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Wagner S, Bring A, Åsenlöf P. Construct validity of the Mini-BESTest in individuals with chronic pain in specialized pain care. BMC Musculoskelet Disord 2023; 24:391. [PMID: 37198616 DOI: 10.1186/s12891-023-06504-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/09/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Balance assessment scales are important clinical tests to identify balance impairments. Chronic pain (> 3 months) is associated with impaired dynamic balance; however, very few balance assessment scales are psychometrically evaluated for the population. The purpose of this study was to evaluate the construct validity and internal consistency of the Mini-BESTest for individuals with chronic pain in specialized pain care. METHODS In this cross-sectional study, 180 individuals with chronic pain (> 3 months) were assessed with the Mini-BESTest and included in the analyses. For construct validity, five alternative factor structures were evaluated using a confirmatory factor analysis. In addition, we tested the a priori hypotheses about convergent validity with the 10-meter walk test, and divergent validity with the Brief Pain Inventory (BPI): pain intensity, the Tampa Scale of Kinesiophobia-11 (TSK-11), and the Pain Catastrophizing Scale (PCS-SW). Internal consistency was evaluated for the model with the best fit. RESULTS A one-factor model with added covariance via the modification indices showed adequate fit indices. In line with our hypotheses, Mini-BESTest showed convergent validity (rs = > 0.70) with the 10-meter walk test, and divergent validity (rs = < 0.50) with BPI pain intensity, TSK-11, and PCS-SW. Internal consistency for the one-factor model was good (α = 0.92). CONCLUSIONS Our study supported the construct validity and internal consistency of the Mini-BESTest for measuring balance in individuals with chronic pain, who were referred to specialized pain care. The one-factor model showed an adequate fit. In comparison, models with subscales did not reach convergence, or showed high correlations between subscales, implying that Mini-BESTest is measuring one construct in this sample. We, therefore, propose using the total score, instead of subscale scores, for individuals with chronic pain. However, further studies are necessary to establish the reliability of the Mini-BESTest in the population.
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Affiliation(s)
- Sofia Wagner
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Annika Bring
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Pernilla Åsenlöf
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Bühne D, Alles T, Hetzel C, Streibelt M, Trippolini M. Matching Perceived Physical Capacity and Work Demands: A New Classification of the Modified Spinal Function Sort (M-SFS). JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:96-102. [PMID: 34024022 DOI: 10.1007/s10926-021-09986-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/08/2021] [Indexed: 06/12/2023]
Abstract
Purpose The aims of this study were (1) to develop a new classification for the scores of the Modified Spinal Function Sort (M-SFS) which is related to the level of physical work demands and (2) to test the predictive value of the M-SFS classification. Methods The classification was carried out in 194 subjects with musculoskeletal disorders (MSD) attending a work-related medical rehabilitation from four rehabilitation centers. External criterion was a Functional Capacity Evaluation (FCE)-based work capacity estimation according to the classification used in Germany ("REFA") which differentiates between light, light to medium, medium and heavy work. The optimal cut-offs for the M-SFS were allocated using the Youden index. Logistic regression models were calculated based on 147 subjects who participated in the follow-up survey to evaluate the predictive validity of the M-SFS classification with regard to sustainable return to work (RTW; employment at the 3-month follow-up combined with a low level of sick leave). Results Cut-offs for M-SFS scores were 44 (light work), 54 (light to medium work), 62 (medium work) and 73 (heavy work). A match between the M-SFS category and the level of physical work demands was associated with a more than threefold higher RTW chance compared to subjects with a negative discrepancy. In case the M-SFS category was above the physical demand level the RTW-chance was more than 13-fold higher. Conclusions M-SFS scores can be classified into four levels of physical work demands. If the perceived work capacity matches or exceeds the level of physical work demands patients with MSD have a substantially higher probability to return to work after rehabilitation. More studies are needed to confirm or reject our findings and overcome some of the weaknesses of this study.
