Use Of Assessment Instruments Research Articles

Commentary on Parish et al. (2017): What is the best exposure for estimating alcohol-attributable burden of disease?

Triangulation of survey data on alcohol use with more reliable per capita data is a common procedure for estimating true alcohol exposure. Improved methodology for such triangulation will also help to establish comparability between surveys, and to improve comparative risk assessments for burden of disease. However, additional research is needed to loosen the assumption of under-reporting of all survey respondents by a fixed proportion. Survey data usually underestimate true consumption in a population, and triangulation with per-capita data is a common procedure for estimating true alcohol exposure or alcohol-attributable harm 1, 2. Parish and colleagues presented a new methodology for such triangulations 3, which will not only improve comparability between consumption level of surveys, but also lead to more reliable comparative risk assessments for burden of disease. To measure alcohol use in a population, aggregate statistics based on sales or on production, export and import have been shown to yield reliable and, in most cases, much higher levels of use compared to surveys 4, 5. However, the level of coverage varies widely, from as low as 12% in some South African surveys 6 to close to 90% in New Zealand surveys 7. This leads to problems of comparability between surveys within and between countries, with estimating much lower consumption levels based on surveys with low coverage compared to surveys with high coverage. Triangulations such as the one by Parish and colleagues 3 can be used for more valid comparisons, by standardizing to per capita consumption or an arbitrary proportion thereof 1, 8. A more difficult question is to determine the best level of adult per-capita consumption to be used for alcohol-attributable burden calculations as part of comparative risk assessments. Undercoverage of surveys results from three main mechanisms: (a) individual under-reporting; (b) use of assessment instruments which make it difficult to capture variability and thus will result in omission of heavy drinking occasions (e.g. questions on usual drinking 9); and (c) sampling frames which exclude the heaviest drinkers and differential non-response 10. Individual under-reporting may also occur in medical cohort studies to determine risk relations so, if one uses 100% of adult per-capita consumption for triangulation, it may lead to overestimation of harm. The assessment methodology in medical epidemiology is often different, and has been shown to be associated with less underestimation (e.g. 48 hours’ dietary protocol 11; see also 12). Moreover, for clinical cases with very heavy consumption, there is not necessarily an under-reporting of alcohol 13, 14. Finally, as epidemiological studies do not have to be representative to estimate risk relations, and as the whole variation of exposure can be covered by meta-analyses of different studies, including studies with samples of heavy or very heavy drinkers, the problem of sampling frame is irrelevant. Taken together, these considerations led the World Health Organization (WHO) Technical Advisory Group on Substance Use Epidemiology to recommend an assumption of 80% coverage for triangulation. Such a recommendation could also be implemented easily using the Parish approach. Up to now, all triangulation approaches suffer from one crucial assumption, that all survey respondents under-report their alcohol consumption by a fixed proportion. This assumption is certainly false in this rigidity. Future research will need to differentiate levels of underestimation by different types of responders with different drinking patterns. In this context it should be noted that, for different kinds of risk relations, precision in different parts of the alcohol use exposure is important. For example, for diseases with relatively flat and almost linear curvature of the relative risk curve such as breast cancer 15, estimating mild to moderate levels of drinking correctly becomes crucial, whereas for exponential curves such as liver cirrhosis 16, estimating the heavy drinking levels is more important (for an overview of curvatures see 17, 18). Thus, flexible triangulation techniques such as the Parish methodology 3 will become more important. Unfortunately for these estimates, the causal impact of alcohol use on disease and mortality is not limited to the dimension of level of use 17. Patterns of drinking, especially irregular heavy drinking occasions, play a crucial role, and current triangulation methods have not yet created solutions for capturing this dimension comparatively. In summary, while the contribution of Parish and colleagues 3 will enlarge our methodological arsenal, many more such contributions are needed to improve population distributions of alcohol exposure and attributable harm. Given the importance of alcohol as a risk factor for burden of disease and mortality 19, the scarcity of such research is surprising. None. Part of this work was supported by WHO Collaboration Centre for Addiction and Mental Health.

