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Liu W, Lewis FM, Oxford M, Kantrowitz-Gordon I. Common dyadic coping and its congruence in couples facing breast cancer: The impact on couples' psychological distress. Psychooncology 2024; 33:e6314. [PMID: 38459736 DOI: 10.1002/pon.6314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 01/28/2024] [Accepted: 02/16/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE Psychological distress is prevalent in couples facing breast cancer. Couples often deal with breast cancer as a unit instead of as individuals. Couple's dyadic coping is important for their adjustment to breast cancer; however, little is known about how couple's coping congruence influences their distress. This study examined how common dyadic coping (CDC) and coping congruence impact psychological distress in couples facing breast cancer. METHODS Baseline data were analyzed from 343 women with recently diagnosed early-stage breast cancer and their partners who participated in a randomized clinical trial. Psychological distress was indicated by depressed mood and state anxiety. Common dyadic coping was measured by a self-report scale. Coping congruence was assessed by the absolute difference between a woman's and her partner's CDC scores. RESULTS Higher CDC scores were associated with lower psychological distress in both women and partners. In the CDC subscales, women who suffered less scored higher on open communication, sharing a positive outlook, and lower on avoidance coping. Partners who suffered less scored higher on open communication, sharing a positive outlook, spending time talking, and lower on avoidance coping. Greater congruence in CDC was associated with lower psychological distress in women and their partners. Congruence in sharing a positive outlook benefited both members of the dyad; congruence in avoidance coping significantly benefited patients; congruence in open communication significantly benefited partners. CONCLUSIONS CDC and its congruence in specific areas have potential benefit to couple's psychological distress when facing breast cancer. Health care providers could consider enhancing couple's CDC and coping congruence to improve their adjustment.
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Affiliation(s)
- Wenjia Liu
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington, USA
| | - Frances Marcus Lewis
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington, USA
- Affiliate, Public Health Sciences & Member, Clinical Sciences Divisions, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Monica Oxford
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington, USA
| | - Ira Kantrowitz-Gordon
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington, USA
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Harrer M, Nixon P, Sprenger AA, Heber E, Boß L, Heckendorf H, Buntrock C, Ebert DD, Lehr D. Are web-based stress management interventions effective as an indirect treatment for depression? An individual participant data meta-analysis of six randomised trials. BMJ MENTAL HEALTH 2024; 27:e300846. [PMID: 38351099 PMCID: PMC10897957 DOI: 10.1136/bmjment-2023-300846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 11/15/2023] [Indexed: 02/16/2024]
Abstract
QUESTION Depression is highly prevalent and associated with numerous adverse consequences for both individuals and society. Due to low uptake of direct treatment, interventions that target related, but less stigmatising problems, such as perceived stress, have emerged as a new research paradigm.This individual participant data (IPD) meta-analysis examines if a web-based stress management intervention can be used as an 'indirect' treatment of depression. STUDY SELECTION AND ANALYSIS Bayesian one-stage models were used to estimate pooled effects on depressive symptom severity, minimally important improvement and reliable deterioration. The dose-response relationship was examined using multilevel additive models, and IPD network meta-analysis was employed to estimate the effect of guidance. FINDINGS In total, N=1235 patients suffering from clinical-level depression from K=6 randomised trials were included. Moderate-to-large effects were found on depressive symptom severity at 7 weeks post-intervention (d=-0.65; 95% credibility interval (CrI): -0.84 to -0.48) as measured with the Center for Epidemiological Studies' Depression Scale. Effects were sustained at 3-month follow-up (d=-0.74; 95% CrI: -1.01 to -0.48). Post-intervention symptom severity was linearly related to the number of completed sessions. The incremental impact of guidance was estimated at d=-0.25 (95% CrI: -1.30 to 0.82), with a 35% posterior probability that guided and unguided formats produce equivalent effects. CONCLUSIONS Our results indicate that web-based stress management can serve as an indirect treatment, yielding effects comparable with direct interventions for depression. Further research is needed to determine if such formats can indeed increase the utilisation of evidence-based treatment, and to corroborate the favourable effects for human guidance. STUDY REGISTRATION Open material repository: osf.io/dbjc8, osf.io/3qtbe. TRIAL REGISTRATION NUMBER German Clinical Trial Registration (DRKS): DRKS00004749, DRKS00005112, DRKS00005384, DRKS00005687, DRKS00005699, DRKS00005990.
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Affiliation(s)
- Mathias Harrer
- Technical University of Munich, Munich, Germany
- Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany
| | - Patricia Nixon
- Health Psychology and Applied Biological Psychology, Leuphana Universitat Luneburg, Luneburg, Germany
| | | | - Elena Heber
- GetOn Institut für Gesundheitstrainings GmbH/HelloBetter, Hamburg, Germany
| | - Leif Boß
- Health Psychology and Applied Biological Psychology, Leuphana Universitat Luneburg, Luneburg, Germany
| | - Hanna Heckendorf
- Health Psychology and Applied Biological Psychology, Leuphana Universitat Luneburg, Luneburg, Germany
| | | | | | - Dirk Lehr
- Health Psychology and Applied Biological Psychology, Leuphana Universitat Luneburg, Luneburg, Germany
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Benoni R, Sartorello A, Mazzi M, Berti L, Sorina M, Paiola E, Varischi G, Tardivo S, Rimondini M, Moretti F. The use of 12-item General Health Questionnaire (GHQ-12) in Ukrainian refugees: translation and validation study of the Ukrainian version. Health Qual Life Outcomes 2024; 22:6. [PMID: 38218847 PMCID: PMC10788012 DOI: 10.1186/s12955-024-02226-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 01/02/2024] [Indexed: 01/15/2024] Open
Abstract
Following the Russian-Ukrainian conflict, the well-being of millions of Ukrainians has been jeopardised. This study aims to translate and test the psychometric features of the Ukrainian version of the General Health Questionnaire 12 (GHQ-12). The study included Ukrainian refugees housed in Verona (Italy) between November/2022 and February/2023. The Ukrainian translation was obtained through a 'forward-backward' translation. Questionnaire was completed by 141 refugees (females: 78.7%). Median age was 36 years (IQR 23-43). Individuals with a score suggestive of psychological distress were 97 (68.8%). Cronbach's coefficient was 0.84 (0.95CI 0.80-0.88). According to confirmatory factor analysis, both single- (modelB1) and two-factor (model B2) structures with bimodal scoring method fitted the data satisfactorily. The two factors of model B2 had a 0.88 correlation. Pearson coefficient showed a positive significant correlation between the GHQ-12 and International Trauma Questionnaire scores (ρ = 0.53, 0.95CI 0.40-0.64, p < 0.001). The GHQ-12 Ukrainian translation showed good psychometric features being a reliable and valid instrument to assess Ukrainian refugees' general well-being.