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Affiliation(s)
- David Bühne
- Institute for Quality Assurance in Prevention and Rehabilitation at the German Sport University Cologne (IQPR), Eupener Str. 70, 50933, Cologne, Germany.
| | - Torsten Alles
- Institute for Quality Assurance in Prevention and Rehabilitation at the German Sport University Cologne (IQPR), Eupener Str. 70, 50933, Cologne, Germany
| | - Christian Hetzel
- Institute for Quality Assurance in Prevention and Rehabilitation at the German Sport University Cologne (IQPR), Eupener Str. 70, 50933, Cologne, Germany
| | - Marco Streibelt
- Department of Rehabilitation, German Federal Pension Insurance, Ruhrstr. 2, 10704, Berlin, Germany
| | - Maurizio Trippolini
- Department of Health, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
- University Hospital Bern, Inselspital, Freiburgstrasse 18, 3010, Bern, Switzerland
- Massachusetts General Hospital, Institute of Health Professions, Charlestown Navy Yard, 36 1st Avenue, Boston, MA, 02129-4557, USA
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Choe YW, Kim MK. Could Self-Control and Emotion Influence Physical Ability and Functional Recovery after Stroke? MEDICINA (KAUNAS, LITHUANIA) 2021; 57:1042. [PMID: 34684079 PMCID: PMC8540988 DOI: 10.3390/medicina57101042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/23/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: This study was conducted to determine whether self-control and emotions could influence patients' physical ability and functional recovery after stroke. Materials and Methods: Twenty-four patients within eight weeks after a stroke were included in this study (age: 54.04 ± 10.31; days after stroke: 42.66 ± 8.84). The subjects participated in tests at the baseline, four weeks later, and eight weeks later. Subjects were asked to complete the following: (1) self-control level test, (2) positive and negative emotion test, (3) knee muscle strength testing, (4) static balance test, (5) gait measurement, and (6) activities of daily living evaluation. Results: The muscle strength of the knee, static balance, gait ability, and the Functional Independence Measure score increased significantly in the stroke patients over time. A significant correlation was noted between the emotion and physical variables in stroke patients. The self-control level was significantly associated with the change in the physical variables in stroke patients over time. Conclusions: The self-control level was positively related to the increases in functional recovery of stroke patients with time, while the emotions were related more to the physical abilities.
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Affiliation(s)
- Yu-Won Choe
- Department of Rehabilitation Sciences, Graduate School, Daegu University, Jillyang, Gyeongsan 712-714, Korea;
| | - Myoung-Kwon Kim
- Department of Physical Therapy, College of Rehabilitation Sciences, Daegu University, Jillyang, Gyeongsan 712-714, Korea
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Pelekanou R, Thomson OP. A blame game and sticky labels: A qualitative study of osteopaths’ experiences of managing patients with pain catastrophising. INT J OSTEOPATH MED 2021. [DOI: 10.1016/j.ijosm.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lassfolk M, Escorpizo R, Korniloff K, Reneman M. Linking the Spinal Function Sort and Functional Capacity Evaluation Tests to the International Classification of Functioning, Disability and Health Core Set of Vocational Rehabilitation. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:166-174. [PMID: 32500472 DOI: 10.1007/s10926-020-09905-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose The International Classification of Functioning, Disability and Health (ICF) Comprehensive Core Set for Vocational Rehabilitation (CSVR) is a shortlist of functioning domains developed for use with people of working age that experience limitation in their work-related functional capacity. Functional capacity can be measured by, for example, Spinal Function Sort pictorial questionnaire and Functional Capacity Evaluation tests such as the: Complete Minnesota Dexterity Test, grip strength test, pushing, pulling, progressive iso-inertial lifting and carrying. However, these tests have not yet been linked to the CSVR. The objective of this study was to evaluate the extent to which the Spinal Function Sort and Functional Capacity Evaluation tests could be mapped to the ICF categories of the CSVR. Methods Two raters independently performed the linking of the Spinal Function Sort and the Functional Capacity Evaluation related tests to the CSVR according to established ICF linking rules. If an item could not accurately be linked to a CSVR category, the item was linked to the most fitting ICF category. Disagreements were resolved in a consensus meeting. Interrater agreement between raters was expressed in percentage agreement. Results The Spinal Function Sort and Functional Capacity Evaluation tests described a total of 39 unique ICF categories, out of which only six (15%) came from the CSVR. Interrater agreement ranged between 17 and 91%. Conclusions The study found six categories including vestibular functions, muscle power functions, writing, lifting and carrying objects, fine hand use and hand and arm use within the CSVR using the Spinal Function Sort and The Complete Minnesota Dexterity Test. With the rest of the items, the CSVR was considered too broad.
