Validated Assessment Tools Research Articles

DOES THE FACTS ON AGING QUIZ ASSESS AGING STEREOTYPES?

Abstract The World Health Organization (WHO) Global Report on Ageism urges researchers to develop and validate assessment tools, thus enabling the field to better address ageism. This study assesses the internal consistency and construct validity of a short Facts on Aging Quiz (SFAQ, 10-items). We hypothesize that the SFAQ is a valid and reliable tool for assessing aging stereotypes. Data from the National Resource Center on Nutrition and Aging 2022 Needs Assessment were utilized. Data were collected via an online survey through a convenience sample of the National Aging Network (n=1,910). Three aging perspective tools were included: SFAQ, Expectations Regarding Aging (ERA, 12-items), and the WHO Ageism Quiz (AQ, 8-items). An exploratory factor analysis assessed whether negative (NEG) and positive (POS)-stereotype SFAQ items emerged as constructs. The factor analysis showed that NEG and POS-SFAQ accounted for 31.39% and 19.63% of the total variance, respectively. Cronbach alpha evaluated the internal consistency of the tools. Internal consistency for ERA (α=.81) and AQ (α=.57) were acceptable but low for total SFAQ (α=.28); reliability was acceptable for NEG-SFAQ (α=.71) and lower for POS-SFAQ (α=.40). Pearson correlation assessed convergent validity, with a significance level of p<.0001 (df=1,908) for all correlations. A negative correlation was detected between POS-SFAQ and ERA (r=-.31) and positive correlations between NEG-SFAQ and both ERA (r=.55) and AQ (r=.65), confirming convergent validity. POS-SFAQ was negatively correlated with NEG-SFAQ (r=-.19), suggesting the SFAQ may contain conflicting items. In conclusion, versions of the FAQ may perform better as a tool to assess aging stereotypes.

FACTORS INFLUENCING OLDER KOREAN AMERICAN IMMIGRANTS’ FRAILTY: A QUALITATIVE STUDY

Abstract The older immigrant population, characterized by unique attributes such as diverse cultural backgrounds, health beliefs, health behaviors, language barriers, and low health literacy, requires a specific focus on identifying factors that influence frailty. This study aims to explore the influencing factors of frailty among older Korean American immigrants (OKAIs) residing in suburban areas with limited Korean healthcare infrastructure. Semi-structured interviews were conducted with 9 OKAIs residing in Lee County, Alabama, focusing on four factors associated with frailty: health literacy, physical activity, diet, and mental health. Qualitative content analysis was employed to analyze the data. Validated assessment tools for frailty, health literacy, physical activity, nutrition, depression, and cognitive impairment were also used to gather participant characteristics and complement the qualitative findings. Participants exhibited significant differences in health literacy scores between the Korean and English versions. Content analysis yielded seven categories and twenty-two sub-categories were derived from the eighty identified codes. In addition to typical age-related changes observed among older adults in general, their social activities, health behaviors, and healthcare visits were constrained by different environments/healthcare systems compared to Korea, as well as limited English proficiency and healthcare resources. Participants expressed a need for Korean healthcare providers or interpreters during their healthcare visits and emphasized their preference for Korean food and sought ways to maintain vitality. To prevent and manage frailty among OKAIs, interventions need to consider their unique characteristics, facilitators, and barriers. This approach may also benefit other ethnic minority populations facing similar challenges, thus enhancing healthcare for these communities.

Curriculum for diagnostic endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