Expert Consensus to Examine the Cross-Cultural Utility of Substance Use and Mental Health Assessment Instruments for Use with Indigenous Clients

Evaluation of minority-culture specific treatment centres for substance use and mental health is challenging. The challenge is compounded by a paucity of validated instruments for assessing substance use and mental ill health. In the field of Australian Indigenous alcohol and other drug service provision there are few guidelines to determine which instruments should be targets for validation for use with Indigenous clients. As such, reliable, validated, evaluable data on the client population is limited, posing multifaceted concerns for clinicians and service providers as well as evaluators. The aim of this study was to pilot the use of a participatory expert consensus approach to evaluate, rate and select suitable majority-culture substance use and mental health assessment instruments for use with their clients. Eight practitioners of an Indigenous-specific substance misuse residential treatment centre participated. The findings reinforce the value of consensus approaches for stakeholder engagement and to provide a sense of ownership of the results. In this setting, consensus on the implementation of an agreed set of Indigenous-specific and non-Indigenous specific instruments improved the ownership of the instruments by clinicians allowing for the use of valid and/or reliable instruments that also had good face validity. This makes it more probable that reliable client wellbeing data will be collected. This is crucial to program evaluation at a later point in time. This study was a novel approach to generating evidence to inform practice in the absence of normative practice guidelines.

Conformity of nurse prescribing to care needs: nurses' understanding.

investigate the understanding of nurses on nurse prescribing conformity to the care needs of hospitalized patients and factors associated with that conformity. a descriptive study, with a quantitative approach, was conducted at 20 in-patient units of a teaching hospital in the state of São Paulo. The participants (N=139) answered a semi-structured questionnaire. For 43 (30.9%) nurses, nurse prescribing is always in line with patients' care needs. The fields of body care and elimination, skin and mucosa care and investigation and monitoring were the most frequently addressed. in the perception of most nurses, nurse prescribing does not conform with patients' health heeds. The establishment of strategies to improve prescribing quality is recommended, as well as the development of permanent qualification programs and the systematic use of instruments for assessment of patients' care demands regarding nursing.

Student Self-Assessment and Faculty Assessment of Performance in an Interprofessional Error Disclosure Simulation Training Program

Objectives. To conduct a prospective evaluation for effectiveness of an error disclosure assessment tool and video recordings to enhance student learning and metacognitive skills while assessing the IPEC competencies. Design. The instruments for assessing performance (planning, communication, process, and team dynamics) in interprofessional error disclosure were developed. Student self-assessment of performance before and after viewing the recordings of their encounters were obtained. Faculty used a similar instrument to conduct real-time assessments. An instrument to assess achievement of the Interprofessional Education Collaborative (IPEC) core competencies was developed. Qualitative data was reviewed to determine student and faculty perceptions of the simulation. Assessment. The interprofessional simulation training involved a total of 233 students (50 dental, 109 nursing and 74 pharmacy). Use of video recordings made a significant difference in student self-assessment for communication and process categories of error disclosure. No differences in student self-assessments were noted among the different professions. There were differences among the family member affects for planning and communication for both pre-video and post-video data. There were significant differences between student self-assessment and faculty assessment for all paired comparisons, except communication in student post-video self-assessment. Students' perceptions of achievement of the IPEC core competencies were positive. Conclusion. The use of assessment instruments and video recordings may have enhanced students' metacognitive skills for assessing performance in interprofessional error disclosure. The simulation training was effective in enhancing perceptions on achievement of IPEC core competencies. This enhanced assessment process appeared to enhance learning about the skills needed for interprofessional error disclosure.

A systematic review of observational pain assessment instruments for use with nonverbal intubated critically ill adult patients in the emergency department: an assessment of their suitability and psychometric properties.