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Affiliation(s)
- M Lassfolk
- University of Eastern Finland, Kuopio, Finland.
| | - R Escorpizo
- Department of Rehabilitation and Movement Science, The University of Vermont, Burlington, VT, USA
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - K Korniloff
- School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - M Reneman
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Ansuategui Echeita J, Bethge M, van Holland BJ, Gross DP, Kool J, Oesch P, Trippolini MA, Chapman E, Cheng ASK, Sellars R, Spavins M, Streibelt M, van der Wurff P, Reneman MF. Functional Capacity Evaluation in Different Societal Contexts: Results of a Multicountry Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:222-236. [PMID: 29802582 PMCID: PMC6510856 DOI: 10.1007/s10926-018-9782-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Purpose To examine factors associated with Functional Capacity Evaluation (FCE) results in patients with painful musculoskeletal conditions, with focus on social factors across multiple countries. Methods International cross-sectional study was performed within care as usual. Simple and multiple multilevel linear regression analyses which considered measurement's dependency within clinicians and country were conducted: FCE characteristics and biopsychosocial variables from patients and clinicians as independent variables; and FCE results (floor-to-waist lift, six-minute walk, and handgrip strength) as dependent variables. Results Data were collected for 372 patients, 54 clinicians, 18 facilities and 8 countries. Patients' height and reported pain intensity were consistently associated with every FCE result. Patients' sex, height, reported pain intensity, effort during FCE, social isolation, and disability, clinician's observed physical effort, and whether FCE test was prematurely ended were associated with lift. Patient's height, Body Mass Index, post-test heart-rate, reported pain intensity and effort during FCE, days off work, and whether FCE test was prematurely ended were associated with walk. Patient's age, sex, height, affected body area, reported pain intensity and catastrophizing, and physical work demands were associated with handgrip. Final regression models explained 38‒65% of total variance. Clinician and country random effects composed 1-39% of total residual variance in these models. Conclusion Biopsychosocial factors were associated with every FCE result across multiple countries; specifically, patients' height, reported pain intensity, clinician, and measurement country. Social factors, which had been under-researched, were consistently associated with FCE performances. Patients' FCE results should be considered from a biopsychosocial perspective, including different social contexts.
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Affiliation(s)
- Jone Ansuategui Echeita
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 30.002, 9750 RA, Haren, Groningen, The Netherlands.