The European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in diagnostic endoscopic ultrasound (EUS). This manuscript represents the outcome of a formal Delphi process resulting in an official Position Statement of the ESGE and provides a framework to develop and maintain skills in diagnostic EUS. This curriculum is set out in terms of the prerequisites prior to training; the recommended steps of training to a defined syllabus; the quality of training; and how competence should be defined and evidenced before independent practice. 1: Trainees should have achieved competence in upper gastrointestinal endoscopy before training in diagnostic EUS. 2: The development of diagnostic EUS skills by methods that do not involve patients is advisable, but not mandatory, prior to commencing formal training in diagnostic EUS. 3: A trainee's principal trainer should be performing adequate volumes of diagnostic EUSs to demonstrate maintenance of their own competence. 4: Training centers for diagnostic EUS should offer expertise, as well as a high volume of procedures per year, to ensure an optimal level of quality for training. Under these conditions, training centers should be able to provide trainees with a sufficient wealth of experience in diagnostic EUS for at least 12 months. 5: Trainees should engage in formal training and supplement this with a range of learning resources for diagnostic EUS, including EUS-guided fine-needle aspiration and biopsy (FNA/FNB). 6: EUS training should follow a structured syllabus to guide the learning program. 7: A minimum procedure volume should be offered to trainees during diagnostic EUS training to ensure that they have the opportunity to achieve competence in the technique. To evaluate competence in diagnostic EUS, trainees should have completed a minimum of 250 supervised EUS procedures: 80 for luminal tumors, 20 for subepithelial lesions, and 150 for pancreaticobiliary lesions. At least 75 EUS-FNA/FNBs should be performed, including mostly pancreaticobiliary lesions. 8: Competence assessment in diagnostic EUS should take into consideration not only technical skills, but also cognitive and integrative skills. A reliable valid assessment tool should be used regularly during diagnostic EUS training to track the acquisition of competence and to support trainee feedback. 9: A period of supervised practice should follow the start of independent activity. Supervision can be delivered either on site if other colleagues are already practicing EUS or by maintaining contacts with the training center and/or other EUS experts. 10: Key performance measures including the annual number of procedures, frequency of obtaining a diagnostic sample during EUS-FNA/FNB, and adverse events should be recorded within an electronic documentation system and evaluated.

Combined use of the CLivD score and FIB-4 for prediction of liver-related outcomes in the population.

A need exists for effective and practical tools to identify individuals at increased risk of liver-related outcomes (LROs) within the general population. We externally validated the chronic liver disease (CLivD) score for LROs in the UK Biobank cohort. We also investigated the sequential combined use of CLivD and fibrosis-4 (FIB-4) scores. Our analysis included 369,832 adults without baseline liver disease and with available data for CLivD and FIB-4 computation. LROs reflecting compensated or decompensated liver cirrhosis or HCC were ascertained through linkages with electronic health care registries. Discriminatory performance and cumulative incidence were evaluated with competing-risk methodologies. Over a 10-year follow-up, time-dependent AUC values for LRO prediction were 0.80 for CLivD lab (including gamma-glutamyltransferase), 0.72 for CLivD non-lab (excluding laboratory values), and 0.75 for FIB-4. CLivD lab demonstrated AUC values exceeding 0.85 for liver-related death and severe alcohol-associated liver outcomes. The predictive performance of FIB-4 increased with rising CLivD scores; 10-year FIB-4 AUC values ranged from 0.60 within the minimal-risk CLivD subgroup to 0.81 within the high-risk CLivD subgroup. Moreover, in the minimal-risk CLivD subgroup, the cumulative incidence of LRO varied from 0.05% to 0.3% across low-to-high FIB-4 strata. In contrast, within the high-risk CLivD subgroup, the corresponding incidence ranged from 1.7% to 21.1% (up to 33% in individuals with FIB-4 >3.25). The CLivD score is a valid tool for LRO risk assessment and improves the predictive performance of FIB-4. The combined use of CLivD and FIB-4 identified a subgroup where 1 in 3 individuals developed LROs within 10 years.

A STUDY ON THE ADAPTATION OF THE TEACHERS’ RATINGS OF CHILD SECURE BASE BEHAVIOUR AND EMOTION REGULATION SCALE INTO TURKISH CULTURE

The goal of this study is to adapt the Teachers’ Ratings of Child Secure Base Behaviour and Emotion Regulation Scale into Turkish culture. The research group of the study included 295 children aged from 48 to 72 months. A total of 59 teachers participated in the adaptation study for the children. Data obtained were firstly used for confirmatory factor analysis in the scale validity test. According to the CFA results, a 28-item and two-factor structure of the scale was accepted with no need for any amendments. Strong significance was found between the reference scales and the scales on which the criterion-related validity test focused. The Cronbach’s alpha value of the scale was found to be .970 in the reliability test. A strong correlation was found between the two applications in the test re-test stage. The study findings reveal that the scale is a valid and reliable assessment tool for Turkish culture.

