1,720,965 research outputs found
Self-management following stroke. Concepts and measurement
No full textStroke is a major cause of disability world-wide, representing a significant health and social burden (Feigin et al., 2009). Self-management has potential importance for reducing the personal and health service impact of illness, but is yet to be fully understood or measured in stroke (Boger et al., 2013, Jones & Riazi, 2011).This research sought to develop a new patient-reported outcome measure (PROM) of self-management following stroke. A mixed methods paradigm with three distinct phases was adopted. Focus group methodology (n=28) first explored self-management from the perspectives of people following stroke and informed the content of a preliminary PROM. Three key themes identified from the data affect stroke self-management; Individual capacity; Support for self-management and Self-management environment. Following the focus group enquiry, the preliminary PROM item pool consisted of 57 items relating to Individual Capacity. Cognitive Interviewing methodology (n=11) was next employed to refine the item pool and explore acceptability of the items. Finally, the revised PROM was subject to psychometric evaluation using responses from a nationally derived sample (n=87). Mokken scale analysis and correlations with additional outcome measures of theoretical importance were used to identify scale structure and investigate reliability and validity. The subsequent PROM, the Stroke Self-Management Questionnaire (SSMQ) forms a unidimensional Mokken scale which measures the construct of self-management competency. The SSMQ possesses excellent internal consistency reliability (Mokken r 0.89), test retest reliability (ICC 0.928) and represents a valid tool for the evaluation of stroke self-management interventions
A review of the evidence in support of the SF-36 and general-efficacy scale to evaluate a vocational rehabilitation service
No full textThe purpose of this paper is to examine the evidence for using the General self-efficacy scale and physical functioning scale of the SF-36 to evaluate a vocational rehabilitation service to 1) inform researchers, clinicians and commissioners about the properties of the measures in use and 2) make recommendations for the future evaluation of vocational rehabilitation.Methods: Electronic databases, United Kingdom government websites, generic internet search engines and hand searches of reference lists were reviewed for relevant articles. Abstracts were selected against inclusion criteria and relevant articles retrieved for appraisal.Findings: 19 articles were retrieved and reviewed for inclusion criteria.7 articles met the inclusion criteria and contributed to the review of the evidence. The use of the SF-36 and GSES in vocational rehabilitation settings appears to be based on evidence drawn from studies with methodological flaws. No evidence could be found in support of the sensitivity and responsiveness of the GSES.Discussion and implications for practice: The use of outcome measures that have questionable reliability and validity, and an absence of evidence with regard to responsiveness and sensitivity in vocational rehabilitation populations, contributes to an inability to evaluate the effectiveness of vocational rehabilitation services. Further enquiry into how vocational rehabilitation operates, would help to clarify the nature and range of specific activities to be targeted and aid the selection of existing appropriate measures or the development of new measures that reflect the conceptual premises that supportvocational rehabilitation
Paracetamol use in musculoskeletal pain: an audit of use and patient perceptions of paracetamol as an effective analgesic
No full textMusculoskeletal pain is a complex problem with often very detrimental consequences which affects a high proportion of the general population. Health care professionals, when prescribing for musculoskeletal pain, often overlook simple analgesia. Patient perceptions of analgesia may vary to those of health care professionals, and in part affect the use of simple analgesia for musculoskeletal pain. This paper describes an audit of paracetamol use and patient perceptions of paracetamol as an effective analgesic agent, in 113 patients attending a musculoskeletal pain outpatient clinic in a university teaching hospital. The audit has helped prompt the development of a multi-disciplinary strategy to achieve optimum managemen
Self-management: a systematic review of outcome measures adopted in self-management interventions for stroke
No full textPurpose: To systematically review the psychometric properties of outcome measures used in stroke self-management interventions (SMIs) to (1) inform researchers, clinicians and commissioners about the properties of the measures in use and (2) make recommendations for the future development of self-management measurement in stroke. Methods: Electronic databases, government websites, generic internet search engines and hand searches of reference lists. Abstracts were selected against inclusion criteria and retrieved for appraisal and systematically scored, using the COSMIN checklist. Results: Thirteen studies of stroke self-management originating from six countries were identified. Forty-three different measures (mean 5.08/study, SD 2.19) were adopted to evaluate self-SMIs. No studies measured self-management as a discreet concept. Six (46%) studies included untested measures. Eleven (85%) studies included at least one measure without reported reliability and validity in stroke populations. Conclusions: The use of outcome measures which are related, indirect or proxy indicators of self-management and that have questionable reliability and validity, contributes to an inability to sensitively evaluate the effectiveness of stroke self-SMIs. Further enquiry into how the concept of self-management in stroke operates, would help to clarify the nature and range of specific self-management activities to be targeted and aid the selection of existing appropriate measures or the development of new measures
Stroke self-management: a focus group study to identify the factors influencing self-management following stroke
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Development and psychometric evaluation of a new patient -reported outcome measure for stroke self -management: The Southampton Stroke Self - Management Questionnaire (SSSMQ)
Full text linkBackground: Self-management is important to the recovery and quality of life of people following stroke. Many interventions to support self-management following stroke have been developed, however to date no reliable and valid outcome measure exists to support their evaluation. This study outlines the development and preliminary investigation of the psychometric performance of a newly developed patient-reported outcome measure (PROM) of self-management competency following stroke; the Southampton Stroke Self-Management Questionnaire (SSSMQ).Methods: A convenience sample of 87 people who had had a stroke completed responses to the SSSMQ, the Stroke Self-Efficacy Questionnaire and the Stroke Impact Scale. Scaling properties were assessed using Mokken Scale Analysis. Reliability and construct validity were assessed using intra-class correlation coefficient (ICC), Mokken and Cronbach’s reliability coefficients and Spearman rank order correlations with relevant measures.Results: Mokken scaling refined the SSSMQ to 28 scalable items. Internal consistency reliability (Mokken r = 0.89) and test-retest reliability (ICC = 0.928) were excellent. Hypotheses of expected correlations with additional measures held, demonstrating good evidence for construct validity.Conclusions: Early findings suggest the Southampton Stroke Self-Management Questionnaire is a reliable and valid scale of self-management competency. The SSSMQ represents a potentially valid PROM for the evaluation of self-management following stroke.<br/
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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