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Affiliation(s)
- Roberto Benoni
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
| | - Anna Sartorello
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Mariangela Mazzi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Loretta Berti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Marina Sorina
- "Malve di Ucraina" Non-profit Organization (NPO), Verona, Italy
| | - Elena Paiola
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giovanna Varischi
- Prevention Department, Unità Locale Socio Sanitaria (ULSS) 9, Verona, Italy
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Michela Rimondini
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesca Moretti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Uchida H, Kuroiwa C, Ohki S, Takahashi K, Tsuchiya K, Kikuchi S, Hirao K. Assessing the Smallest Detectable Change of the Kessler Psychological Distress Scale Score in an Adult Population in Japan. Psychol Res Behav Manag 2023; 16:2647-2654. [PMID: 37465046 PMCID: PMC10351679 DOI: 10.2147/prbm.s417446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 07/09/2023] [Indexed: 07/20/2023] Open
Abstract
Background Psychological distress is prevalent worldwide and can lead to the development of mental conditions such as major depression and anxiety disorders. It is essential to assess the severity of patient-reported outcomes to provide effective treatment for psychological distress. The Kessler Psychological Distress Scale (K6) is one of the most widely used psychological distress scales. However, the smallest detectable change (SDC) of the K6 score has not been elucidated. Therefore, the current study aimed to determine the SDC of the K6 score in a Japanese adult population. Methods Participants aged 20-59 years who are native Japanese speakers were recruited from the panel list of a web research firm. The K6 score was assessed at baseline (T1) and at 2-week follow-up (T2). SDCs were calculated at the individual (SDCind) and group (SDCgroup) levels. Intraclass correlation coefficient agreement (ICCagreement) was calculated to assess test-retest reliability and Cronbach's alpha to evaluate internal consistency. Results A total of 3254 (1627 [50%] female) responded at T1 and T2. The mean (standard deviation) K6 scores were 5.71 (5.84) at T1 and 5.65 (5.83) at T2. The SDCind and SDCgroup of the K6 score were 8.47 (35.31%) and 0.15 (0.63%), respectively. The ICCagreement was 0.73, and the Cronbach's alpha was 0.94. Conclusion Our study provided evidence on the reliability and interpretation of the K6 score. Calculating the SDC of the K6 score can help identify the significance of changes in psychological distress over time and can determine the efficacy of interventions for psychological distress.
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Affiliation(s)
- Hiroyuki Uchida
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Chiaki Kuroiwa
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Sae Ohki
- Department of Occupational Therapy, Faculty of Medicine, Gunma University, Maebashi, Japan
| | - Kana Takahashi
- Department of Rehabilitation, Okayama Kounan Hospital, Okayama, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan
| | - Senichiro Kikuchi
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
- Department of Occupational Therapy, Faculty of Medicine, Gunma University, Maebashi, Japan
| | - Kazuki Hirao
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
- Department of Occupational Therapy, Faculty of Medicine, Gunma University, Maebashi, Japan
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Beach B, Steptoe A, Zaninotto P. Depression and anxiety in people with cognitive impairment and dementia during the COVID-19 pandemic: Analysis of the English Longitudinal Study of Ageing. PLoS Med 2023; 20:e1004162. [PMID: 37093859 PMCID: PMC10124844 DOI: 10.1371/journal.pmed.1004162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/27/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Some studies have identified declines in mental health during the Coronavirus Disease 2019 (COVID-19) pandemic in different age groups, including older people. As anxiety and depression are common neuropsychiatric symptoms among people with cognitive impairment, the mental health experiences of older people during the pandemic should take cognitive function into consideration, along with assessments made prior to the pandemic. This study addresses evidence gaps to test whether changes in depression and anxiety among older people through the COVID-19 pandemic were associated with cognitive impairment. It also investigates whether associations varied according to key sources of sociodemographic inequality. METHODS AND FINDINGS Using data from the English Longitudinal Study of Ageing (ELSA) collected from 2018/2019 to November/December 2020, we estimated changes in depression and anxiety for people aged 50+ in England across 3 cognitive function groups: no impairment, mild cognitive impairment, and dementia. Conditional growth curve models were estimated for continuous measures over 3 time points (N = 5,286), with mixed-effects logistic regression used for binary measures. All models adjusted for demographics (age, gender, ethnicity, and cohabiting partnership), socioeconomics (education, wealth, and employment status), geography (urban/rural and English region), and health (self-rated and the presence of multimorbidity). We found that depression (measured with CES-D score) worsened from 2018/2019 to November/December 2020 for people with mild cognitive impairment (1.39 (95% CI: 1.29 to 1.49) to 2.16 (2.02 to 2.30)) or no impairment (1.17 (95%CI: 1.12 to 1.22) to 2.03 (1.96 to 2.10)). Anxiety, using a single-item rating of 0 to 10 also worsened among those with mild cognitive impairment (2.48 (2.30 to 2.66) to 3.14 (2.95 to 3.33)) or no impairment (2.20 (2.11 to 2.28) to 2.85 (2.77 to 2.95)). No statistically significant increases were found for those with dementia. Using a clinical cutoff for likely depression (CES-D ≥4), we found statistically significant increases in the probability of depression between 2018/2019 and November/December 2020 for those with no impairment (0.110 (0.099 to 0.120) to 0.206 (0.191 to 0.222)) and mild impairment (0.139 (0.120 to 0.159) to 0.234 (0.204 to 0.263)). We also found that differences according to cognitive function that existed before the pandemic were no longer present by June/July 2020, and there were no statistically significant differences in depression or anxiety among cognitive groups in November/December 2020. Wealth and education appeared to be stronger drivers for depression and anxiety, respectively, than cognitive impairment. For example, those with no impairment in the richest two-thirds scored 1.76 (1.69 to 1.82) for depression in June/July, compared to 2.01 (1.91 to 2.12) for those with no impairment in the poorest third and 2.03 (1.87 to 2.19) for those with impairment in the poorest third. Results may be limited by the small number of people with dementia and are generalizable only to people living in the community, not to those in institutional care settings. CONCLUSIONS Our findings suggest a convergence in mental health across cognitive function groups during the pandemic. This suggests mental health services will need to meet an increased demand from older adults, especially those not living with cognitive impairment. Further, with little significant change among those with dementia, their existing need for support will remain; policymakers and care practitioners should ensure this group continues to have equitable access to mental health support.