Cross-cultural adaptation and validation of the Autism Family Experience Questionnaire to an Indian context

Purpose The Autism Family Experience Questionnaire (AFEQ) is a 48-item questionnaire that assesses parental priorities for outcomes of early intervention of parents of children with autism spectrum disorder (ASD). The present study aims to adapt and validate the AFEQ to the Indian context as an attempt to provide a measure of family life and parent-reported outcomes before and after intervention. Methods Seventy-five parents of children with ASD were recruited for the study. The adapted version of AFEQ was given to five experienced professionals for content validation to assess cultural suitability in the Indian context. The test–retest reliability was assessed by re-administering the questionnaire to 40 parents within 15 to 30 days of initial administration. Results The Cronbach’s alpha value for the overall AFEQ score was 0.64, indicating acceptable internal consistency. Cohen’s kappa agreement was found to be 0.62, indicating good agreement between the five professionals. The adapted AFEQ scale showed good test–retest reliability (ICC = 0.72). Conclusion Results of our study indicated that AFEQ has good internal consistency, test–retest reliability, and content validity. The adapted AFEQ is a reliable and valid assessment tool that can be used to assess the parental experiences of families with ASD in the Indian context.

The ASQ did not predict low IQ scores when children born VPT were six years.

There is a need for methods that can provide valid assessment tools in a follow-up programme without great financial costs. This study assessed the accuracy of the 60-month Ages and Stages Questionnaire as a screening tool to predict a low intelligence quotient score at 6 years in children born very preterm. Totally, 54 children participated in a six-year follow-up study, which included an intelligence quotient test at 6 years of age and a 60-month Ages and Stages Questionnaire at four and a half or 5 years of age at respond. We used the receiver operating characteristic curve and evaluated the optimal cut-off score to predict a low intelligence quotient score. At four and a half years, the optimal cut-off value for predicting a low intelligence quotient score was 242, with a sensitivity of 67% and a specificity of 59%. At 5 years, only one child had a low intelligence quotient score, and the analysis was not performed. Our results did not support the use of the 60-month Ages and Stages Questionnaire as a valuable screening tool to predict a low intelligence quotient score in children born very preterm at 6 years of age.

Development and Validation of Tool for Assessment of Knowledge About Childhood Hypertension Among Final Year Medical Student.

Childhood hypertension (HTN) is becoming one of the most important health concerns in children, and it is the most important predictor of adult HTN. The objective was to assess the level of knowledge and to develop and validate questionnaires about childhood HTN among final-year medical students. This facility-based cross-sectional study was conducted from January 2018 to September 2018 in 5 teaching hospitals of Central India. A total of 383 interviews were conducted by non-probability purposive sampling using a validated tool. Exploratory factor analysis was used to assess the validity of the questionnaire, and internal consistency of items was assessed with Cronbach α. A total of 26 items were finalized through consensus. The Kaiser-Meyer-Olkin (KMO) measure of sample adequacy was measures of sampling adequacy (MSA) = 0.83, and Bartlett's test of sphericity was (x2 = 15.89, P = .014). This study shows that the tool developed had acceptable validity and reliability to assess the knowledge about childhood HTN among undergraduate medical students.

Measuring Critical Thinking in Reacting to the Past

Reacting to the Past is a popular pedagogy in the history classroom. Practitioners frequently contend that it supports students' critical thinking. This paper uses the Critical thinking Assessment Test (CAT) to measure students' critical thinking development as a result of playing two role-playing games. In addition, students completed two surveys to gather supplemental information. This study finds that Reacting does lead to improved critical thinking scores, but not evenly across subskills. This finding suggests that researchers should more clearly define critical thinking in order to evaluate Reacting's value as an intervention. The study also finds that student self-report is not a reliable means of measuring critical thinking gains and encourages further use of objective, validated assessment tools.

A systematic review of the biopsychosocial dimensions affected by chronic pain in children and adolescents: identifying reliable and valid pediatric multidimensional chronic pain assessment tools.

Pediatric chronic pain is a complex experience that is often challenging to describe and measure. Multidimensional tools that evaluate the biopsychosocial impact of chronic pain in pediatric patients can help clinicians to prioritize and tailor interdisciplinary pain care; yet, the psychometric value and clinical utility of such tools has not yet been systematically studied in the literature. The purpose of this review was to identify multidimensional biopsychosocial tools used in pediatric chronic pain, synthesize their reliability and validity evidence, and draw on this evidence to describe the relationships between chronic pain and biopsychosocial domains. The search involved 2 phases to (1) identify eligible tools and (2) conduct a measured forward citation search of tool development articles. Tool eligibility was guided by the Multidimensional Biobehavioral Model of Pediatric Pain and study eligibility was focused on primary chronic pain diagnoses unrelated to disease. Data extraction was focused on reliability and validity evidence of eligible tools, guided by the Standards for Educational and Psychological Testing. Results yielded 6 tools that included 64 eligible studies, highlighting 84 significant relationships between pain and functional interference across 11 biopsychosocial variables. All tools were shown to have good internal consistency and evidence of validity, primarily through relationships to other variables. Of the 6 tools, the most brief and easy to use were the most under studied. Further psychometric research is warranted for these tools to investigate their clinical utility and psychometric properties in guiding and prioritizing pain care for children and adolescents.

