Visual Analogue Self-Esteem Scale Research Articles

Psychosocial factors of psychological maladaptation in female patients of a cosmetology clinic

Introduction. In the field of aesthetic medicine, there is a lack of psychological research despite the obvious impact of cosmetic defects on the emotional state and social functioning of a person. Only a few studies indicate psychological maladaptation in patients of a cosmetology clinic, which is reflected in the frequency of the occurrence of anxiety, depression and personality disorders exceeding their levels in population. The objective was to identify psychosocial factors associated with the risk of psychological maladaptation in female patients of the cosmetology clinic. Methods and materials. To achieve the goal, female patients (n=161, mean age was 39.53±0.86 years) were studied using the author’s structured interview and 7 psychodiagnostic methods: «Neuropsychic Adaptation Test» (NPA), «Social Frustration Level» (SFL), «Visual Analogue Self-Esteem Scale» (VASES), «Semantic Time Differential» (STD), «Perceived Stress Scale» (PSS-10), «Well-Being Index» (WHO-5), «Quality of Life Satisfaction Questionnaire» (QOL). Groups of female patients without psychological maladaptation (group 1, n=74) and those with psychological maladaptation (group 2, n=87), selected on the basis of the final NPA test score were compared. Results. The results showed a statistically significant predominance in group 2 compared to group 1 of the frequency of emotionally neutral relationships with their own children, of living alone, as well as dissatisfaction in significant areas of life, especially in the material economic sphere, in the sphere of self-accepting as a personality and one’s physical «Ego», in the sphere of attitude to past and present life. In group 2, higher rates of perceived stress and frequency of psychotraumatic situations in anamnesis as well as lower rates of general psychological well-being and satisfaction with the quality of life were revealed. Conclusion. The factors influencing the psychological maladaptation in female patients of the cosmetology clinic were identified. The prospects of the study associated with the determination of the most informative factors for the prognosis of psychological adaptation based on the analysis on not only psychological but also individual and personal characteristics in female patients of the cosmetology clinic were indicated.

Quality of life improves with return of voice in tracheostomy patients in intensive care: An observational study

PurposeTo measure patient-reported change of mood, communication-related quality of life, and general health status with return of voice among mechanically ventilated tracheostomy patients admitted to the intensive care unit (ICU). Materials and MethodsA prospective observational study in a tertiary ICU was conducted. Communication-related quality of life was measured daily using the Visual Analogue Self-Esteem Scale. General health status was measured weekly using the EuroQol-5D. ResultsAspects of communication self-esteem that significantly improved with the return of voice were ability to be understood by others (P = .006) and cheerfulness (P = .04), both with a median difference from before to after return of voice of 1 on the 5-point scale. Return of voice was not associated with a significant improvement in confidence, sense of outgoingness, anger, sense of being trapped, optimism, or frustration. Reported general health status did not significantly improve. ConclusionsReturn of voice was associated with significant improvement in patient reported self-esteem, particularly in being understood by others and in cheerfulness. Improved self-esteem may also improve quality of life; however, further research is needed to confirm this relationship. Early restoration of voice should be investigated as a way to improve the experience of ICU for tracheostomy patients.

Communication and Low Mood (CALM): a randomized controlled trial of behavioural therapy for stroke patients with aphasia

Objective: The aim was to evaluate behavioural therapy as a treatment for low mood in people with aphasia. Design: A randomized controlled trial comparing behavioural therapy plus usual care with a usual care control. Potential participants with aphasia after stroke were screened for the presence of low mood. Those who met the criteria and gave consent were randomly allocated. Setting: Participants were recruited from hospital wards, community rehabilitation, speech and language therapy services and stroke groups. Subjects: Of 511 people with aphasia identified, 105 had low mood and were recruited. Interventions: Behavioural therapy was offered for up to three months. Outcomes were assessed three and six months after random allocation. Main measures: Stroke Aphasic Depression Questionnaire, Visual Analog Mood Scales ‘sad’ item, and Visual Analogue Self-Esteem Scale. Results: Participants were aged 29 to 94 years (mean 67.0, SD 13.5) and 66 (63%) were men. Regression analysis showed that at three months, when baseline values and communication impairment were controlled for, group allocation was a significant predictor of the Stroke Aphasic Depression Questionnaire (P < 0.05), visual analogue ‘sad’ (P = 0.03), and Visual Analogue Self-Esteem Scale (P < 0.01). At six months, group alone was a significant predictor of the Stroke Aphasic Depression Questionnaire (P < 0.05), and remained significant when baseline values were controlled for (P = 0.02). Mean Stroke Aphasic Depression Questionnaire 10-item hospital version scores decreased from baseline to six months by six points in the intervention group as compared with an increase of 1.9 points in the control group. Conclusions: Behavioural therapy seemed to improve the mood of people with aphasia.