| | - Matthias Bethge
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Berry J van Holland
- Institute for Sports Studies, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada
| | - Jan Kool
- Rehabilitation Centre Valens, Valens, Switzerland
| | - Peter Oesch
- Rehabilitation Centre Valens, Valens, Switzerland
| | - Maurizio A Trippolini
- Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, Boston, USA
- PhD in Rehabilitation Sciences Program, Institute for Health Professions, Massachusetts General Hospital (MGH), Charlestown, Boston, USA
- Department of Work Rehabilitation, Rehaklinik Bellikon, Suva Care, Bellikon, Switzerland
| | | | - Andy S K Cheng
- Ergonomics and Human Performance Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | | | | | - Marco Streibelt
- Department of Rehabilitation, German Federal Pension Insurance, Berlin, Germany
| | - Peter van der Wurff
- Research & Development, Military Rehabilitation Center Aardenburg, Doorn, The Netherlands
- Institute for Human Movement Studies, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Michiel F Reneman
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 30.002, 9750 RA, Haren, Groningen, The Netherlands
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Pain Behaviour Scale (PaBS): An Exploratory Study of Reliability and Construct Validity in a Chronic Low Back Pain Population. Pain Res Manag 2019; 2019:2508019. [PMID: 30863470 PMCID: PMC6377952 DOI: 10.1155/2019/2508019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 12/07/2018] [Accepted: 01/03/2019] [Indexed: 01/08/2023]
Abstract
Objectives To examine the interrater and intrarater reliability and construct validity of the Pain Behaviour Scale during standard physical performance tests in people with chronic low back pain and to confirm the test-retest reliability of the physical performance tests in this population. The Pain Behaviour Scale (PaBS) is an observational scale that was recently designed to uniquely measure both the presence and severity of observed pain behaviours. Methods Twenty-two participants with chronic low back pain were observed during performance of five physical performance tests by two raters. Pain behaviours were assessed using the Pain Behaviour Scale. The Visual Analogue Scale and Modified Oswestry Disability Index were used to measure pain and disability, respectively. Descriptive statistics were used to report demographic features of participants. Reliability was analyzed using ICCs. Rater agreement was analyzed using the weighted Cohen's kappa. Correlations between PaBS, self-reported measures, and physical performance tests were calculated using Pearson's product-moment correlations. Results The PaBS demonstrated excellent interrater (ICC2,1 = 1.0, 95% CI: 0.9 to 1.0) and intrarater (ICC3,1 = 0.9, 95% CI: 0.8 to 1.0) reliability. Component physical performance tests (i.e., time and distance) demonstrated good test-retest (0.6–1.0) reliability. Perfect agreement in the reporting of pain behaviours was found (95–100%). Correlations between pain behaviour severity and pain intensity (r = 0.6) and disability (r = 0.6) were moderate. Moderate correlations were found between pain behaviours and physical performance tests in sit to stand (r = 0.5), trunk flexion (r = 0.4), timed up and go (r = 0.4), and 50-foot walk (r = 0.4). Conclusion The Pain Behaviour Scale is a valid and reliable tool for measuring the presence and severity of pain behaviour, and the physical performance tests are reliable tests.
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Factors influencing decision making for healthcare services outsourcing: A review and Delphi study. Med J Islam Repub Iran 2018; 32:56. [PMID: 30175082 PMCID: PMC6113583 DOI: 10.14196/mjiri.32.56] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Indexed: 11/18/2022] Open
Abstract
Background: Outsourcing is considered as one of the tools for organizational development and promotion of productivity by managers. In recent years, outsourcing of healthcare services has become significant. The aim of this study was to identify the most important factors influencing the decision making of outsourcing healthcare services. Methods: This study is a combined study. First, the literature was examined to identify the factors influencing decision making for outsourcing. Then, with the aim of consensus on the most important factors affecting the decision making of outsourcing in health services, the panel of experts and Delphi technique were used. Sampling was purposeful. Results: In the selected articles, a total of 180 factors were extracted. The members of the panel of experts from these 180 factors selected 29 sub-factors in the form of six main factors: strategy, quality, management, technology, performance feature, and economy, as the most important factors affecting the outsourcing of services. Finally, the results of Delphi showed that 22 sub-factors were more important in outsourcing decision making at healthcare services. Conclusion: The study showed that the decision making to outsource health services is a complex and multi-criteria decision. Therefore, when deciding to outsource healthcare services, attention should be paid to various factors, such as strategy, quality, management, technology, and economics.