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Affiliation(s)
- Brian Beach
- Research Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London, United Kingdom
| | - Andrew Steptoe
- Research Department of Behavioural Science & Health, Institute of Epidemiology & Health Care, University College London, London, United Kingdom
| | - Paola Zaninotto
- Research Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London, United Kingdom
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Hirao K, Takahashi H, Kuroda N, Uchida H, Tsuchiya K, Kikuchi S. Differences in Center for Epidemiologic Studies Depression Scale, Generalized Anxiety Disorder-7 and Kessler Screening Scale for Psychological Distress Scores between Smartphone Version versus Paper Version Administration: Evidence of Equivalence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4773. [PMID: 36981682 PMCID: PMC10049019 DOI: 10.3390/ijerph20064773] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
The use of electronic patient-reported outcomes has increased recently, and smartphones offer distinct advantages over other devices. However, previous systematic reviews have not investigated the reliability of the Center for Epidemiologic Studies Depression Scale (CES-D), Generalized Anxiety Disorder-7 (GAD-7), and Kessler Screening Scale for Psychological Distress (K6) when used with smartphones, and this has not been fully explored. This study aimed to evaluate the equivalence of the paper and smartphone versions of the CES-D, GAD-7, and K6, which were compared following a randomized crossover design method in 100 adults in Gunma, Japan. Participants responded to the paper and smartphone versions at 1-week intervals. The equivalence of paper and smartphone versions was evaluated using the intraclass correlation coefficient (ICCagreement). The mean participant age was 19.86 years (SD = 1.08, 23% male). The ICCagreements for the paper and smartphone versions of the CES-D, GAD-7, and K6 were 0.76 (95% confidence interval [CI] 0.66-0.83), 0.68 (95% CI 0.59-0.77), and 0.83 (95% CI 0.75-0.88), respectively. Thus, the CES-D and K6 scales are appropriate for use in a smartphone version, which could be applied to clinical and research settings in which the paper or smartphone versions could be used as needed.
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Affiliation(s)
- Kazuki Hirao
- Graduate School of Health Sciences, Gunma University, Maebashi 371-8514, Japan
- Department of Occupational Therapy, Faculty of Medicine, Gunma University, Maebashi 371-8514, Japan
| | - Hyono Takahashi
- Department of Occupational Therapy, Faculty of Medicine, Gunma University, Maebashi 371-8514, Japan
| | - Natsuki Kuroda
- Department of Occupational Therapy, Faculty of Medicine, Gunma University, Maebashi 371-8514, Japan
| | - Hiroyuki Uchida
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki 710-0826, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano 381-2227, Japan
| | - Senichiro Kikuchi
- Graduate School of Health Sciences, Gunma University, Maebashi 371-8514, Japan
- Department of Occupational Therapy, Faculty of Medicine, Gunma University, Maebashi 371-8514, Japan
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7
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Oliveira TAA, Gouveia VV, Ribeiro MGC, Oliveira KG, Melo RLPD, Montagna E. General Health Questionnaire (GHQ12): new evidence of construct validity. CIENCIA & SAUDE COLETIVA 2023; 28:803-810. [PMID: 36888864 DOI: 10.1590/1413-81232023283.09452022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 08/24/2022] [Indexed: 03/08/2023] Open
Abstract
This study aimed to gather evidence on the adequacy of the General Health Questionnaire (GHQ-12) in Brazil, considering a random sample of Brazilian physicians. Specifically aimed: (1) to test the GHQ-12 bifactor structure compared to alternative models, (2) to check its factorial invariance regarding to gender and the diagnosis of mental and behavioral disorders, and (3) to know the association of this measure with indicators of poor health (e.g., suicidal thoughts, decreased libido, medication use). The study included 1,085 physicians with a mean age of 45.7 (SD = 10.6), mostly male (61.5%), married (72.6%) and Catholic (59.2%). They answered the GHQ-12, the Positive and Negative Suicidal Ideation Inventory, and demographic questions. The best fit model was the bifactor structure composed of anxiety and depression, in addition to a general dimension, which presented Cronbach's alpha, McDonald's ω and composite reliability higher than 0.70 just for a general fact. Psychological distress scores correlated with suicidal ideation and indicators of health and sexual satisfaction. This is a psychometrically suitable instrument that can be used in terms of its total, but its specific factors need to be used with caution.
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Affiliation(s)
- Tulio Augusto Andrade Oliveira
- Faculdade de Medicina do ABC, Centro Universitário Saúde do ABC. Av. Lauro Gomes 2.000, Vila Sacadura Cabral. 09060-870 Santo André SP Brasil.
| | - Valdiney Veloso Gouveia
- Departamento de Psicologia, Centro de Ciências Humanas, Letras e Artes, Universidade Federal da Paraíba. João Pessoa PB Brasil
| | | | - Karen Guedes Oliveira
- Departamento de Fundamentação da Educação, Centro de Educação, Universidade Federal da Paraíba. João Pessoa PB Brasil
| | | | - Erik Montagna
- Faculdade de Medicina do ABC, Centro Universitário Saúde do ABC. Av. Lauro Gomes 2.000, Vila Sacadura Cabral. 09060-870 Santo André SP Brasil.