Psychometric properties of a revised version of the Visual Analog Mood Scales

Objective: To assess the internal consistency, validity and factor structure of a revised version of the Visual Analog Mood Scales (VAMS-R) in healthy older adults and aphasic stroke patients. Design: Cross-sectional study. Participants: Fifty healthy older people and 71 aphasic stroke patients. Setting: Community and hospital. Measures: The healthy participants were asked to complete the Hospital Anxiety and Depression Scale (HADS) and the VAMS-R. The aphasic stroke patients completed the VAMS-R and Visual Analogue Self Esteem Scale (VASES) and the Stroke Aphasic Depression Questionnaire 21 (SADQH-21) was completed by a nurse or carer. Results: The internal consistency of the scale was high (healthy adults alpha 0.74, aphasic stroke patients alpha 0.80). The VAMS-R correlated significantly with the HADS in healthy participants (HADS Anxiety rs = 0.59, P < 0.001, HADS Depression rs = 0.49, P = 0.001) and the VASES (rs = −0.69, P < 0.001) and SADQH-21 (rs = 0.43, P = 0.001) in stroke patients. Exploratory factor analysis identified three factors in the scale: negative mood states, energy levels and happiness. The three factors accounted 73% of the variance in healthy participants and 70% of the variance in aphasic stroke patients. Conclusions: The VAMS-R showed better psychometric properties than the original VAMS. Reversing the happy and energetic items improved the ability of the scale to assess mood states.

Predictors of Emotional Distress After Stroke

The aim of this prospective longitudinal study was to identify factors relating to emotional distress in the first 6 months after stroke in a sample including patients with aphasia. One hundred patients who were in hospital at 1 month after stroke were recruited and assessed on measures of communication impairment (Sheffield Screening Test), personal activities of daily living (Barthel Index), and emotional distress (Visual Analogue Self-Esteem Scale). Demographic and stroke characteristics were recorded. Patients (n=92) were reassessed on the same measures 6 months after stroke, in addition to assessing extended activities of daily living (Nottingham Extended Activities of Daily Living Scale). Patients were aged 44 to 86 years (51 men), and 21 were classified as having aphasia. Multiple linear regression showed that expressive communication impairment and dependence in personal activities of daily living were significant predictors of emotional distress at 1 month after stroke (R(2)=24%). Expressive communication impairment, emotional distress at 1 month after stroke, and having a more severe stroke were significant predictors of emotional distress at 6 months after stroke (R(2)=55%). Distress levels were similar at 1 month and 6 months after stroke. Demographic characteristics and side of lesion were unrelated to distress. Expressive communication impairment and level of disability in personal activities of daily living were related to distress. Distress was persistent in the first 6 months after stroke. Appropriate treatment strategies need to be developed and evaluated for patients who have communication impairments.

Self-esteem in an acute stroke rehabilitation sample: a control group comparison

Objective: To compare ratings of self-esteem and depressive mood in a sample of stroke survivors in an acute inpatient rehabilitation setting to those of a matched control group. Design: Stroke survivors (n = 80) were matched on age and education to a group of neurologically intact community-dwelling control participants. Between-group analysis compared mean ratings of self-esteem and depressive measures. Within-group correlational analyses explored the relationship between self-esteem and mood. Between-group comparison of the correlations between self-esteem and mood explored differences in the strength of association between these constructs. Regression analyses explored the relationship of self-esteem measures after controlling for depressive mood. Main measures: Visual Analogue Self-Esteem Scale, Rosenberg Self-Esteem Scale, Geriatric Depression Scale. Results: Stroke survivors rated significantly lower mean levels of self-esteem on the Visual Analogue Self-Esteem Scale (37 versus 41) and the Rosenberg Self-Esteem Scale (21 versus 24) than the control group. Stroke survivors also rated higher mean levels of depressive mood on the Geriatric Depression Scale (9 versus 6). Significantly higher correlations between self-esteem and mood ratings were noted in the stroke group than in the control group. Lower self-esteem ratings do not appear to be a byproduct of depressive mood. Conclusions: Self-esteem is negatively impacted by stroke and is strongly, but independently, associated with depressive mood. Clinicians may better facilitate the emotional adjustment of the survivor by considering this facet of psychological impact and intervening to address self-esteem.