Putting occupational balance on the radar: Content validity of the 11-item Danish Occupational Balance Questionnaire

Background: Assessment of occupational balance is of clinical relevance for occupational therapists working with patients with reduced occupational performance. Clinical practice lacks validated assessment tools to measure occupational balance. Aim: To establish the content validity of the 11-item Danish version of the Occupational Balance Questionnaire (OBQ-DK) with a radar chart add-on for use in occupational therapy practice. Materials and methods: A convergent mixed-methods study was performed investigating content validity. Three group interviews were conducted in 3 settings with 12 occupational therapists. A deductive content analysis covered face validity, relevance, comprehensiveness and comprehensibility. The relevance of the 11 items was further assessed using a content validity index. Results: All items were found to be relevant to the construct of occupational balance. Even so, concerns were raised regarding content validity. The comprehensiveness was questioned regarding the coverage of the balance of meaningful occupations. Comprehensibility was questioned for 6 of the 11 items, and the response scale. Conclusion: Content validity was investigated. The doubts raised in relation to comprehensiveness call for new wordings or elaborate instructions to enhance constructional clarity. The response scale levels should be adapted.

A preliminary study for developing perceived ESG scale to measure public perception toward organizations’ ESG performance

ESG has arisen as a key priority of investors in making sustainable investment decisions. Despite its growing popularity in the business and investment sectors, ESG has yet gained momentum in public relations research. The purpose of this study is to develop a Perceived ESG Scale (P-ESG), a valid and reliable measure to examine public perceptions of an organization’s ESG activities. Following a legitimate procedure of scale development, this study developed a three-dimensional P-ESG scale with 26 items. A series of measures (i.e., content validity, construct validity, concurrent validity, and predictive validity) were implemented to test the validity of the scale. The results indicate that the P-ESG is a reliable and valid assessment tool that can be applied to examine public’s perception on organizations’ ESG performance. The present study also revealed the superiority of the P-ESG model over the corporate social reliability (CSR) model in predicting attitudinal as well as behavioral outcomes of the public (i.e., corporate reputation, purchase intention, investment intention). The Perceived ESG Scale would aid PR research on ESG, providing theoretical insight into how an organization's ESG initiatives lead to concrete behavioral results and business achievements. Such research can highlight the importance of incorporating PR into an organization's ESG outcomes by determining whether key stakeholders and the public endorse the organization's ESG initiatives and achievements.

Analgosedation Management in the Intensive Care Unit: A Narrative Systematic Review

Background: Intensive care unit (ICU) patients' pain and sedation management is a significant nursing challenge. Sedatives and muscle relaxants administration has been long used for improving patients' comfort and tolerance to mechanical ventilation. This practice led to an increase in adverse ICU outcomes in terms of health status, hospitalization stay, infections, and mortality. The use of appropriate ICU pain and sedation assessment tools is limited. Methods: We conducted a narrative literature systematic review (from 2010 to 2022) whose primary aims were to analyze the analgosedation definition and identify ICU patients’ pain, agitation, and sedation assessment tools; secondary aims were to explore analgesia and sedation pharmacological and non-pharmacological treatments and nurses’ perceptions and attitudes regarding analgosedation issues. Results: We retrieved 45 eligible articles. Analgosedation foresees early pain management - using pharmacological and non-pharmacological approaches and then, if necessary, implementing adequate sedation. Recommended assessment tools are the Behavioral Pain Scale (BPS) and the Critical Care Observational Tool (CPOT) for pain assessment, the Richmond Agitation Sedation Scale (RASS), and the Sedation Agitation Scale (SAS) for sedation assessment. Guidelines and specific protocols recommend both pharmacological and non-pharmacological approaches. Health professionals report mainly barriers (lack of adherence to guidelines and protocols, workload, reduced awareness, and own perceptions) to analgosedation correct application. The implementation of ICU analgosedation strategies requires continuous health professionals’ commitment and collaboration and valid assessment tools use. Conclusion: ICU analgosedation management (pain control first, and then sedation if necessary) is limited due to health professionals' knowledge gaps, inappropriate use of assessment tools, guidelines, and specific protocols. Recommended assessment tools are the BPS and CPOT for pain assessment and the RASS and SAS for sedation assessment. Interventions to improve ICU analgosedation awareness and practice include training events, the use and consultation of literature guidelines, and the use of validated assessment tools.