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Ansuategui Echeita J, van Holland BJ, Gross DP, Kool J, Oesch P, Trippolini MA, Reneman MF. Association between social factors and performance during Functional Capacity Evaluations: a systematic review. Disabil Rehabil 2018. [PMID: 29521595 DOI: 10.1080/09638288.2018.1448120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose: Determine the association of different social factors with Functional Capacity Evaluation (FCE) performance in adults. Materials and methods: A systematic literature search was performed in MEDLINE, CINAHL, and PsycINFO electronic databases. Studies were eligible if they studied social factor's association with the performance of adults undergoing FCE. Studies were assessed on methodological quality and quality of evidence. The review was performed using best-evidence synthesis methods. Results: Thirteen studies were eligible and 11 social factors were studied. Considerable heterogeneity regarding measurements, populations, and methods existed among the studies. High quality of evidence was found for the association of FCE performance with the country of FCE and examiner's fear behavior; moderate quality of evidence with previous job salary; and low or very low quality of evidence with compensation status, litigation status, type of instruction, time of day (workday), primary or mother language, and ethnicity. Other social factors were not studied. Conclusions: Evidence for associations of various social factors with FCE performance was found, but robust conclusions about the strength of the associations cannot be made. Quality of evidence ranged from high to very low. Further research on social factors, also within a biopsychosocial context, is necessary to provide a better understanding of FCE performance. Implications for Rehabilitation Research on Functional Capacity Evaluation (FCE) performance and its association with biopsychosocial factors have scarcely addressed the impact of social factors, limiting full understanding of FCE results. The social factors, healthcare (examiner's fear behavior and type of instruction), personal or cultural systems (country of FCE, primary or mother language, and ethnicity), workplace system (previous job salary, time of day (workday)), and legislative and insurance system (compensation and litigation status), have a bearing in FCE performance. Better understanding of factors associating with functional capacity provide insights in FCE, allowing clinicians to improve the evaluations and interpretations of the assessment and better design the rehabilitation program. Better understanding of factors that influence FCE performance, and of unstudied factors, will allow researchers guidance to further investigate the construct of functional capacity.
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Affiliation(s)
- Jone Ansuategui Echeita
- a Department of Rehabilitation Medicine , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Berry J van Holland
- b Institute for Sports Studies , Hanze University of Applied Sciences , Groningen , The Netherlands
| | - Douglas P Gross
- c Department of Physical Therapy , University of Alberta , Edmonton , Canada
| | - Jan Kool
- d Rehabilitation Centre Valens , Valens , Switzerland
| | - Peter Oesch
- d Rehabilitation Centre Valens , Valens , Switzerland
| | - Maurizio A Trippolini
- e Center for Disability Research , Liberty Mutual Research Institute for Safety , Boston , MA , USA.,f Massachusetts General Hospital , Institute for Health Professions , Boston , MA , USA.,g Department of Work Rehabilitation , Rehaklinik Bellikon , Bellikon , Switzerland
| | - Michiel F Reneman
- a Department of Rehabilitation Medicine , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
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Backe IF, Patil GG, Nes RB, Clench-Aas J. The relationship between physical functional limitations, and psychological distress: Considering a possible mediating role of pain, social support and sense of mastery. SSM Popul Health 2017; 4:153-163. [PMID: 29349284 PMCID: PMC5769123 DOI: 10.1016/j.ssmph.2017.12.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/19/2017] [Accepted: 12/19/2017] [Indexed: 10/29/2022] Open
Abstract
The aim of this study was to examine associations between selected physical functional limitations related to performing daily activities and psychological distress. We also aimed to investigate if these associations vary across age (moderation), and to explore pain, sense of mastery and social support as potential moderators and mediators. The study was based on pooled data from two rounds (2008 and 2012) of a Norwegian nationally representative cross-sectional health survey (N = 8520) including individuals aged ≥ 16 years (Age groups = 16-44 and ≥ 45 years). Physical functional limitations comprised decreased ability to: i) climb stairs, ii) carry objects, or iii) both. Psychological distress was measured as anxiety and depressive symptoms occurring separately or in combination (CAD). Of respondents reporting physical functional limitations, 8-14% reported depressive symptoms, 5-7% anxiety symptoms, and 13-28% reported CAD. Physical functional limitations were significantly associated with all three forms of psychological distress, particularly among individuals 16-44 years, and were more strongly related to CAD than to anxiety or depression occurring separately. The association with CAD was twice as strong when both types of physical functional limitations were present. Pain, sense of mastery and social support were significant modifiers of depression, whereas all three were significant mediators of the relationship between physical functional limitations and anxiety, depression and CAD. Sense of mastery mediated the relationship between physical functional limitations and CAD, but most strongly among those 16-44 years. Social support was only a significant mediator among those [Formula: see text] 45 years. Close associations between physical functional limitations and psychological distress highlight special needs among individuals experiencing daily functional limitations. The results also suggest that pain, low social support, and low sense of mastery may contribute to aggravate psychological distress.