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Aburub AS, Phillips SP, Curcio CL, Guerra RO, Khalil H, Auais M. Circumstances and Factors Associated With Falls Among Community-Dwelling Older Adults Diagnosed With Heart Disease Using the International Mobility in Aging Study (IMIAS). J Geriatr Phys Ther 2023; 46:53-63. [PMID: 34225314 DOI: 10.1519/jpt.0000000000000316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND PURPOSE To identify the circumstances of falls and the factors associated with falls among older adults with cardiovascular disease (CVD). METHODS Baseline (2012) data from the International Mobility in Aging Study (IMIAS), a cross-sectional study, were used. Falling was measured by the subjective question, "Have you fallen in the last 12 months?" Several subjective questions were asked to obtain information about the circumstances of falls. Potential clinical factors associated with falling were cognitive status, depressive symptoms, physical performance, grip strength, visual acuity, and fear of falling (FOF). These clinical factors were measured respectively with the Leganes Cognitive Test, the Center for Epidemiological Studies Scales Depressive Symptoms, the Short Physical Performance Battery, a Jamar handgrip dynamometer, the Early Treatment Diabetic Retinopathy Study (ETDRS) tumbling E chart placed at 2 m, and the Falls Efficacy Scale-International. A χ 2 test was used to determine whether there were significant differences in fall circumstances among older adults with and without CVD. Two-sample t tests were used to test for any significant differences between older adults with and without CVD. Bonferroni correction was applied to limit type I errors and was corrected to .007. Simple and multiple logistic regressions identified which clinical factors were associated with falling. RESULTS A total of 429 older adults with CVD (mean age 69.5 ± 2.9) and 431 older adults without CVD (69.2 ± 2.9) participated in the study. Approximately 53% of fallers with CVD had 2 or more falls compared with fallers without CVD (39%). The most common location for falling was at home (43%) for fallers with CVD or in the street (50%) for fallers without CVD. Approximately 9% of fallers with CVD needed to be hospitalized while only 3% of fallers without CVD were admitted to the hospital. Approximately 42% of fallers with CVD had some residual sequelae (eg, being unable to walk around the house or do housework) compared with only 27% of fallers without CVD. Fallers with CVD had significantly ( P value < .007) more depressive symptoms (mean ± SD, 14.7 ± 12.9) and poorer physical performance (8.4 ± 3.0) compared with fallers without CVD (10.1 ± 9.4 and 9.6 ± 2.5, respectively); however FOF was the only significant clinical factor ( P value < .05) associated with falling for older adults with CVD. CONCLUSIONS Incidence of recurrent falls is higher among older adults with CVD than those without CVD. Circumstances of falls among fallers with CVD differ from those identified among fallers without CVD. Fear of falling was the only predictor of fall history among older adults with CVD. The results suggest the merit of considering FOF when designing prevention and intervention programs to reduce falls among older adults with CVD.
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Affiliation(s)
- Ala' S Aburub
- Physical Therapy Department, Faculty of Allied Medical Sciences, Isra University, Amman, Jordan
| | - Susan P Phillips
- Department of Family Medicine, Queen's University, Kingston, Ontario, Canada
| | - Carmen-Lucia Curcio
- Research Group on Geriatrics and Gerontology, Faculty of Health Sciences, Universidad de Caldas, Manizales, Colombia
| | | | - Hanan Khalil
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Auais
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
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9
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Haase I, Winkeler M, Imgart H. Ascertaining minimal clinically meaningful changes in symptoms of depression rated by the 15-item Centre for Epidemiologic Studies Depression Scale. J Eval Clin Pract 2022; 28:500-506. [PMID: 34647399 DOI: 10.1111/jep.13629] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES In clinical practise and in clinical studies on depression it is important to estimate whether changes in symptomatology measured by self-rating instruments are, in fact, clinically relevant. Therefore, the aim of the study was to estimate the clinical relevance of changes on the 15-item version of the Centre for Epidemiologic Studies Depression Scale (CES-D-15) based on the concept of the minimal clinically important difference (MCID). METHODS Data was acquired from 4781 patients with depression symptoms from a German psychosomatic hospital who have been assessed using the CES-D-15 before and after treatment. Threshold values representing the MCID were estimated on the basis of mean change scores and sensitivity/specificity analyses. Patients' global impression of change, clinical (therapists') global impression of change and change in impairment severity were used as external anchor criteria. RESULTS On average, the MCID was represented by a reduction of approximately 11 points in the CES-D-15, irrespective of age, gender, type of treatment and first or secondary diagnosis. However, higher baseline scores in the CES-D-15 required larger changes of raw values to represent a clinically important difference. CONCLUSIONS Anchor-based values are suggested here as an estimation of the clinical relevance of changes in the CES-D-15. Thus, instead of relying solely on effect sizes, the evaluation of treatment outcomes should be supplemented by reporting the percentage of patients who have reached the MCID. Further examinations to verify our results in other patient populations and with other types of anchor criteria will be needed.
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Affiliation(s)
- Ingo Haase
- Department of Research, Development and Quality Assurance, Clinic Group Enzensberg, Hopfen am See, Germany
| | - Markus Winkeler
- Department of Psychosomatics and Psychotherapy, Parkland Clinic, Bad Wildungen, Germany
| | - Hartmut Imgart
- Department of Psychosomatics and Psychotherapy, Parkland Clinic, Bad Wildungen, Germany
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Cha J, Peterson CM, Millenbah AN, Louwagie K, Baker ZG, Shah A, Jensen CJ, Gaugler JE. Delivering Personalized Recommendations to Support Caregivers of People Living With Dementia: Mixed Methods Study. JMIR Aging 2022; 5:e35847. [PMID: 35503650 PMCID: PMC9067568 DOI: 10.2196/35847] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/18/2022] [Accepted: 03/14/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Estimates suggest that 6.2 million Americans aged ≥65 years are living with Alzheimer dementia in 2021, and by 2060, this number could more than double to 13.8 million. As a result, public health officials anticipate a greater need for caregivers of persons with Alzheimer disease or related dementia and support resources for both people living with dementia and their caregivers. Despite the growing need for dementia caregiver support services, there is a lack of consensus regarding how to tailor these services to best meet the heterogeneous needs of individual caregivers. To fill this gap, Care to Plan (CtP), a web-based tool for caregivers of people living with dementia, was developed to provide tailored support recommendations to dementia caregivers. OBJECTIVE The aim of this study is to formally explore the feasibility, acceptability, and utility of CtP for 20 family members of people living with dementia within a health system over a 1-month time period using a mixed methods parallel convergent design. METHODS A moderately sized health system in the mid-Atlantic region was selected as the site for CtP implementation, where 20 caregivers who were family members of people living with dementia were enrolled. The web-based CtP tool was used by caregivers and facilitated by a health care professional (ie, a senior care navigator [SCN]). Caregivers were given a 21-item review checklist to assess barriers and facilitators associated with reviewing CtP with an SCN. Following the 21-item review checklist, semistructured telephone interviews, which included 18 open-ended questions, focused on the facilitators of and barriers to CtP implementation and recommendations for future implementation. RESULTS Quantitative results suggested that 85% (17/20) of caregivers indicated that CtP was helpful and 90% (18/20) would recommend CtP to someone in a similar situation. The qualitative analysis identified 4 themes regarding facilitators of and barriers to implementation: caregiver factors, SCN factors, CtP tool system factors, and recommendations and resources factors. CONCLUSIONS CtP was found to be not only feasible but also a valuable tool for caregivers seeking resources for themselves and their people living with dementia. Long-term evaluation findings aim to generate results on how CtP can be integrated into care plans for caregivers and how SCNs can provide additional support for caregivers of people living with dementia over an extended period.
