 were without a voice pathology and 42 were with a voice pathology. The total Cronbach's alpha coefficient was 0.917. The item-total correlations ranged between 0.51 and 0.89. The weighted kappa values of test-retest correlation values of the items were 0.82-0.91. The Cronbach's alpha values of two part of the questionnaire based on the split-half method were 0.89 and 0.84. The mean total scale scores were 21.8±18.5 and 53.6±28.9 in normal and pathology groups, respectively and there was a statistically significant difference in scores between these two groups (p=0.000). The Turkish version of the Singing Voice Handicap Index is a valid and reliable scale which can be used in the evaluation of voice problems of Turkish-speaking singing voice users.

Reliability and validity of a novel Haemophilia‐specific Self‐Efficacy Scale

Higher self-efficacy in chronic disease patients is associated with higher development of self-management skills and increased quality-of-life. Quantification and monitoring of self-efficacy is therefore of importance. Self-efficacy in haemophilia patients has received little attention due to lack of standardized scales. To validate the novel Haemophilia-specific Self-Efficacy Scale (HSES) in haemophilia patients on prophylactic home treatment, haemophilia patients aged 1-18years on prophylactic treatment ≥1year were included from three Dutch Haemophilia Treatment Centres. The HSES consists of 12 items, relating to perceptions of the ability to function on a day-to-day basis with regard to patient's disease. Retest was performed in a subsample. Validity was proven by the General Self-Efficacy Scale and by the health-related quality-of-life assessment tool Haemo-QoL. Data were analysed from 53 children (response 75%), with a mean age of 9.8years (SD 4.0). Mean total scale score of HSES was 55.5 (SD 4.7; range 38-60), with a ceiling effect of 17%. The HSES showed adequate internal consistency (Cronbach's alpha 0.72) and good test-retest reliability (Intra-Class-Correlation coefficient 0.75; P<0.01; n=37). The convergent validity was adequate as haemophilia-specific self-efficacy correlated significantly with general self-efficacy (r=0.38; P<0.01). High HSES scores correlated significantly with quality-of-life as measured by the Haemo-QoL (r=-0.42; P≤0.01). The novel HSES is a reliable and valid tool to assess self-efficacy in paediatric haemophilia patients on prophylactic home treatment. High self-efficacy correlated with higher quality-of-life, further underlining the importance to standardly assess, monitor and improve self-efficacy.

Interactive Web-Based Breastfeeding Monitoring

Background: Strategies that promote higher exclusive breastfeeding rate and duration are highly recommended. To date, no study has tested the feasibility of Web-based monitoring among breastfeeding mothers. Goals: To develop an interactive Web-based breastfeeding monitoring system (LACTOR) and examine its feasibility, usability, and acceptability among breastfeeding mothers. Methods: A prospective, descriptive, mixed-methods study was conducted. Mothers who met the study inclusion criteria were recruited from mother infant units in 2 Midwestern hospitals in the United States. Mothers were asked to enter their breastfeeding data daily through the system for 30 days and then submit an online exit survey. This survey consisted of a system usability scale and mothers’ perceptions form. Twenty-six mother/infant dyads completed the study. Results: The Feasibility of LACTOR was established by mothers’ compliance in entering their breastfeeding data. The mean was 8.87 (SD = 1.21) daily entries, and the range was 6-13 times per day. Usability scale total mean score was 3.35 (SD = 0.33; scale range 0-4). Ninety-two percent of the mothers thought that they did not need to learn many skills before they started to use LACTOR and did not need any technical support. Mothers reported that the monitoring was beneficial and gave them the chance to track their infants’ feeding patterns and detect any problems early. Conclusions: This study demonstrated the feasibility of LACTOR, and it was user-friendly and acceptable among mothers. Further studies to test its effect on breastfeeding outcomes are needed.

Comparison of oral-health-related quality of life during treatment with headgear and functional appliances

Functional and headgear are two well-known approaches in the treatment of skeletal class II malocclusion in preadolescent children. Assessment of psycho-social impacts of wearing devices during the treatment period is central to enhancing the quality of healthcare services. This study aimed to compare oral-health-related quality of life in two groups consisting of children wearing headgear or functional appliances. We also compared these groups with a non-malocclusion group. The study population consisted of 187, 11- to 14-year-old children in three groups of functional (n = 67), headgear (n = 67) and non-malocclusion (n = 53). Children were asked to complete the translated version of the short form of the Child Perceptions Questionnaire. Total scores and subscale scores of the three clinical groups were compared through ANOVA. There was no significant difference in mean total scale score and subscale scores between functional and headgear groups (P > 0.05). Significant differences were found in both mean total and subscale scores between the malocclusion and non-malocclusion groups (P < 0.001) except oral symptoms subscale (P > 0.05). The results of this study reveal that functional and headgear appliances do not differ in terms of impact on daily life during the treatment. Moreover, both groups have poorer OHQoL compared to malocclusion group.