To examine the psychometric properties and suitability of the available observational pain instruments for potential use with nonverbal critically ill adult patients in the emergency department. In the emergency department, assessing pain in critically ill patients is challenging, especially those unable to communicate the presence of pain. Critically ill patients are commonly unable to verbally communicate pain due to altered oral communication (e.g. endotracheal intubation) and/or diminished consciousness (e.g. sedation, delirium), placing them at great risk of inadequate pain management. Over half of intensive care critically ill intubated patients experience moderate-to-severe pain whilst intubated and mechanically ventilated. Systematic review. The CINAHL, EMBASE, MEDLINE, ProQuest databases, and the Cochrane Library and the National Institute of Clinical Excellence were also searched from their date of inception to April 2016, with no language restrictions applied. Studies were identified using predetermined inclusion criteria. Data were extracted and summarised and underwent evaluation using published classification of psychometric tests for consistency of interpretation. Twenty-six studies evaluating five observational pain assessment instruments that had been used with critically ill intubated patients were identified. All five instruments included behavioural indicators, with two including physiologic indicators. All five instruments have undergone validity and reliability testing involving nonverbal critically ill intubated patients, three were examined for feasibility, and one instrument underwent sensitivity and specificity testing. None have been tested within the emergency department with nonverbal critically ill intubated adult patients. The use of an appropriate and valid observational pain assessment instrument is fundamental to detecting and optimising pain management in nonverbal critically ill intubated patients in the emergency department. Of the observational pain assessment instruments reviewed, the Critical-Care Pain Observation Tool was identified as most appropriate for testing in a prospective trial in an emergency department setting.

Measuring pediatric hematology-oncology fellows' skills in humanism and professionalism: A novel assessment instrument.

Educators in pediatric hematology-oncology lack rigorously developed instruments to assess fellows' skills in humanism and professionalism. We developed a novel 15-item self-assessment instrument to address this gap in fellowship training. Fellows (N = 122) were asked to assess their skills in five domains: balancing competing demands of fellowship, caring for the dying patient, confronting depression and burnout, responding to challenging relationships with patients, and practicing humanistic medicine. An expert focus group predefined threshold scores on the instrument that could be used as a cutoff to identify fellows who need support. Reliability and feasibility were assessed and concurrent validity was measured using three established instruments: Maslach Burnout Inventory (MBI), Flourishing Scale (FS), and Jefferson Scale of Physician Empathy (JSPE). For 90 participating fellows (74%), the self-assessment proved feasible to administer and had high internal consistency reliability (Cronbach's α = 0.81). It was moderately correlated with the FS and MBI (Pearson's r = 0.41 and 0.4, respectively) and weakly correlated with the JSPE (Pearson's r = 0.15). Twenty-eight fellows (31%) were identified as needing support. The self-assessment had a sensitivity of 50% (95% confidence interval [CI]: 31-69) and a specificity of 77% (95% CI: 65-87) for identifying fellows who scored poorly on at least one of the three established scales. We developed a novel assessment instrument for use in pediatric fellowship training. The new scale proved feasible and demonstrated internal consistency reliability. Its moderate correlation with other established instruments shows that the novel assessment instrument provides unique, nonredundant information as compared to existing scales.

The Prediction of Problem-Solving Assessed Via Microworlds

Abstract. In this study, we explored the network of relations between fluid reasoning, working memory, and the two dimensions of complex problem solving, rule knowledge and rule application. In doing so, we replicated the recent study by Bühner, Kröner, and Ziegler (2008) and the structural relations investigated therein [ Bühner, Kröner, & Ziegler, (2008) . Working memory, visual-spatial intelligence and their relationship to problem-solving. Intelligence, 36, 672–680]. However, in the present study, we used different assessment instruments by employing assessments of figural, numerical, and verbal fluid reasoning, an assessment of numerical working memory, and a complex problem solving assessment using the MicroDYN approach. In a sample of N = 2,029 Finnish sixth-grade students of which 328 students took the numerical working memory assessment, the findings diverged substantially from the results reported by Bühner et al. Importantly, in the present study, fluid reasoning was the main source of variation for rule knowledge and rule application, and working memory contributed only a little added value. Albeit generally in line with previously conducted research on the relation between complex problem solving and other cognitive abilities, these findings directly contrast the results of Bühner et al. (2008) who reported that only working memory was a source of variation in complex problem solving, whereas fluid reasoning was not. Explanations for the different patterns of results are sought, and implications for the use of assessment instruments and for research on interindividual differences in complex problem solving are discussed.