Development and validation of the Pain-Induced Comfort Eating Scale in a chronic pain sample

ABSTRACT Background Chronic pain and higher body weight frequently co-occur. This common comorbidity is thought to be mediated by the use of comfort eating as a strategy for managing both the physical and psychological pain and discomfort associated with flare-ups of chronic pain. Valid and reliable assessment tools are needed to inform the development of effective treatments. Aims This study aimed to assess the psychometric properties of a new brief measure of pain-induced comfort eating in chronic pain, the Pain-Induced Comfort Eating Scale (PICES). Methods A sample of 166 patients with chronic pain completed an online test battery including the PICES along with measures of chronic pain and pain-related symptoms, disordered eating, and related psychological factors. Results Results of exploratory factor analysis revealed a single-factor model for the four-item PICES. Further, the PICES demonstrated evidence of good internal consistency as well as convergent validity with demonstrated correlations with related measures. The results of this study also revealed that comfort eating in chronic pain appears to be related to psychological distress; the PICES correlated more strongly with measures assessing mood and psychological distress compared to interference/intensity of physical pain itself. Scores on the PICES also correlated strongly with measures of uncontrolled and emotional eating. Conclusions Overall, our results indicate that the PICES provides a valid and useful brief measure of comfort eating in chronic pain that might be useful to inform treatments targeting the comorbid disordered eating practices that can lead to higher body weights in patients with chronic pain.

Diagnostic validity of premenstrual dysphoric disorder: revisited

The World Health Organization (WHO) and American Psychiatric Association (APA) have recognised premenstrual dysphoric disorder (PMDD) as an independent diagnostic entity, legitimising the distress and socio-occupational impairment experienced by affected women. However, the biological validity of this diagnosis remains inexplicit. This illness has also been criticised for a feminist-led, sympathetic reaction to the modern cultural challenges of urban, literate, employed, high-functioning women. This article systematically reviews existing literature on PMDD using the criteria established by Robins and Guze for the validity of a psychiatric diagnosis (clinical description, laboratory study, exclusion of other disorders, follow-up study, and family study). Despite the early recognition of premenstrual syndrome (PMS) in the 1950s, the research has encountered challenges due to two groups of proponents viewing it with psychologising bias and medicalising bias. PMDD is currently understood as the most severe form of PMS, characterised by the presence of psychological features. Recent evidence suggests that PMDD perhaps has neurodevelopmental underpinnings (attention deficit hyperactive disorder, adverse childhood experiences) affecting the fronto-limbic circuit that regulates the emotions. In addition, the affected individuals exhibit an increased sensitivity to gonadal hormonal fluctuations as observed during premenstrual, pregnancy, and perimenopausal phases of life. The prevalence is comparable between high-income countries and low- and middle-income countries (LAMIC), refuting the notion that it mostly affects modern women. Instead, a greater prevalence is observed in LAMIC. Despite the fact that educated women possess knowledge regarding the importance of getting help, there is a prevalent issue of inadequate help-seeking behaviour. This can be attributed to the perception of seeking help as an isolating experience, which is influenced by profound internalised stigma and discrimination in the workplace. Future studies must aim to develop culturally validated assessment tools and more research to understand the life course of the illness, in addition to systematically examining for more biological validators (animal models, genetics, imaging, neurotransmitters).

Blueprinting of Assessment for the Lower Limb in Undergraduate Anatomy Curriculum.