Health Promotion and Risk Behaviors Among Adolescents in Turkey

Adolescents experience the onset and development of several health-related behaviors. The purpose of this study is to determine health risk and promotion behaviors of adolescents between the ages of 11 and 19 who were attending and to test the reliability and validity analysis of the Turkish version of Adolescent Health Promotion Scale (AHPS). The study was a cross-sectional survey and the sample consisted of 1,351 participants. A questionnaire that included demographic information, health risk behaviors, and AHPS was used to collect data. In the current study, the Cronbach's α coefficient for the AHPS was calculated as .92. Female students had significantly higher mean total scale scores than males (p < .05). The 11-14 age group had a statistically significant higher scale total mean score than the 15-19 age group (p = .001). International directives highlight the important function nurses fulfill in health promotion. Nurses may play a key role in school health services.

The Creutzfeldt-Jakob disease (CJD) neurological status scale: a new tool for evaluation of disease severity and progression

To develop a scale sensitive for the neurological manifestations of Creutzfeldt-Jakob disease (CJD). A 26-item CJD neurological status scale (CJD-NS) was created based on characteristic disease manifestations. Each sign was assigned to one of eight neurological systems to calculate a total scale score (TSS) and a system involvement score (SIS). The scale was administered to 37 CJD patients, 101 healthy first-degree relatives of the patients and 14 elderly patients with Parkinson's disease (PD). The mean TSS (±SD) was significantly higher in patients with CJD (13.19 ± 5.63) compared with normal controls (0.41 ± 0.78) and PD patients (9.71 ± 3.05). The mean SIS was also significantly different between the CJD (5.19 ± 1.22) and PD (2.78 ± 1.18 P ≤ 0.01) groups reflecting the disseminated nature of neurological involvement in CJD. Using a cutoff of TSS > 4 yielded a sensitivity of 97% for CJD, and specificity of 100% against healthy controls. All individual items showed excellent specificity against healthy subjects, but sensitivity was highly variable. Repeat assessments of CJD patients over 3-9 months revealed a time-dependent increase in both the TSS and the SIS reflecting the scale's ability to track disease progression. The CJD-NS scale is sensitive to neurological signs and their progression in CJD patients.

Validity and reliability of the ‘good perioperative nursing care scale’ for Turkish patients and nurses

To test the validity and reliability of the Turkish version of Good Perioperative Nursing Care Scale for nurses and patients. The nursing care in operating departments has an important role in modern health care and therefore more research concerning perioperative care quality is needed and the development of a measurement tool is necessary. The study was designed as a cross-sectional survey. The research population was 346 patients who had surgery and 159 operating room nurses who worked at 11 hospitals. The GPNCS contains 32 items. The items on the nurses' form were changed as little as possible to create the form for patients to be able to directly compare them. To determine the tool's language equivalency/adaptation of the questionnaire for both nurses and patients, the tool was translated into Turkish then retranslated, and a pilot study was conducted. The total scale's total mean score and standard deviation for nurses was determined to be 113·23 (SD 2·13) and for patients was 128·23 (SD 1·27). To test the scale's stability over time, a test-retest was conducted and the results showed a strong confirmatory correlation. The GPNCS was determined to be a tool that had indicators of being adequate, reliable and valid for the Turkish population. This study highlighted the importance of comparing the quality and effectiveness of nursing care in different operating departments. It is recommended that it be used to determine the quality of perioperative nursing care in Turkey.

Measuring Primary Care of Children in Pediatric Resident Continuity Practices: A Continuity Research Network Study

Pediatric resident continuity practices provide care to more than one fifth of the socioeconomically disadvantaged population of the United States. With the structural challenges of resident training, there may be concerns about a lower quality of care received by patients. The objectives of this study were to measure parental perception of resident primary care, to determine the characteristics associated with better care, and to compare perception with a previously published community standard. A cross-sectional survey using the Parents' Perception of Primary Care was conducted of patients enrolled at 19 national academically affiliated resident continuity practices from the Continuity Research Network. Outcome measures included mean total scale score for the Parents' Perception of Primary Care and mean scores for each primary care domain. Comparisons were made between the subset of resident patients who were older than 5 years and a previously published community survey of parents of school-age children. A total of 2572 patients were enrolled with a final sample size of 2211 analyzable surveys. The sample was 37% black and 40% Hispanic; 81% of the children had Medicaid insurance; and 20% of the parents had less than a high school education. Parents rated the care that they received in resident continuity with high total scores and subscale scores, with an overall mean total scale score of 74.0. Higher scores were associated with number of visits to the provider and being able to name the resident as the primary care provider, whereas minority status was associated with lower access and communication scores. The resident sample over age 5 had higher mean scores for the total scale and every domain as compared with the community sample. Parents of patients at resident continuity sites rated residents as providers of high-quality care to a socioeconomically disadvantaged population as compared with a previously published community sample. Efforts to improve resident continuity and identification may help improve care delivered in resident practices.