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Affiliation(s)
- Ingeborg Flåten Backe
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - Grete Grindal Patil
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - Ragnhild Bang Nes
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Psychology, University of Oslo, Norway
| | - Jocelyne Clench-Aas
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
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Dickman A, Bickerstaff M, Jackson R, Schneider J, Mason S, Ellershaw J. Identification of drug combinations administered by continuous subcutaneous infusion that require analysis for compatibility and stability. BMC Palliat Care 2017; 16:22. [PMID: 28335763 PMCID: PMC5364569 DOI: 10.1186/s12904-017-0195-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 03/16/2017] [Indexed: 11/13/2022] Open
Abstract
Background A continuous subcutaneous infusion (CSCI) delivered via syringe pump is a method of drug administration used to maintain symptom control when a patient is no longer able to tolerate oral medication. Several classes of drugs, such as opioids, antiemetics, anticholinergics, antipsychotics and benzodiazepines are routinely administered by CSCI alone or in combinations. Previous studies attempting to identify the most-common CSCI combinations are now several years old and no longer reflect current clinical practice. The aim of this work was to review current clinical practice and identify CSCI drug combinations requiring analysis for chemical compatibility and stability. Methods UK pharmacy professionals involved in the delivery of care to palliative patients in hospitals and hospices were invited to enter CSCI combinations comprised of two or more drugs onto an electronic database over a 12-month period. In addition, a separate Delphi study with a panel of 15 expert healthcare professionals was completed to identify a maximum of five combinations of drugs used to treat more complex, but less commonly encountered symptoms unlikely to be identified by the national survey. Results A total of 57 individuals representing 33 separate palliative care services entered 1,945 drug combinations suitable for analysis, with 278 discrete combinations identified. The top 40 drug combinations represented nearly two-thirds of combinations recorded. A total of 23 different drugs were administered in combination and the median number of drugs in a combination was three. The Delphi study identified five combinations for the relief of complex or refractory symptoms. Conclusion This study represents the first step towards developing authoritative national guidance on the administration of drugs by CSCI. Further work will ensure healthcare practitioners have the knowledge and confidence that a prescribed combination will be both safe and efficacious.
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Affiliation(s)
- Andrew Dickman
- Marie Curie Palliative Care Institute Liverpool, Cancer Research Centre, Liverpool, L3 9TA, UK.
