The Influence of Perceived Pain on Satisfaction With Community Participation After Hospital Discharge

The Italian version of the Physical Therapy Patient Satisfaction Questionnaire - [PTPSQ-I(15)]: psychometric properties in a sample of inpatients

BACKGROUND

In a previous study we described the translation, cultural adaptation, and validation of the Italian version of the PTPSQ [PTPSQ-I(15)] in outpatients. To the authors' knowledge, the PTPSQ was never studied in a hospital setting.The aims of this study were: (1) to establish the psychometric properties of the Physical Therapy Patient Satisfaction Questionnaire [PTPSQ- I(15)] in a sample of Italian inpatients, and (2) to investigate the relationships between the characteristics of patients and physical therapists and the indicators of satisfaction.

METHODS

The PTPSQ-I(15) was administered to inpatients in a Physical Medicine and Rehabilitation Unit. Reliability of the PTPSQ-I(15) was measured by internal consistency (Cronbach's α) and test-retest stability (ICC 3,1). The internal structure was investigated by factor analysis. Divergent validity was measured by comparing the PTPSQ-I(15) with a Visual Analogue Scale (VAS) for pain and with a 5-point Likert-type scale evaluating the Global Perceived Effect (GPE) of the physical therapy treatment.

RESULTS

The PTPSQ-I(15) was administered to 148 inpatients, and 73 completed a second administration. The PTPSQ-I(15) showed high internal consistency (α = 0.949) and test-retest stability (ICC = 0.996). Divergent validity was moderate for the GPE (r = - 0.502, P < 0.001) and strong for the VAS (r = -0.17, P = 0.07). Factor analysis showed a one-factor structure.

CONCLUSIONS

The administration of PTPSQ-I(15) to inpatients demonstrated strong psychometric properties and its use can be recommended with Italian-speaking population. Further studies are suggested on the concurrent validity and on the psychometric properties of the PTPSQ-I(15) in different hospital settings or with other pathological conditions.

Measuring participation after stroke: a review of frequently used tools

OBJECTIVE

To identify and critique the measures currently used to assess participation in clinical stroke studies.

DATA SOURCES

Relevant articles published between January 2001 and April 2012 identified through Medline, CINAHL, and ProQuest Central databases.

STUDY SELECTION

Published articles involving poststroke assessment of participation. Case studies, cohort studies, and randomized controlled trials were included.

DATA EXTRACTION

The most frequently used measures were identified and the psychometric properties evaluated. Three raters independently evaluated each measure relative to the first and second coding levels of the International Classification of Functioning, Disability and Health (ICF) Activities and Participation domain categories.

DATA SYNTHESIS

Thirty-six measures were identified. The Stroke Impact Scale (SIS), London Handicap Scale, Assessment of Life Habits (LIFE-H), Frenchay Activities Index, and Activity Card Sort (ACS) were used most frequently. No single measure met criteria across all psychometric indices, and not one covered all 9 of the ICF Activities and Participation domains. The SIS, LIFE-H, and ACS covered the widest range. The domains covered most frequently were Community, Social and Civic Life, Domestic Life, and Mobility. Learning and Applying Knowledge, General Tasks and Demands, and Communication were the domains less frequently covered.

CONCLUSIONS

This review identified and evaluated the most frequently used participation measures in clinical stroke studies. The SIS, LIFE-H, and ACS covered the ICF Activities and Participation domain categories most comprehensively. However, none of the measures covered all the ICF Activities and Participation domain categories. The information provided in this systematic review can be used to guide the selection of participation measures to meet specific clinical and research purposes.

Client and Responder Perceptions of a Personal Emergency Response System: Lifeline

A mixed methodology mail survey was used to gauge level of customer satisfaction with, and identify issues that may help improve, personal emergency response system service delivery. A total of 1,236 surveys were mailed out to subscribers of Victoria Lifeline (Canada; n = 618) and their designated responders (n = 618). Overall response rate was 50%. Significant predictors of subscriber and responder satisfaction were satisfaction with the service during an emergency and whether expectations of service were met. In addition, for responders, customer service also predicted satisfaction. Thematic analysis of subscriber and responder comments identified the need for improvement in several areas: equipment, cost of the service, training sessions for users, and communication between subscribers and service providers. Although more than 95% of subscribers and responders were satisfied with the service, the findings provide direction to personal emergency response service providers about ways in which their product and service delivery might be enhanced, and underscore the need for research examining the impacts of response systems on family caregivers and public policy regarding community care solutions.

Determinants of satisfaction with community reintegration in older adults with chronic stroke: role of balance self-efficacy

BACKGROUND AND PURPOSE

Many people with stroke have a low level of satisfaction with community reintegration. Although previous studies focused on the effect of physical factors on community reintegration, the effect of psychological factors, such as balance self-efficacy, has been ignored. The purpose of this study was to determine the contribution of balance self-efficacy to satisfaction with community reintegration in older adults with chronic stroke.

SUBJECTS

A sample of 63 community-dwelling older adults (50 years of age or older) with chronic stroke (onset of 1 year or more) participated in this study.

METHODS

This study involved a secondary analysis of data collected from a stroke exercise clinical trial. Satisfaction with community reintegration was measured with the Reintegration to Normal Living (RNL) Index, and balance self-efficacy was measured with the Activities-specific Balance Confidence (ABC) Scale.

RESULTS

Bivariate correlation analyses showed that the RNL Index scores were moderately correlated with the ABC Scale scores. In a multiple regression analysis, after adjusting for age, sex, depression, and other impairments after stroke, balance self-efficacy remained independently associated with the RNL Index scores, accounting for 6.5% of the variance in the RNL Index scores.

DISCUSSION AND CONCLUSION

Balance self-efficacy is an independent predictor of satisfaction with community reintegration in older adults with chronic stroke. Improving balance self-efficacy may be instrumental in enhancing community reintegration in this population.