Assessment and correlates of self-esteem following stroke using a pictorial measure

Objective: To describe the characteristics of a non-verbal measure of self-esteem in a sample of individuals in the acute phase following stroke. Design: Acute-phase stroke survivors (n=156) were administered measures of self-esteem, depression, anxiety, general emotional distress and cognitive functioning during admission to an inpatient stroke rehabilitation unit. Main measures: Visual Analogue Self-Esteem Scale (VASES), Geriatric Depression Scale, Adult Manifest Anxiety Scale, Visual Analog Mood Scales, measures of neuropsychological functioning. Results: VASES performance was not related to demographic variables, cognitive functioning, visual acuity, prior stroke or severe visuoperceptual impairment/left visual neglect. The VASES was most related to emotional functioning, with lower self-esteem ratings associated with higher levels of depressive symptoms and general emotional distress. Individuals with right hemisphere stroke tended to endorse lower self-esteem ratings, while aphasic individuals may have misunderstood the intent of the task. Conclusions: The non-verbal VASES appears to be minimally impacted by potentially invalidating patient factors (e.g. visual acuity, left visual neglect), although its use with patients with severe communication deficits is cautioned. The VASES may prove useful in identifying acute stroke survivors most at risk for emotional dysfunction, and may be useful as a research tool in this population.

Validation of screening measures for assessing mood in stroke patients

There are few validated measures to assess mood in stroke patients and even fewer suitable for all stroke patients, including those with communication problems. The aim of this study was to compare the Stroke Aphasic Depression Questionnaire Hospital version (SADQ-H), Signs of Depression Scale (SODS), Visual Analogue Mood Scale (VAMS) and Visual Analogue Self-esteem Scale (VASES) in screening for mood problems after stroke. Fifty healthy older adults and 100 stroke patients in hospital completed the VAMS and VASES. A nurse completed the SADQ-H and SODS in relation to the stroke patients. A relative/carer completed the SADQ-H and SODS in relation to the healthy older adults. Those without communication problems also completed the Hospital Anxiety and Depression Scale (HADS). The internal consistency of the scales was low in healthy older adults. In stroke patients the internal consistency of the SADQ-H, VAMS, and VASES was high (alpha = .71-.84) but that of the SODS was low (alpha = .53). In healthy older adults, correlations between the HADS and the VAMS and VASES were high but low between the HADS and SADQ-H and SODS. In stroke patients, the HADS depression scale correlated significantly with all the scales (0.35-0.55) but only the SADQ-H 10, VAMS, and VASES were significantly correlated with the HADS anxiety scale (0.40-0.52). Appropriate cut-offs were found for the SADQ-H (17/18), SADQ-H 10 (5/6), SODS (1/2), and VAMS 'sad' item (22/23) in comparison to depression on the HADS. No appropriate cut-offs were identified in comparison to anxiety on the HADS. The SADQ-H, SADQ-H10 and SODS were all appropriate for screening for possible depression after stroke but not for screening for possible anxiety. The SADQ-H 10 had greater internal consistency and higher sensitivity and specificity than the SODS and is shorter than the SADQ-H. It was also significantly correlated with both the anxiety and depression scales of the HADS. The SADQ-H 10 was therefore recommended as the most appropriate for screening purposes. The VAMS and VASES provided no clear cut-offs for use in screening but scores were highly correlated with the HADS. They are therefore more suitable for assessing severity of low mood rather than for screening purposes. The cut-offs identified need further validation in an independent sample of stroke patients, including a higher proportion with low mood.

Evaluation of communication, life participation and psychological well‐being in chronic aphasia: The influence of group intervention

Background: The impact of change in communication, life participation, and psychological well‐being in aphasia is recognised but still not fully explored. Further, considerable scope exists to address these factors within the context of intervention. Innovative practices and group intervention are advocated for people with chronic aphasia but detail and evidence remains limited. We are grateful to Leeds Health Authority, the Leeds Speech and Language Therapy Service, Leeds Social Services, Leeds Metropolitan University and the Leeds Modernisation Team ‐ Disability for funding and other resources for the group and the research. Our thanks in particular are conveyed to the group participants. Additionally we thank the reviewers for their guidance. Aims: To explore the experience of aphasia within the context of communication, life participation and psychological well‐being and evaluate the outcomes of these phenomena in people with chronic aphasia following participation in a group intervention involving a social model approach. Methods & Procedures: A group of seven people with chronic moderate aphasia were assessed on communication measures, by means of the Conversational Analysis Profile for People with Aphasia (CAPPA), and aspects of psychological well‐being, by means of The Hospital Anxiety and Depression Scale (HADS) and The Visual Analogue Self‐esteem Scale (VASES) pre, post, and at 3‐month follow‐up of a group intervention. The group involved a social model approach and the use of Total Communication to support conversation. Speech and language therapy and social care personnel, including an equality disability trainer, contributed to the group. Outcomes & Results: Although variation in individual participants was demonstrated, results showed evidence of statistically significant beneficial change in conversation experiences (many of these related to life participation) and, to a lesser degree, beneficial change in conversation abilities. Additionally there were beneficial changes for some participants on psychological well‐being measures. Due to the small sample, participant variation, and (in the case of psychological well‐being measures) the lack of evidence of serious reduction in psychological well‐being at the outset, the results have to be evaluated with caution. Conclusions: Appropriately planned group intervention can produce benefits in conversation, life participation, and psychological well‐being in chronic aphasia.