| | - Matthew Bickerstaff
- Cancer Research UK Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, L69 3GL, UK
| | - Richard Jackson
- Cancer Research UK Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, L69 3GL, UK
| | - Jennifer Schneider
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Stephen Mason
- Marie Curie Palliative Care Institute Liverpool, Cancer Research Centre, Liverpool, L3 9TA, UK
| | - John Ellershaw
- Marie Curie Palliative Care Institute Liverpool, Cancer Research Centre, Liverpool, L3 9TA, UK
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Integration and Application of the International Classification of Functioning, Disability and Health (ICF) in Return to Work. HANDBOOKS IN HEALTH, WORK, AND DISABILITY 2016. [DOI: 10.1007/978-1-4899-7627-7_6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Influence of Physical Therapists' Kinesiophobic Beliefs on Lifting Capacity in Healthy Adults. Phys Ther 2015; 95:1224-33. [PMID: 25838337 DOI: 10.2522/ptj.20130194] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 03/23/2015] [Indexed: 02/09/2023]
Abstract
BACKGROUND Physical therapists' recommendations to patients to avoid daily physical activity can be influenced by the therapists' kinesiophobic beliefs. Little is known about the amount of influence of a physical therapist's kinesiophobic beliefs on a patient's actual lifting capacity during a lifting test. OBJECTIVE The objective of this study was to determine the influence of physical therapists' kinesiophobic beliefs on lifting capacity in healthy people. DESIGN A blinded, cluster-randomized cross-sectional study was performed. METHODS The participants (n=256; 105 male, 151 female) were physical therapist students who performed a lifting capacity test. Examiners (n=24) were selected from second-year physical therapist students. Participants in group A (n=124) were tested in the presence of an examiner with high scores on the Tampa Scale of Kinesiophobia for health care providers (TSK-HC), and those in group B (n=132) were tested in the presence of an examiner with low scores on the TSK-HC. Mixed-model analyses were performed on lifting capacity to test for possible (interacting) effects. RESULTS Mean lifting capacity was 32.1 kg (SD=13.6) in group A and 39.6 kg (SD=16.4) in group B. Mixed-model analyses revealed that after controlling for sex, body weight, self-efficacy, and the interaction between the examiners' and participants' kinesiophobic beliefs, the influence of examiners' kinesiophobic beliefs significantly reduced lifting capacity by 14.4 kg in participants with kinesiophobic beliefs and 8.0 kg in those without kinesiophobic beliefs. LIMITATIONS Generalizability to physical therapists and patients with pain should be studied. CONCLUSIONS Physical therapists' kinesiophobic beliefs negatively influence lifting capacity of healthy adults. During everyday clinical practice, physical therapists should be aware of the influence of their kinesiophobic beliefs on patients' functional ability.
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Janssen SJ, ter Meulen DP, Nota SP, Hageman MG, Ring D. Does Verbal and Nonverbal Communication of Pain Correlate With Disability? PSYCHOSOMATICS 2015; 56:338-44. [DOI: 10.1016/j.psym.2014.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 04/15/2014] [Accepted: 04/16/2014] [Indexed: 11/15/2022]
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16
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Fore L, Perez Y, Neblett R, Asih S, Mayer TG, Gatchel RJ. Improved Functional Capacity Evaluation Performance Predicts Successful Return to Work One Year After Completing a Functional Restoration Rehabilitation Program. PM R 2014; 7:365-75. [DOI: 10.1016/j.pmrj.2014.09.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 09/24/2014] [Accepted: 09/26/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Lisa Fore
- PRIDE Research Foundation, Dallas, TX
| | | | | | - Sali Asih
- PRIDE Research Foundation, Dallas, TX
| | - Tom G. Mayer
- Department of Orthopedic Surgery, University of Texas Southwestern Medical Center at Dallas, 5701 Maple Ave. #100, Dallas, TX 75235
| | - Robert J. Gatchel
- Department of Psychology, University of Texas at Arlington, Arlington, TX
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Yen TH, Liou TH, Chang KH, Wu NN, Chou LC, Chen HC. Systematic review of ICF core set from 2001 to 2012. Disabil Rehabil 2013; 36:177-84. [DOI: 10.3109/09638288.2013.782359] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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18
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Pas LW, Kuijer PPFM, Wind H, Sluiter JK, Groothoff JW, Brouwer S, Frings-Dresen MHW. Clients’ and RTW experts’ view on the utility of FCE for the assessment of physical work ability, prognosis for work participation and advice on return to work. Int Arch Occup Environ Health 2013; 87:331-8. [DOI: 10.1007/s00420-013-0865-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Accepted: 02/27/2013] [Indexed: 11/29/2022]
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