A review of psychological assessment instruments for use in bariatric surgery evaluations.

Bariatric surgery is a viable treatment option for patients with extreme obesity and associated medical comorbidities; however, optimal surgical outcomes are not universal. Surgical societies, such as the American Society for Metabolic and Bariatric Surgery (ASMBS), recommend that patients undergo a presurgical psychological evaluation that includes reviewing patients' medical charts, conducting a comprehensive clinical interview, and employing some form of objective psychometric testing. Despite numerous societies recommending the inclusion of self-report assessments, only about 2/3 of clinics actively use psychological testing-some of which have limited empirical support to justify their use. This review aims to critically evaluate the psychometric properties of self-report measures when used in bariatric surgery settings and provide recommendations to help guide clinicians in selecting instruments to use in bariatric surgery evaluations. Recommended assessment batteries include use of a broadband instrument along with a narrowband eating measure. Suggestions for self-report measures to include in a presurgical psychological evaluation in bariatric surgery settings are also provided. (PsycINFO Database Record

Theory-based assessment in environmental education: a tool for formative evaluation

This article reports on the development of a theory-informed assessment instrument for use in evaluating environmental education programs. The instrument involves coding learners’ brief reflective writing on five established educational and social psychological constructs that correspond to five important goals of environmental education: promoting learners’ perceived relevance of environmental content, sense of personal and collective responsibility for sustainability, knowledge of environmental content, readiness for environmental action, and identity exploration around environmental questions. The article describes the development of the instrument and its use for coding the reflective writing of 242 early adolescents who participated in a large-scale environmental education program.

Are South African Speech-Language Therapists adequately equipped to assess English Additional Language (EAL) speakers who are from an indigenous linguistic and cultural background? A profile and exploration of the current situation.

This article presents the results of a survey conducted on Speech-Language Therapists (SLTs) regarding current practices in the assessment of English Additional Language (EAL) speakers in South Africa. It forms part of the rationale for a broader (PhD) study that critiques the use of assessment instruments on EAL speakers from an indigenous linguistic and cultural background. This article discusses an aspect of the broader research and presents the background, method, findings, discussion and implications of the survey. The results of this survey highlight the challenges of human and material resources to, and the dominance of English in, the profession in South Africa. The findings contribute to understanding critical factors for acquiring reliable and valid assessment results with diverse populations, particularly the implications from a cultural and linguistic perspective.

The Brazilian Version of the Edmonton Symptom Assessment System (ESAS) Is a Feasible, Valid and Reliable Instrument for the Measurement of Symptoms in Advanced Cancer Patients.

PurposesTo develop and validate a Portuguese version of the Edmonton Symptom Assessment System (ESAS) in Brazilian patients with advanced cancer.MethodsThe ESAS was translated and then back translated into Portuguese in accordance with international guidelines. The final version was approved by an Expert Committee after pilot testing on 24 advanced cancer patients. Subsequently, we evaluated the time to complete the assessment, the number of unanswered items, internal consistency, convergent validity, and known-group validity in a sample of 249 advanced cancer patients who completed the ESAS along with the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30), Hospital Anxiety and Depression Scale (HADS), and Epworth Sleepiness Scale (ESS). A total of 90 clinically stable patients were retested after 4 to 96 hours (test-retest reliability), and 80 patients answered the ESAS after 21 (±7) days to measure scale responsiveness using an anchor-based method.ResultsThe ESAS was completed in a mean time of only 2.2 minutes. The internal consistency was good (Cronbach's alpha = 0.861), and the removal of single items did not change the overall alpha value. For convergent validity, Spearman’s correlation coefficients between the ESAS symptom scores and the corresponding EORTC QLQ-C30 and ESS symptom scores ranged between 0.520 (95% CI = 0.424–0.605) and 0.814 (95% CI = 0.760–0.856), indicating moderate to strong correlations. Test-retest reliability values were considered adequate, with intraclass correlation coefficients ranging from 0.758 (95% CI = 0.627–0.843) to 0.939 (95% CI = 0.905–0.960).ConclusionsESAS is a feasible, valid and reliable multi-symptom assessment instrument for use in Brazil.