Competency-based medical education is followed by most of the medical schools in India. Health universities are changing their question paper pattern and practical assessment pattern to ensure valid and reliable evaluation of student learning but assessment of entire curriculum competencies is a difficult task to achieve. Assessment blueprinting can provide a guiding map for balanced and rational assessment. It ensures similar exam content from year to year (over- or under-representing a topic can be avoided). The assessment blueprint provides ideas of appropriate formats for the knowledge/skills being assessed. The study aims toobserve facilitators' perceptions and develop an assessment blueprint for the anatomy curriculum. Thiseducationalmixed-method study was conducted inthe Department of Anatomy of All India Institute of Medical Sciences, Jodhpur, India. Perceptions of 13 facilitators of the Anatomy Departmentabout assessmentblueprinting were observed on a five-point Likert scale. Topics of the lower limb were identified based on the Undergraduate Curriculum Volume-1 document provided by the National Medical Council of the Government of India. Weightage to each topic was given on the basis of anatomical importance and clinical significance at the undergraduate level. Marks for the topic as per relative weightage werecalculated. The blueprint was prepared and validated by the subject expert of the institute. An example question paper template was prepared as per the assessment blueprint. In the present study, all 13 (100%) participants agreed that there is a need for a valid assessment framework to maintain the reliability of assessment, 11 (85%) participants agreed that an assessment blueprint can provide a valid tool for assessment, and 10 (77%) participants agreed that assessments are not planned as per learning domain requirement, and planning of assessment as per blueprintrequires more time and resource. Of the participants,eight (62%) agreed that all topics or competencies are not included while setting the question paper. The blueprint for assessment of the lower limb provided an idea of high-weightage and low-weightage topics and the suitable types of questions for these topics. Assessment is the key element of competency-based medical education. For a complete, valid, and reliable assessment, a blueprint for assessment is the need of the hour. Assessment blueprinting in this study showed that the anterior thigh region, hip joint, knee joint, and vascularand nerve supply of the lower limbare topics with maximum weightage for the lower limb in the medical anatomy undergraduate curriculum.It can help in reducing under or over-representation of content. With the help of a blueprint, the examiners can assess the majority of contentwithout any intentional or unintentional bias.

Development of Adolescent Strengths Use Scale for Turkish adolescents

ABSTRACT Objective This study aimed to develop and validate a new measure- the Adolescent Strengths Use Scale- to assess school-based strength use among Turkish adolescents. Method The study group consisted 1209 Turkish students in grades 7–12. A 12-item pool was initially created in light of the relevant literature and content analysis of open-ended questions asked to the relevant stakeholders including students, parents, teachers and psychological counsellors. Then, 16 experts evaluated the items in terms of their scope, conformity with language, and compliance with measurement and evaluation principles. The expert evaluation resulted in 7 remaining items which were subsequently tested with a pilot study (n = 103 students). Results Exploratory factor analysis (n = 596 students) yielded a single factor structure that explained 49.4% of the total variance. Confirmatory factor analysis (n = 376) provided a good model fit to the data: X 2/df = 2.52, p < .001, TLI = 0.96, CFI = 0.98, GFI = 0.97, and RMSEA = 0.06. Regarding criterion validity, the scale had a significant positive correlation with student subjective well-being and prosociality while it had negative significant correlations with symptoms of internalising and externalising behaviours. Furthermore, the scale produced strong internal reliability estimates (α = 0,82, Ω = 0,83).The test-retest result was also sufficient (r = 0,88). Conclusions The results suggest that the newly developed scale can be used as a reliable and valid assessment tool to measure adolescents’ strength use in school settings.

Anaesthesia-related cognitive dysfunction following cardiothoracic surgery in late middle-age and younger adults: A scoping review.

The incidence of postoperative cognitive dysfunction (POCD) is notably high after cardiac surgery, ranging from 25% to 30%, and is associated with a lower quality of life, increased patient dependency, and heightened mortality. Anaesthesia during cardiothoracic surgery significantly contributes to the risk of POCD in older adults by adversely affecting the brain, including reductions in blood flow and oxygen levels. This review aimed to evaluate factors associated with anaesthesia-related postoperative cognitive dysfunction (POCD) among adults younger than 65 years who underwent cardiothoracic surgeries. A systematic keyword search, following the scoping review framework, was performed in the PubMed and CINAHL databases. Original English-language studies that included adults younger than 65 years and addressed cognitive function after surgery along with anaesthesia management were included. Retrospective studies, animal research and in vitro and in vivo studies were excluded. Twenty-three articles were included (65.2% interventional studies). All studies lacked theoretical or conceptual frameworks. Ketamine's neuroprotective potential is questionable, and intravenous lidocaine may be considered a possible early agent for preventing POCD, but long-term effectiveness is uncertain. Compared to inhalational anaesthesia, total intravenous anaesthesia (TIVA) may be related to a decreased incidence of POCD. Variation in POCD assessment impacted the lack of homogeneity in obtained data. Moreover, the shorter-term timing of POCD evaluation such as in early days after surgery could be greatly influenced by medication and delirium. Although strategies such as TIVA, the use of neuroprotective anaesthetics and comprehensive preoperative assessments are suggested to prevent POCD, this multifactorial phenomenon cannot be explicitly attributed solely to anaesthetics or anaesthesia-related techniques. Use of standardized, reliable and valid tools for POCD assessment is encouraged for cross-study comparison. Nurses and certified nurse anaesthetists must be aware of risk factors for postoperative delirium and POCD so they can assess patients before and after surgery. Patients and caregivers need to be educated about cognitive changes after surgery and advised to report them to their health care provider if they occur.