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Affiliation(s)
- Jinhee Cha
- Medical School and School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Colleen M Peterson
- University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI, United States
| | - Ashley N Millenbah
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Katie Louwagie
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Zachary G Baker
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Ayush Shah
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Christine J Jensen
- Riverside Center for Excellence in Aging and Lifelong Health, Williamsburg, VA, United States
| | - Joseph E Gaugler
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
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11
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Objective Job Demands of Oneself and One's Partner, and Depressive Symptoms. Evidence from a Nationally Representative Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312688. [PMID: 34886414 PMCID: PMC8656634 DOI: 10.3390/ijerph182312688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/18/2021] [Accepted: 11/26/2021] [Indexed: 12/03/2022]
Abstract
Background: Job characteristics are an important predictor of depressive symptoms. Recent research detected unemployment’s spillover effects on spouses’ depressive symptoms, but there is still a lack of studies that examine the association between objective job demands of oneself and one’s partner and depressive symptoms. Methods: Data were derived from the German Ageing Survey (DEAS), which is a representative sample that includes individuals aged 40 years and older. Psycho-social, physical, and overall job characteristics were assessed objectively, using a validated index developed by Kroll. Depressive symptoms were quantified by the Center for Epidemiologic Studies Depression Scale (CES-D). Results: Regarding fixed-effects regression, we found no significant association between the own or the partner’s job demands and depression among the total sample and among men. However, among women, both increasing psychosocial demands of one’s own occupation and physical job demands of one’s partner’s occupation were related to higher levels of depression, as well as the partner’s overall job demands. Conclusions: The findings of the present longitudinal study highlight the association between job demands and depressive symptoms in women, but not in men, especially regarding the partner’s employment characteristics. Efforts to reduce the burden of high job demands may be helpful. This could help alleviate depressive symptoms. In turn, geriatric giants caused by increased depressive symptoms, such as frailty, could be postponed.
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12
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Haywood KL, Achana F, Nichols V, Pearce G, Box B, Muldoon L, Patel S, Griffiths F, Stewart K, Underwood M, Matharu MM. Measuring health-related quality of life in chronic headache: A comparative evaluation of the Chronic Headache Quality of Life Questionnaire and Headache Impact Test (HIT-6). Cephalalgia 2021; 41:1100-1123. [PMID: 33942667 PMCID: PMC8411468 DOI: 10.1177/03331024211006045] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/08/2021] [Accepted: 03/07/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare the quality and acceptability of a new headache-specific patient-reported measure, the Chronic Headache Quality of Life Questionnaire (CHQLQ) with the six-item Headache Impact Test (HIT-6), in people meeting an epidemiological definition of chronic headaches. METHODS Participants in the feasibility stage of the Chronic Headache Education and Self-management Study (CHESS) (n = 130) completed measures three times during a 12-week prospective cohort study. Data quality, measurement acceptability, reliability, validity, responsiveness to change, and score interpretation were determined. Semi-structured cognitive interviews explored measurement relevance, acceptability, clarity, and comprehensiveness. RESULTS Both measures were well completed with few missing items. The CHQLQ's inclusion of emotional wellbeing items increased its relevance to participant's experience of chronic headache. End effects were present at item level only for both measures. Structural assessment supported the three and one-factor solutions of the CHQLQ and HIT-6, respectively. Both the CHQLQ (range 0.87 to 0.94) and HIT-6 (0.90) were internally consistent, with acceptable temporal stability over 2 weeks (CHQLQ range 0.74 to 0.80; HIT-6 0.86). Both measures responded to change in headache-specific health at 12 weeks (CHQLQ smallest detectable change (improvement) range 3 to 5; HIT-6 2.1). CONCLUSIONS While both measures are structurally valid, internally consistent, temporally stable, and responsive to change, the CHQLQ has greater relevance to the patient experience of chronic headache.Trial registration number: ISRCTN79708100. Registered 16th December 2015, http://www.isrctn.com/ISRCTN79708100.
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Affiliation(s)
- Kirstie L Haywood
- Warwick Research in Nursing, Warwick Medical School, University
of Warwick, Coventry, UK
| | - Felix Achana
- Warwick Clinical Trials Unit, Warwick Medical School, University
of Warwick, Coventry, UK
- Nuffield Department of Primary Care Health Sciences, Oxford
University, Oxford, UK
| | - Vivien Nichols
- Warwick Clinical Trials Unit, Warwick Medical School, University
of Warwick, Coventry, UK
| | - Gemma Pearce
- School of Psychology, Social and Behavioural Sciences, Coventry
University, Coventry, UK
| | - Barbara Box
- Warwick Clinical Trials Unit, Warwick Medical School, University
of Warwick, Coventry, UK
| | - Lynne Muldoon
- Warwick Clinical Trials Unit, Warwick Medical School, University
of Warwick, Coventry, UK
| | - Shilpa Patel
- Warwick Clinical Trials Unit, Warwick Medical School, University
of Warwick, Coventry, UK
| | - Frances Griffiths
- Social Science and Systems in Health, Warwick Medical School,
University of Warwick, Coventry, UK
| | - Kimberly Stewart
- Warwick Clinical Trials Unit, Warwick Medical School, University
of Warwick, Coventry, UK
| | - Martin Underwood
- Warwick Clinical Trials Unit, Warwick Medical School, University
of Warwick, Coventry, UK
- University Hospitals Coventry and Warwickshire, Coventry,
UK
| | - Manjit M Matharu
- The Headache Group, National Hospital for Neurology and
Neurosurgery, University College of London Hospitals NHS Foundation Trust, AC1
London, UK
| | - on behalf of the CHESS Team
- Warwick Research in Nursing, Warwick Medical School, University
of Warwick, Coventry, UK
- Warwick Clinical Trials Unit, Warwick Medical School, University
of Warwick, Coventry, UK
- Nuffield Department of Primary Care Health Sciences, Oxford
University, Oxford, UK
- School of Psychology, Social and Behavioural Sciences, Coventry
University, Coventry, UK
- Social Science and Systems in Health, Warwick Medical School,
University of Warwick, Coventry, UK
- University Hospitals Coventry and Warwickshire, Coventry,
UK
- The Headache Group, National Hospital for Neurology and
Neurosurgery, University College of London Hospitals NHS Foundation Trust, AC1
London, UK
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13
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Choosing and Using Patient-Reported Outcome Measures in Clinical Practice. Arch Phys Med Rehabil 2021; 103:S108-S117. [PMID: 33713697 DOI: 10.1016/j.apmr.2020.12.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/08/2020] [Indexed: 12/27/2022]
Abstract
The increasing use of patient-reported outcome (PRO) measures is forcing clinicians and health care systems to decide which to select and how to incorporate them into their records and clinical workflows. This overview addresses 3 topics related to these concerns. First, a literature review summarizes key psychometric and practical factors (such as reliability, responsiveness, computer adaptive testing, and interpretability) in choosing PROs for clinical practice. Second, 3 clinical decision support issues are highlighted: gathering PROs, electronic health record effect on providers, and incorporating PROs into clinical decision support design and implementation. Lastly, the salience of crosscutting domains as well as 9 key pragmatic decisions are reviewed. Crosscutting domains are those that are relevant across most medical and mental health conditions, such as the SPADE symptom pentad (sleep problems, pain, anxiety, depression, low energy/fatigue) and physical functioning. The 9 pragmatic decisions include (1) generic vs disease-specific scales; (2) single- vs multidomain scales; (3) universal scales vs user-choice selection; (4) number of domains to measure; (5) prioritization of domains when multiple domains are assessed; (6) action thresholds; (7) clinical purpose (screening vs monitoring); as well as the (8) frequency and (9) logistical aspects of PRO administration.