Five Tips for a Successful Submission on Simulation-Based Medical Education.

Over the past 2 decades, there has been an exponential adoption of simulation in health care education throughout the continuum of medical training and practice. During this time evidence demonstrating the effectiveness and impact of simulation-based medical education (SBME) has mounted: When simulation training is conducted under the right conditions and outcomes are measured by instruments with evidence for reliability and validity, research has shown not only that graduate trainees can obtain desired skills in a controlled, simulated environment1 but also that these skills can transfer to the clinical setting2 and, in some cases, lead to improved patient outcomes.3 Several systematic reviews and meta-analyses indicate that the magnitude of the effects of SBME are significant and consistent across medical disciplines, and these studies highlight the features of SBME that lead to more effective results.4–,6 Faculty involved in postgraduate education are increasingly adopting simulation in response to several challenges: mounting curricular demands in a setting in which there are fewer real patient encounters because of changes in patient care reimbursement and work hour restrictions, emphasis on patient safety and quality care, and recently, more rigorous requirements to teach and evaluate on a regular basis the Accreditation Council for Graduate Medical Education (ACGME) core competencies and developmental Milestones.7 These pressures have led to widespread change in postgraduate medical education that increasingly involves simulation technology and innovative ways to provide a standardized training and evaluation program. At the same time, academic medical centers expect their faculty to demonstrate scholarly activity in the form of peer-reviewed publications and presentations at scientific and education meetings. The Journal of Graduate Medical Education provides detailed guidelines for the preparation of manuscripts reporting various categories of scholarly activity, and authors should always follow these instructions before submitting their work for consideration to publish.8 The goal of this brief article is to provide 5 specific tips to authors for a more successful submission (especially in the “Original Research” category) on the use of simulation for health care education.​education. TABLE Key Elements and Examples of a Successful Submission on Simulation-Based Medical Education

Use of Instrument to Measure Student’s Understanding of the Concept of Light Refraction Using Animation Slide Show for Secondary School Students

The purpose of this study was to get an idea of the effect of the use of assessment instruments in the form of animation to test understanding of the concept of refraction of light. The method used is a quasi-experiment with design posttest only nonequivalent control group design. As a control group used items were in the form of paper and pencil tests. Study was conducted on a class X student of SMA Tanjungpinang in Provinsi Kepulauan Riau of academic year 2013/2014. Samples were selected two classes of seventh grade classes were randomly parallel, as a control group and experiment group. Sum of sample of 85 people with 42 people for a percentage of the control class and 43 people for classroom experiments. Data collected after the experimental class and control class equally get learning the refraction of light. Gain control class test in the form of paper and pencil test which amounts to about 20 numbers, and the experimental class to get the test in the form of the same animation and the number 20, numbers matter. The research instrument used was a questionnaire about the pretest and posttest design. Data analysis was conducted using inferential statistics using SPSS 17.Based on the results the average score of the experimental class 74% with a standard deviation of 14 and an average score of 31% control class with a standard deviation of 12. It can be concluded that the test results of students' understanding of the concept of refraction of light that gets items were significantly different in animated form compared to students who obtain items were in the form of paper and pencil test. Understanding students' test results in sub concepts Snell's law, a concave lens and a convex lens using items were in the form of animation is higher than the students who use the items were in the form of paper and pencil tests. Students agree with the use of items were in the form of animation on comprehension tests concept of refraction of light. Students stated that the items were animated very interesting, a better understanding of the issue in question, to understand the purpose and content of questions, and a description of the problem becomes clearer. The use of items was suggested in the form of animation to be developed on other concepts in physics learning.

Observation-centered approach to ASD assessment in Tanzania.