Study of the Reliability and Validity of the Community Health Intensity Rating Scale (CHIRS) in the Turkish Community

The purpose of this study was to examine the reliability and validity of the Community Health Intensity Rating Scale (CHIRS) that was translated into the Turkish language and applied in the Turkish community. The CHIRS is a tool that assesses the intensity of need for care of persons/families in the community. The original version of the tool was translated into Turkish, examined for face validity and language appropriateness by the Turkish experts, and then applied to 372 families living in Odemis, Turkey. Significant correlations were found between total scale score (TSS) and total number of household members, and between the TSS and the total number of visits to any health institution within the previous month. In addition, the self-health care needs evaluation scores supported predictive validity. For reliability, min-max values, standard errors and deviations, skewness, and kurtosis coefficients of parameter scores, domain scores, and TSS were examined. The mean TSS was 26.7 (+/- 5.32) and the mean age of the participants was 35.0 years. For internal consistency, Cronbach's alpha (.525) and Guttman split-half coefficient (.629) values were established for the TSS. In conclusion, the reliability and validity of the Turkish version of CHIRS have been established.

A Pilot Study of Quetiapine Treatment of Aggression Due to Traumatic Brain Injury

A Pilot Study of Quetiapine Treatment of Aggression Due to Traumatic Brain Injury

Validity and reliability of the Arabic translation of the child oral‐health‐related quality of life questionnaire (CPQ11−14) in Saudi Arabia

The purpose of this study was to test the validity and reliability of an Arabic translation and adaptation of the child oral-health-related quality of life questionnaire (CPQ(11-14)) in Saudi Arabia. The modified questionnaire included two global ratings (oral health and oral-health-related well-being), and a battery of 36 questions in four domains (oral symptoms, functional limitations, emotional well-being and social well-being). The study population consisted of 174, 11-14-year-old children (65% healthy and 35% medically compromised). Clinical data on caries status and malocclusion were collected for 138 of the children, and 47 completed the questionnaire a second time. There was a significant difference in mean total scale scores between children with and without malocclusions (P < 0.05). Significant relationships were identified between caries status and oral symptoms subscale scores, and between malocclusion and total scale and social well-being subscale scores (P < 0.05). Correlation was highly significant between scale scores and global ratings (P < 0.01). Cronbach's alpha was 0.81 and the test-retest reliability was substantial (r = 0.65, P < 0.001). However, problems were encountered in Saudi Arabia regarding self-reporting of age, and the questionnaire was too long for many of the medically compromised patients. The questionnaire is valid and reliable for use in Saudi Arabia, although development of a shorter version is recommended.

Improving the Quality Of Infant—Toddler Care Through Professional Development

The effect of a professional development program on the quality of care provided for infants and toddlers was assessed with a sample of 160 caregivers in 96 infant—toddler rooms in 48 childcare programs. Caregivers participated in a 3-month training course with a standardized curriculum of five 3-hour group classes and an out-of-class project. A total of 123 participants in 70 classrooms also received onsite consultation. Consultation was not provided for 37 participants in 26 classrooms. The effect of training program participation was judged using pre- and posttraining comparisons between mean total scale scores on the Infant/Toddler Environment Rating Scale (Harms, Clifford, &amp; Cryer, 1990) . Comparisons also were made between classrooms where score differences were rated as observable change. Observable change was evident in 15 (21.4%) infant—toddler rooms in the consultation group, in comparison to 2 (7.7%) infant—toddler rooms in the no-consultation group.

Ethnic group, hyperkinesis, and modes of behavior

This paper examines modes of behavior across different ethnic groups of children rated as hyperactive on a behavior rating scale. The experimenters questioned the similarity in behavior patterns or modes displayed by 132 black, white, and Mexican-American children who had been rated as hyperactive. Using the Abbreviated Conners Teacher Rating Scale, score patterns of these children were examined through analysis of variance. The results revealed differences across ethnic groups: black children scored significantly higher than the white and Mexican-American children on three scale items and also scored significantly higher than the other two groups in terms of mean total scale score. These findings are interpreted from a sociological perspective.