A validation study of the Cantonese Chinese version of short form McGill pain questionnaire 2 in Cantonese-speaking patients with chronic pain in Hong Kong.

The study tests the reliability and validity of the Cantonese Chinese version of Short Form McGill Pain Questionnaire 2 (SF-MPQ-2-CC). The original Short Form McGill Pain Questionnaire (SF-MPQ-2) was translated into Cantonese Chinese version. Cantonese-speaking chronic pain patients from three pain centers in Hong Kong were recruited and asked to complete SF-MPQ-2-CC, validated Chinese versions of Identification Pain questionnaire (ID Pain), Pain Catastrophizing Scale (PCS), and Short Form Health Survey (SF-36) for evaluation of convergent and divergent validity, 2 weeks apart for evaluation of internal consistency. A total of 333 and 197 participants completed the first and second set of questionnaires, respectively. SF-MPQ-2-CC was shown to have excellent internal consistency, with an overall Cronbach's alpha value of 0.933. The overall correlation coefficient was 0.875 that shows good test-retest reliability. Construct validity was evaluated using confirmatory factor analysis, where a seconder-order factor model demonstrated a good fit with our data (χ2 = 826.51, p < 0.001, CFI = 0.92, TLI = 0.908, RMSEA = 0.097; SRMR = 0.063; error terms adjusted). SF-MPQ-2-CC also showed good convergent validity with Chinese versions of ID Pain (neuropathic pain) and PCS (continuous pain), and divergent validity was shown by a negative correlation with Chinese version of SF-36. Our study demonstrated that SF-MPQ-2-CC is a valid and reliable pain assessment tool for Cantonese-speaking patients in Hong Kong with a wide range of chronic pain conditions. It also helps to identify the presence of neuropathic pain and negative pain cognition among respondents.

Development and validation of an assessment tool for higher education learning abroad programs: A qualitative Delphi study

BackgroundHigher education learning abroad programs provide many benefits to healthcare students. However, inadequate preparation prior to their international travel, and misdirected motivations for their participation, can jeopardise the benefits and increase the risks. While it is pivotal to objectively evaluate pre-departure student preparation and the impact the programs have on students, existing assessment questionnaires fail to inform these aspects. ObjectivesTo develop an assessment tool (two surveys) to holistically evaluate learning abroad programs for higher education healthcare students. DesignA qualitative Delphi technique. ParticipantsA total of 24 experts who had designed, managed, participated in, hosted, funded, and/or researched Australian learning abroad programs for higher education students. MethodsThe study was conducted over a 4-month period. An initial set of pre-departure and post-program questions was developed through a review of the existing literature and from a post-program survey previously used at an Australian higher education institution. Subsequently, experts provided constructive and practical feedback on the questions to be included in the two surveys. ResultsThe experts reached consensus on the 26 questions to be included in the pre-departure survey and the 16 questions in the post-program survey after three Delphi rounds. Key areas of interest to the experts were mitigating student risk, improving effectiveness of pre-departure briefings, gaining a better insight into student motivations for participation, and understanding the impact the programs have on students. ConclusionsThe development of this valid assessment tool (two surveys) will provide higher education institutions and program leaders with the ability to better evaluate the effectiveness of the pre-departure preparation they provide to students, understand the motivations of students who participate, as well as assessing the impact these programs have on students. The insights gathered can be used to improve future program offerings and maximise the benefits to healthcare students while reducing the risks.