Abstract In many lower-income countries, there is a paucity of assessment services for autism spectrum disorders (ASD)., Guidelines will be provided for conducting cross-cultural assessments in the context of limited validated resources in Tanzania. By examining behavioral, social, and adaptive differences we were able to provide differential diagnostic evaluations aligning with best practice standards for 41 children in Tanzania age 2-21 years. We describe the utility of a flexible, behavioral observation instrument, the Childhood Autism Rating Scales, Second Edition (CARS2), to gather diagnostic information in a culturally sensitive manner. We observed that the ASD group was characterized by significantly higher scores on the CARS2, F = 21.09, p < .001, η(2) = .37, than the general delay comparison group. Additional recommendations are provided for making cultural adaptations to current assessment instruments for use in a country without normed instruments, such as Tanzania.

Commentary on DeClue and Zavodny (2014).

This commentary focuses on the paper by DeClue and Zavodny (2014, pp. 145–161) in this issue of the Journal of Threat Assessment and Management. In their series of papers (DeClue, 2013; DeClue & Campbell, 2013; DeClue & Zavodny, 2013), the authors identify six questions commonly encountered by evaluators using Static 99R. The questions relate to the method by which risk estimates are obtained and the reporting of those estimates. In the present study, DeClue and Zavodny (2014) provide clear answers for each of the questions raised and guidelines for evaluators on how to proceed with and present their assessments. In addition to providing this information, their paper raises several important issues that will be discussed herein, including a) the need for similar guidelines for other violence risk assessment instruments, b) the need for research on the use of violence risk assessment instruments in practice, c) the need for research on the communication of violence risk, and d) the selection of violence risk assessment instruments for use in practice. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

Use of the Tinetti Index to Assess Fall Risk in Patients with Sequelae of Stroke

Background and Objective: The knowledge about risk of falls in patients with sequelae of stroke by applying a scale constitutes an important factor fort nurses since it allows planning for quality care and consequently improves the quality of life of such patients. The present study aimed to assess the risk of falls of patients with sequelae of stroke using Tinetti Index. Methods: Transversal descriptive study with 61 hospitalized patients. The data were collected through the application of Tinetti Index, the total score of which is 28 points. Results: The index evaluation shows que 47.9% had 19 points under the ideal score, indicating a high risk of falls, 41.7% from 24 to 28, indicating moderate risk and 10.4% from 19 to 23 points, indicating low risk of falls. The final average was (15.23), the median (16.50) and standard deviation (±11.034). Conclusions: There is a high risk of falls in this population, a quantification of impaired balance and gait anticipate the future risk of falls. The use of assessment instruments has important implications for improving the quality of life in patients with symptomatic stroke.

Scale for assessment of lethality of suicide attempt.

Background:Lethality of suicidal attempt provides useful information regarding the behavior. There is a perceived need for a clinically useful scale that can be easily adapted to various methods and circumstances of attempt.Aims:The study intended to develop and test utility of a scale for measuring lethality that can reflect overall clinical observation taking into account various indicators of lethality and which can be used across clinical scenarios involving different methods.Settings and Design:Cross-sectional study in a hospital.Materials and Methods:The scale for assessment of lethality of suicide attempt (SALSA) has two components: The first component has four items indicating seriousness of the attempt and its likely consequences and the second component is the global impression of lethality. All the items are scored from 1 to 5, higher scores suggestive of increased lethality. SALSA was used to evaluate lethality of 82 consecutive suicide attempters; and it was compared with lethality of suicide attempt rating scale (LSARS) and risk-rescue rating scale.Statistical Analysis:Chi-square, t-test, analysis of variance, Cronbach's alpha, binary logistic regression.Result:There was significant correlation of SALSA score with that of LSARS (r: 0.89) and risk score of risk-rescue rating (r: 0.93, P < 0.001); and negative correlation with rescue score (r: −0.569; P < 0.001). Internal consistency reliability of SALSA was high (Cronbach's alpha: 0.94). Lethality scores of SALSA differentiated known groups with different lethality, e.g. deceased and survived; attempters with different levels of medical intervention: In-patient only, intensive care, ventilator support. SALSA score significantly predicted the lethal outcome (odds ratio: 3.2, confidence interval: 1.12-8.98).Conclusion:SALSA is a useful instrument for assessment of lethality of suicidal behaviors during clinical evaluations considering the ease of administration, its ability to differentiate clinical groups with known variations of lethality and clinical outcomes.

