Rasch Analysis of the Disability Acceptance Scale for Individuals With Cerebral Palsy

Spinal Muscular Atrophy: An Evolving Scenario through New Perspectives in Diagnosis and Advances in Therapies

Spinal muscular atrophy (SMA) linked to 5q is a recessive motor neuron disease characterized by progressive and diffuse weakness and muscular atrophy. SMA is the most common neurodegenerative disease in childhood with an incidence of approximately 1 in 6000-10,000 live births, being long considered a leading cause of hereditary mortality in infancy, worldwide. The classification of SMA is based on the natural history of the disease, with a wide clinical spectrum of onset and severity. We are currently in a new therapeutic era, that, thanks to the widespread use of the newly approved disease-modifying therapies and the possibility of an early administration, should lead to a deep change in the clinical scenario and, thus, in the history of SMA. With the aim to achieve a new view of SMA, in this review we consider different aspects of this neuromuscular disease: the historical perspective, the clinical features, the diagnostic process, the psychological outcome, innovation in treatments and therapies, the possibility of an early identification of affected infants in the pre-symptomatic phase through newborn screening programs.

Rasch analysis of the beck depression inventory in a homeless and precariously housed sample

The approach to analysis of and interpretation of findings from the Beck Depression Inventory (BDI), a self-report questionnaire, depends on sample characteristics. To extend work using conventional BDI scoring, the BDI's suitability in assessing symptom severity in a homeless and precariously housed sample was examined using Rasch analysis. Participants (n=478) recruited from an impoverished neighbourhood in Vancouver, Canada, completed the BDI. Rasch analysis using the partial credit model was done, and the structural validity, unidimensionality, and reliability of the BDI were studied. A receiver operating characteristic curve determined a Rasch cut-off score consistent with clinical depression, and Rasch scores were correlated with raw scores. Good fit to the Rasch model was observed after rescoring all items and removing Item 19 (Weight Loss), and unidimensionality and reliability were satisfactory. Item 9 (Suicidal Wishes) represented the most severe symptom. Rasch-based scores detected clinical depression with moderate sensitivity and specificity, and were positively correlated with conventional scores. The BDI in a community-based sample of homeless and precariously housed adults satisfied Rasch model expectations in a 20-item format, and is suitable for assessing symptom severity. Future research on depression in similar samples may reveal more information on using specific symptoms to determine clinical significance.

Predictors of depression among the elderly persons with disabilities in Indonesia

BACKGROUND

Depression is a major mental problem in the elderly, particularly those with disability. This study's aim was to identify variables that predict depression in the elderly with disabilities.

MATERIALS AND METHODS

This cross-sectional study was conducted in Gunungkidul Regency and Yogyakarta City from April to June 2021. The study participants were community-dwelling elderly aged 60 years and above with disabilities, who could communicate verbally without any apparent cognitive impairment. Data was collected by interviewing participants using structured questionnaire on following sections: Demographic characteristics, Mini-Mental State Examination (MMSE), Washington Group Short Set (WG-SS), Barthel Index of activities of daily living (ADL), Lawton Instrumental ADL (IADL) Scale, and Geriatric Depression Scale-30 (GDS-30). Multivariate linear regression analysis applied to identify variables significantly correlated with depression. Multinomial logistic regression analysis performed to obtain the odds ratio (OR).

RESULTS

Study included 115 elderly persons with disabilities. Most of them had mobility impairment. Higher independence in ADL and being married were related with lower risk of depression, whereas increased age at disability increased the risk of depression (P = 0.001). The elderly who had greater independence with daily activities were less likely to have depression (OR = 0.639 for mild depression and OR = 0.589 for severe depression). Those who were not married were more likely to have mild depression (OR = 3.203) and severe depression (OR = 29.119). compared to the married elderly. Age at acquiring disability was associated with higher risk for mild depression (OR = 1.025) and severe depression (OR = 1.053). Higher independence in ADL and being married were related with lower risk of depression, whereas increased age at disability increased the risk of depression (P = 0.001).

CONCLUSION

Independence in the ADL, being married, and being disabled as a young adult are negative predictors of depression in the elderly with disability.

Psychometric properties of the caregiving difficulty scale in mothers of children with cerebral palsy

BACKGROUND

The Caregiving Difficulty Scale is used to measure the burden of caregiving experienced by mothers of children with cerebral palsy. This study aimed to identify the psychometric properties of the Caregiving Difficulty Scale using the Rasch model.