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Kageyama K, Kato Y, Mesaki T, Uchida H, Takahashi K, Marume R, Sejima Y, Hirao K. Effects of video viewing smartphone application intervention involving positive word stimulation in people with subthreshold depression: A pilot randomized controlled trial. J Affect Disord 2021; 282:74-81. [PMID: 33401126 DOI: 10.1016/j.jad.2020.12.104] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/23/2020] [Accepted: 12/25/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND A smartphone application (i.e., SPSRS) was developed to help people with subthreshold depression (StD) improve depressive symptoms by presenting positive word stimuli in videos. However, to date, no randomized controlled trials (RCTs) were conducted to investigate SPSRS application interventions for depressive symptoms in people with StD. Therefore, a pilot RCT was conducted to assess the preliminary efficacy of the SPSRS application intervention for people with StD. METHODS In a pilot RCT, 32 participants (female = 34.4%, mean age = 20.06, SD = 1.24) with StD were randomized to SPSRS application intervention for approximately 10 min/a day for 5 weeks (experimental group; n = 16) or no intervention (wait list control group; n = 16). The primary outcome is the change from baseline in the Center for Epidemiologic Studies Depression Scale (CES-D) score after the 5-week intervention. The secondary outcomes are the change from baseline in the Kessler Screening Scale for Psychological Distress (K-6) score and the Generalized Anxiety Disorder 7-item scale (GAD-7) after the 5-week intervention. RESULTS No participants dropped out of the study. The experimental group displayed medium, small, and small improvements in CES-D, K-6, and GAD-7 scores (adjusted Hedge's g = -0.64, -0.29, and -0.40), respectively, compared with control. LIMITATIONS The observed effects must be considered preliminary due to the small sample size. CONCLUSIONS The results suggest the potential of intervention using the SPSRS application to reduce depressive symptoms in people with StD. Future studies should replicate these findings in a full-scale RCT.
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Affiliation(s)
- Kaito Kageyama
- Department of Occupational Therapy, Kibi International University, Takahashi, Japan
| | - Yudai Kato
- Department of Occupational Therapy, Kibi International University, Takahashi, Japan
| | - Takanori Mesaki
- Department of Occupational Therapy, Kibi International University, Takahashi, Japan
| | - Hiroyuki Uchida
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Kana Takahashi
- Department of Rehabilitation, Okayama Kounan Hospital, Okayama, Japan
| | - Risako Marume
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Yoshiyuki Sejima
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Kazuki Hirao
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan.
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15
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Smarr KL, Keefer AL. Measures of Depression and Depressive Symptoms. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:608-629. [PMID: 33091258 DOI: 10.1002/acr.24191] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 03/17/2020] [Indexed: 01/27/2023]
Affiliation(s)
- Karen L Smarr
- Harry S. Truman Memorial Veterans' Hospital and University of Missouri School of Medicine, Columbia
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16
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Arikawa AY, Ross J, Wright L, Elmore M, Gonzalez AM, Wallace TC. Results of an Online Survey about Food Insecurity and Eating Disorder Behaviors Administered to a Volunteer Sample of Self-Described LGBTQ+ Young Adults Aged 18 to 35 Years. J Acad Nutr Diet 2020; 121:1231-1241. [PMID: 33158800 DOI: 10.1016/j.jand.2020.09.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/19/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND There are few published studies addressing food insecurity and eating disorders in lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) individuals. OBJECTIVE The primary objective of this study was to describe the proportion of food insecurity and eating disorder behaviors in a volunteer sample of LGBTQ+ individuals aged 18 to 35 years. DESIGN This study was a cross-sectional analysis of questionnaire data collected from 253 participants between March 2018 and March 2019. PARTICIPANTS AND SETTING To be included in the study, participants had to be aged 18 to 35 years and identify as being LGBTQ+. MAIN OUTCOME MEASURES Food security score, Eating Attitudes Test score, Eating Disorder Examination Self-Report Questionnaire score, anxiety score (Beck), and depressive symptoms score. STATISTICAL ANALYSES PERFORMED The χ2 test was used to analyze the categorical outcomes. One-way analysis of variance was used to compare continuous variables across gender identity groups. All P values < 0.05 were taken as statistically significant. RESULTS The proportion of participants identifying as a woman, trans male, gender nonconforming, and a man were 39%, 24%, 24%, and 13%, respectively. Food insecurity was reported by 54.4% of respondents with trans males reporting the highest proportions (64.8%). High levels of depressive symptoms were reported by 68.2% of men, 89.8% of women, 91.4% of trans males, and 95.5% of gender-nonconforming respondents (P = 0.009). High anxiety was reported by 20.5%. Eating Disorder Examination Self-Report Questionnaire scores were significantly higher (P < 0.001) compared with a community-based sample. The eating disorder behavior most frequently reported by respondents was binge eating. Only 4.3% reported having sought treatment for an eating disorder. CONCLUSIONS Members of the LGBTQ+ community are at greater risk for food insecurity, eating disorders, and depression, particularly those who identify as trans males. These findings denote the need to focus future research efforts on effective prevention and treatment strategies that are specific to sexual and gender identity groups within the LGBTQ+ community.