Use of the Tinetti Index to Assess Fall Risk in Patients with Sequelae of Stroke

Background and Objective: The knowledge about risk of falls in patients with sequelae of stroke by applying a scale constitutes an important factor fort nurses since it allows planning for quality care and consequently improving the quality of life of such patients. The present study aimed to assess the risk of falls of patients with sequelae of stroke using Tinetti Index. Methods: Transversal descriptive study with 61 hospitalized patients. The data were collected through the application of Tinetti Index, which total score is 28 points. Results: The index evaluation shows que 47.9% had 19 points under the ideal score, indicating a high risk of falls, 41.7% from 24 to 28, indicating moderate risk and 10.4% from 19 to 23 points, indicating low risk of falls. The final average (15.23), the median (16.50) and standard deviation (±11.034). Discussion and Conclusions: There is a high risk of falls in this population, a quantification of impaired balance and gait anticipate the future risk of falls. The use of assessment instruments has important implications for a quality of life in patients with symptomatic stroke.

The Beech Brook Group Therapy Assessment Tool: A Pilot Study

Assessment is a critical component of therapeutic intervention as it serves as the basis from which clinical goals and objectives are derived. Unfortunately, there is a dearth of reliable group therapy assessment instruments, especially for children and preadolescents who have severe emotional disturbances. The purpose of this study was to test reliability of a newly developed group therapy assessment instrument for use with children who have serious emotional disturbances that require placement in a residential or partial hospitalization treatment program. After conducting an extensive literature review, the authors developed, refined, and tested a group therapy assessment tool for use in both music therapy and traditional therapy, measuring nine items: attention to task (physical and verbal), eye contact, pro-social skills (physical and verbal), empathy (physical and verbal), and managing negative affect (physical and verbal). Six participants with a mean age of 9.5 (SD = 1.85) years were randomly selected to test the group therapy assessment tool from a pool of 60 eligible children receiving group partial hospitalization therapy. Participants were scored by three raters across two partial hospitalization therapy groups for inter-rater reliability. Content and construct validity were also examined. Intraclass Coefficients (ICC) averaged 0.994 across all nine items indicating excellent inter-rater reliability. Content and construct validity was established and the instrument demonstrated good external validity potential. The Beech Brook Therapy Assessment Instrument has demonstrated excellent inter-rater reliability in measuring important behaviors of functioning central in the treatment of youth with severe and emotional disturbances. The measure has potential for wide utility and application in practice and research; however, future studies are needed to establish external validity.

Wie schätzen Pflegende die Suizidalität von Patient(inn)en ein? Erhebung in psychiatrischen Institutionen der deutschen Schweiz

In the interdisciplinary treatment process nurses play an important role, assessing suicide risk. To cope with this responsibility, the use of assessment instruments is recommended. Although a lot of instruments exist to assess the risk of suicide, nurses do not use them consistently. This cross-sectional study seeks to answer the following questions: How do nurses assess the suicidality of patients of psychiatric hospitals in the German speaking part of Switzerland? Do they use assessment instruments and if so, which ones? Ward nurses in every psychiatric hospital (n = 32) were asked about the state of the nursing practice in assessing the suicide risk by means of an electronic questionnaire. The following results emerged: Nurses use instruments to assess suicide risk on about half of the wards (n = 119, 50.63%). 13% of the mentioned instruments are research-based. Nurses mostly assess suicide endangerment in the case of a presumed danger, less often at admission and least often during the discharge process. As suicidality is assessed mostly when nurses assume a danger in this study, and due to the fact that suicides most frequently occur shortly prior to or during the discharge process, an expansion of or the introduction of the assessment is recommended before the discharge process.