METHODS

Data collected from 206 mothers of children with cerebral palsy were analyzed. Unidimensionality, difficulty of item, rating scale appropriateness, and reliability using the separation index of the Caregiving Difficulty Scale were verified. Unidimensionality of all 25 items was identified through the item fit.

RESULTS

Our analysis of item difficulty indicated that person ability and item difficulty are expressed as a similar logit extend. The use of the 5-point rating scale appeared to be appropriate. Outcome analysis revealed that the reliability was high based on the person and that the item separation level was acceptable.

CONCLUSIONS

This study showed that the Caregiving Difficulty Scale could be a valuable tool for evaluating the caregiving burden in mothers of children with cerebral palsy.

The Psychometric Properties of the Trunk Impairment Scale in Children with Cerebral Palsy

The Trunk Impairment Scale (TIS) measures static and dynamic seated trunk control in children with cerebral palsy (CP) who have postural control problems. Studies have investigated the reliability and validity of the TIS. However, the fitness and difficulty of the scale items have not been investigated. This study used Rasch analysis to test the construct validity of TIS for children with CP. TIS data were collected from 60 children with CP and analyzed for person and item fit, item difficulty, rating scale suitability, and separation reliability. Principal component analyses of residuals revealed that TIS had unidimensionality. Five misfit items (static sitting balance (SSB) items 2 and 3, dynamic sitting balance (DSB) items 4 and 5, and coordination (COO) item 3) were identified. DSB8 is the most difficult item, followed by DSB3 and COO4. On the other hand, the SSB3 item was found to be a relatively easy item. The rating scales demonstrated that out of the three subscales, SSB, DSB, and COO, only the SSB subscale did not meet the appropriate criteria. We demonstrated that statistical item analysis with the Rasch model could provide valuable information related to psychometric properties.

Current Status of Acceptance of Disability and the Correlation With the Life Quality in Parkinson's Disease in Southwest China

Background

Acceptance of disability (AOD) is a process that a patient must undergo to cope with altered abilities, but its effect in Parkinson's disease (PD) remains unclear. The present study aimed to determine the level of AOD, examine the influence of sociodemographic variables and disease characteristics on the AOD level, and evaluate the relation between AOD level and quality of life in a cohort of PD patients from Southwest of China.

Methods

A total of 336 PD patients were consecutively recruited from November 2018 to October 2020. At enrollment, demographic and clinical data were obtained using a questionnaire, and the Acceptance of Disability Scale-Revised (AODS-R) scale was used to measure the AOD level.

Results

The mean total score of AOD is 87.28, indicating a moderate level of disability acceptance in PD patients. Statistical analysis showed that understanding of PD, family support, and UPDRS-II score were major factors affecting AOD level, and patients with low AOD levels were more likely to have poorer quality of life.

Conclusion

AOD is a serious problem in PD patients in Southwest China, especially among individuals with insufficient family support and a lack of recognition of the disease. AOD was also associated with motor function and daily living ability, thus suggesting that evaluation of the AOD and promotion of the awareness may be helpful to improve the quality of life in patients with PD.

Disease Acceptance and Eudemonic Well-Being Among Adults With Physical Disabilities: The Mediator Effect of Meaning in Life

The acceptance of disability is recognized as one of the most frequently mentioned factors that plays a particularly significant role in subjective well-being. However, so far, only a very small amount of research has been undertaken to clarify how and why acceptance of illness relates to eudemonic well-being. Hence, comprehension of the direct and indirect effects underlying this relationship seems essential for interventions that increase the recovery of people with impairments and enhance their quality of life. The current research was aimed at investigating the association between acceptance of illness, meaning in life, and eudemonic well-being, as well as the possible mediatory effect of meaning in life on the relationship between acceptance of illness and well-being. The sample consisted of 102 participants (71% women) aged between 20 and 64 years. The respondents had a range of different impairments (e.g., cerebral palsy, neurological disorders, spinal muscular atrophy, and sight defects). The Acceptance of Illness Scale, the Meaning in Life Questionnaire, and the Ryff Scales of Psychological Well-Being were used. It was confirmed that acceptance of illness correlated positively and significantly with the presence of meaning, self-acceptance, positive relations, environmental mastery, personal growth, general well-being, cohesion, flexibility, communication, and family satisfaction. The presence of meaning mediated the relationship between acceptance of illness and general well-being with its four other dimensions: self-acceptance, environmental mastery, purpose in life, and personal growth. Conversely, the search for meaning did not have any mediatory effect on this relationship.