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17
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Uchida H, Hiragaki Y, Nishi Y, Nakahara S, Koumoto J, Onmyoji Y, Fujimoto N, Kawakami K, Ishii M, Hirao K. An iPad application-based intervention for improving post-stroke depression symptoms in a convalescent rehabilitation ward: A pilot randomized controlled clinical trial protocol. Internet Interv 2020; 21:100340. [PMID: 32944505 PMCID: PMC7481559 DOI: 10.1016/j.invent.2020.100340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/28/2020] [Accepted: 07/02/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Post-stroke depression (PSD) is a neuropsychiatric sequela that causes serious adverse effects on the prognosis of stroke patients. Our developed iPad application is a very innovative approach designed to improve participants' depressive symptoms by presenting positive words stimuli in a video. Although this application has fewer side effects than existing pharmacological and non-pharmacological interventions and is likely less burdensome for patients and caregivers, its efficacy for PSD has not been investigated. Here we present a pilot randomized controlled trial (RCT) protocol to investigate the therapeutic potential of this application intervention for PSD patients. METHODS This study is designed as a 5-week, single-center, open-label, parallel-group, pilot RCT. Thirty-two patients with PSD will be randomly assigned to a combination of the iPad application and usual rehabilitation or usual rehabilitation alone (1:1 allocation ratio). The iPad application intervention lasts 3 min a day, and the usual rehabilitation lasts 3 h a day. The primary outcome is the change from baseline in The Center for Epidemiologic Studies Depression Scale score at the end of the 5-week intervention. DISCUSSION This pilot RCT is the first study to investigate the potential of iPad application interventions to reduce depressive symptoms in PSD patients. This pilot RCT determines whether this is a viable and effective intervention and informs the design for a full-scale trial. If our hypothesis is correct, this trial can provide evidence to augment the standard practice of iPad application interventions to improve depressive symptoms in patients with PSD.
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Key Words
- API, Application Programming Interface
- CBT, Cognitive Behavioral Therapy
- CRW, Convalescent Rehabilitation Ward
- Depression
- Mobile applications
- OT, Occupational Therapists
- PSD, Post-stroke Depression
- PT, Physical Therapists
- RCT, Randomized Controlled Trial
- Rehabilitation
- SPSRS, Subliminal Priming with Supraliminal Reward Stimulation
- ST, Speech Therapists
- Stroke
- rTMS, Repetitive Transcranial Magnetic Stimulation
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Affiliation(s)
- Hiroyuki Uchida
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Yoshiya Hiragaki
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Yuta Nishi
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Shiori Nakahara
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Junki Koumoto
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Yusuke Onmyoji
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Norimasa Fujimoto
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Kazuho Kawakami
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Masato Ishii
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Kazuki Hirao
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
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18
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Phang JK, Kwan YH, Fong W, Tan CS, Lui NL, Thumboo J, Leung YY. Validity and reliability of Work Productivity and Activity Impairment among patients with axial spondyloarthritis in Singapore. Int J Rheum Dis 2020; 23:520-525. [PMID: 32020752 DOI: 10.1111/1756-185x.13801] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/08/2019] [Accepted: 12/21/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To assess the validity and reliability of the Work Productivity and Activity Impairment (WPAI) questionnaire in patients with axSpA. METHODS English-speaking patients seen at a dedicated axSpA clinic in a Singapore tertiary referral hospital were recruited from 2017 to 2019. Content validity of the WPAI was assessed through cognitive debriefing interviews (CDIs). Construct validity was assessed by a priori hypotheses regarding the correlations of the WPAI outcomes (absenteeism, presenteeism, overall work productivity loss, and activity impairment) with Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Patient Global Score (BAS-G), patient global assessment (PGA) and pain scores. Known group validity was assessed relative to disease activity. Test-retest reliability was assessed by intraclass correlation coefficients (ICC) in patients without treatment change 2 weeks apart. RESULTS Cognitive debriefing interviews conducted with 10 patients (22-46 years old, 50% male) supported the content validity of the WPAI. We analyzed cross-sectional data from 168 patients (mean [SD] age 41.0 [14.4], 79.8% male). Construct validity was established by meeting 100% of the hypotheses. Presenteeism, overall work productivity loss, and activity impairment demonstrated strong correlations with BASFI, BAS-G, PGA, and pain (rs > .6). The WPAI was able to distinguish patients grouped by disease activity. Test-retest reliability conducted with 50 patients ranged from moderate to good for all the four outcomes (absenteeism: ICC = 0.54; presenteeism: ICC = 0.76; activity impairment: ICC = 0.79; overall work productivity loss: ICC = 0.83; all P < .01). CONCLUSIONS This study supports the content validity, construct validity, and test-retest reliability of the WPAI in patients with axSpA.
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Affiliation(s)
- Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - Yu Heng Kwan
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore.,Program in Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore.,NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Nai Lee Lui
- LUI Centre for Arthritis & Rheumatology, Singapore
| | - Julian Thumboo
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore.,Program in Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore.,NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ying Ying Leung
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore.,NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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19
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Kato Y, Kageyama K, Mesaki T, Uchida H, Sejima Y, Marume R, Takahashi K, Hirao K. Study protocol for a pilot randomized controlled trial on a smartphone application-based intervention for subthreshold depression: Study protocol clinical trial (SPIRIT Compliant). Medicine (Baltimore) 2020; 99:e18934. [PMID: 31977910 PMCID: PMC7004731 DOI: 10.1097/md.0000000000018934] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Interventions aimed at addressing subthreshold depression (StD) are important to prevent the onset of major depressive disorder. Our video playback application (SPSRS) is designed to reduce depressive symptoms by presenting positive words in videos, shedding new light on the treatment of StD. However, no randomized controlled trial (RCT) has utilized this video playback application for the treatment of individuals with StD. Therefore, a pilot RCT was designed to determine the feasibility of a full-scale trial. We herein present a study protocol for investigating the utility of a video playback application intervention for individuals with StD. METHODS This 5-week, single-blind, 2-arm, parallel-group, pilot RCT will determine the effectiveness of the video playback application by comparing individuals who had and had not been exposed to the same. A total of 32 individuals with StD will be randomly assigned to the experimental or control group at a 1:1 ratio. The experimental group will receive a 10-minute intervention containing the video playback application per day, whereas the control group will receive no intervention. The primary outcome will include changes in the Center for Epidemiologic Studies Depression Scale score after the 5-week intervention, while secondary outcomes will include changes in the Kessler Screening Scale for psychological distress and the generalized anxiety disorder 7-item scale score after the 5-week intervention. Statistical analysis using linear mixed models with the restricted maximum likelihood estimation method will then be performed. DISCUSSION This pilot RCT will have been the first to explore the utility of SPSRS application interventions that display positive words in videos for individuals with StD. The results of this pilot trial are expected to help in the design and implementation of a full-scale RCT that investigates the effects of SPSRS applications among individuals with StD. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04136041.