SHORT REPORTThe relationship between the severity of post‐stroke aphasia and state self‐esteem

Background: The study of self‐esteem after stroke may provide valuable prognostic information of the potential for functional recovery and may also inform the approach to treatment. Hitherto, research into the effect of post‐stroke aphasia on self‐esteem has received little attention. The purpose of the present study is to examine the relationship between aphasia and self‐esteem and to establish whether the severity of aphasia correlates significantly with the level of self‐esteem.Methods & Procedures: Self‐esteem was measured with the Visual Analogue Self‐Esteem Scale (VASES) and aphasia was assessed with the Western Aphasia Battery (WAB). Assessments were made as soon as practicable after the stroke onset and 3 and 6 months after the first evaluation.Outcomes & Results: Of 51 eligible patients, 40 completed the study. The mean (SD) VASES scores at baseline, 3 and 6 months post‐entry were 36.8 (7.6), 37.6 (7.2), and 38.5 (7.7), respectively. WAB scores were 71.3 (22.9) at 3 months and 72.0 (21.1) at 6 months. This compares to a baseline score of 45.5 (26.2). The changes in WAB scores from baseline to the 3 and 6 months post‐entry assessments were statistically significant. However, the correlation between the severity of aphasia and self‐esteem did not reach statistical significance either at baseline, or at the subsequent assessments.Conclusions: The severity of aphasia does not appear to correlate significantly with the level of self‐esteem in the first 6 months after stroke.

Assessing mood in patients with multiple sclerosis

To assess the validity and reliability of mood measures for use with people with multiple sclerosis (MS). Four mood measures designed for use with people with communication and cognitive problems were completed; two were completed with the patient at interview and two by hospital staff or carers of the patients. This procedure was repeated two weeks later to assess test-retest reliability. People with MS at a rehabilitation unit (n = 22) and living in the community (n = 27). The Stroke Aphasic Depression Questionnaire (SADQ) and Signs of Depression Scale (SODS) were completed by rehabilitation unit staff or by carers of the patients. An assistant psychologist completed the Visual Analogue Self-Esteem Scale (VASES) and the Visual Analogue Mood Scales (VAMS) with each patient. The Guy's Neurological Disability Scale (GNDS) was administered to assess physical disability. Nonprofessional carers were asked to complete the General Health Questionnaire 12 (GHQ-12) about themselves. In both samples there were significant correlations between scores on the two self-report measures (VASES and VAMS) (r(s) = 0.51-0.79) and between scores on the two observational measures (SADQ and SODS) (r(s) = 0.62-0.81) but not between the observational and self-report measures. There was a significant correlation between the SODS and the carer GHQ (r(s) = 0.68, p < 0.01), indicating that carer mood influenced reporting of patients' mood. There was no significant influence of profession on the observational measures, indicating good inter-rater reliability. Test-retest reliability was high for patients in the community but not for patients in hospital. In both the inpatient and community samples, the self-report and observational mood measures appeared to be measuring different aspects of patients' mood. Further investigation is needed to determine which of these is providing the most accurate information.

The development and validation of the Visual Analogue Self-Esteem Scale (VASES).

To develop a visual analogue measure of self-esteem and test its psychometric properties. Two correlational studies involving samples of university students and aphasic speakers. Two hundred and forty-three university students completed multiple measures of self-esteem, depression and anxiety as well as measures of transitory mood and social desirability (Study 1). Two samples of aphasic speakers (N = 14 and N = 20) completed the Visual Analogue Self-Esteem Scale (VASES), the Rosenberg (1965) self-esteem scale and measures of depression and anxiety. (Study 2). Study 1 found evidence of good internal and test-retest reliability, construct validity and convergent and discriminant validity for a 10-item VASES. Study 2 demonstrated good internal reliability among aphasic speakers. The VASES is a short and easy to administer measure of self-esteem that possesses good psychometric properties.