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Affiliation(s)
- Yudai Kato
- Department of Occupational Therapy, Kibi International University, Takahashi
| | - Kaito Kageyama
- Department of Occupational Therapy, Kibi International University, Takahashi
| | - Takanori Mesaki
- Department of Occupational Therapy, Kibi International University, Takahashi
| | - Hiroyuki Uchida
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki
| | - Yoshiyuki Sejima
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki
| | - Risako Marume
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki
| | - Kana Takahashi
- Department of Rehabilitation, Okayama Kounan Hospital, Okayama, Japan
| | - Kazuki Hirao
- Department of Occupational Therapy, Kibi International University, Takahashi
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20
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Kwan YH, Aw FF, Fong W, Phang JK, Kiltz U, Lim KK, Chew EH, Lui NL, Tan CS, Thumboo J, Østbye T, Leung YY. Validity and reliability of the Assessment of Spondyloarthritis International Society Health Index in English-speaking patients with axial spondyloarthritis in Singapore. Int J Rheum Dis 2019; 22:1644-1651. [PMID: 31245926 DOI: 10.1111/1756-185x.13640] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 04/17/2019] [Accepted: 05/27/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To assess the validity and reliability of the Assessment of Spondyloarthritis International Society Health Index (ASAS HI) among patients with axial spondyloarthritis (axSpA) in Singapore. METHODS We collected data from English-speaking patients with axSpA seen at a dedicated axSpA clinic in a Singapore tertiary referral hospital from 2017 to 2018. Face validity of the English version of ASAS HI was assessed through cognitive debriefing interviews (CDIs). Structural validity was assessed with confirmatory factor analysis. Convergent construct validity was assessed with 12 a priori hypotheses about the magnitude and direction of correlations between the ASAS HI summary score and other patient-reported outcome measures. Internal consistency was assessed using Cronbach's alpha. Test-retest reliability was assessed by intraclass correlation coefficient (ICC). Measurement error was assessed by analyzing smallest detectable change (SDC). RESULTS Ten patients (age range 22-46 years, 50% male) participated in CDIs and face validity was supported. Among 108 patients (median age: 37 [21-77], 80.6% males), unidimensionality was confirmed (comparative fit index = 0.960, Tucker-Lewis Index = 0.952, root mean square error of approximation = 0.038, standardized root mean residuals = 0.068, model Chi-square test P = 0.1251) in the 17-item ASAS HI. The ASAS HI showed good internal consistency of 0.83 and excellent test-retest reliability (ICC = 0.95; 95% CI 0.91-0.98) when baseline was compared with week 2. SDC was 1.02. Convergent validity was supported as hypotheses were confirmed in 100% of the results. CONCLUSIONS This study supports the ASAS HI as a valid and reliable measure of health status for use in patients with axSpA in Singapore.
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Affiliation(s)
- Yu Heng Kwan
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Fang Fang Aw
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Uta Kiltz
- Rheumazentrum Ruhrgebiet, Herne, Germany
| | - Ka Keat Lim
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Eng Hui Chew
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Nai Lee Lui
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Julian Thumboo
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Truls Østbye
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Ying Ying Leung
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Takahashi K, Takada K, Hirao K. Feasibility and preliminary efficacy of a smartphone application intervention for subthreshold depression. Early Interv Psychiatry 2019; 13:133-136. [PMID: 29356332 DOI: 10.1111/eip.12540] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 11/14/2017] [Accepted: 12/17/2017] [Indexed: 11/28/2022]
Abstract
AIM We developed a motion picture-reproducing smartphone application (app) designed to improve self-confidence in individuals with subthreshold depression (StD) and examined the feasibility and preliminary efficacy of an app intervention for individuals with StD. METHODS We conducted an open-label, single-arm pre-post study of 22 young adults with StD. Our intervention involved app usage for at least 70 min/wk for 5 weeks. The primary outcome measure was the adherence rate. Secondary outcome measures were safety and Center for Epidemiologic Studies Depression Scale (CES-D) scores. RESULTS No participants dropped out during the study. The adherence rate was 50%. The mean time of app use over 5 weeks was 124.23 ± 81.94 min/wk. No adverse events were reported. The CES-D scores were significantly improved at 5 weeks post-intervention. CONCLUSIONS Although this app intervention has the potential to reduce depressive symptoms, the app needs to be improved to increase adherence rates.
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Affiliation(s)
- Kana Takahashi
- Department of Occupational Therapy, Kibi International University, Takahashi, Japan
| | - Koki Takada
- Department of Occupational Therapy, Kibi International University, Takahashi, Japan
| | - Kazuki Hirao
- Department of Occupational Therapy, Kibi International University, Takahashi, Japan
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Takada K, Takahashi K, Hirao K. Measurement error in the Liebowitz Social Anxiety Scale: results from a general adult population in Japan. Int J Psychiatry Clin Pract 2018; 22:289-295. [PMID: 29338470 DOI: 10.1080/13651501.2018.1426772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective: Although the self-report version of Liebowitz Social Anxiety Scale (LSAS) is frequently used to measure social anxiety, data is lacking on the smallest detectable change (SDC), an important index of measurement error. We therefore aimed to determine the SDC of LSAS. Methods: Japanese adults aged 20-69 years were invited from a panel managed by a nationwide internet research agency. We then conducted a test-retest internet survey with a two-week interval to estimate the SDC at the individual (SDCind) and group (SDCgroup) levels. Results: The analysis included 1300 participants. The SDCind and SDCgroup for the total fear subscale (scoring range: 0-72) were 23.52 points (32.7%) and 0.65 points (0.9%), respectively. The SDCind and SDCgroup for the total avoidance subscale (scoring range: 0-72) were 32.43 points (45.0%) and 0.90 points (1.2%), respectively. The SDCind and SDCgroup for the overall total score (scoring range: 0-144) were 45.90 points (31.9%) and 1.27 points (0.9%), respectively. Conclusions: Measurement error is large and indicate the potential for major problems when attempting to use the LSAS to detect changes at the individual level. These results should be considered when using the LSAS as measures of treatment change.
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Affiliation(s)
- Koki Takada
- a Department of Occupational Therapy , Kibi International University , Takahashi , Japan
| | - Kana Takahashi
- a Department of Occupational Therapy , Kibi International University , Takahashi , Japan
| | - Kazuki Hirao
- a Department of Occupational Therapy , Kibi International University , Takahashi , Japan
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