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Evaluating the consistency of scales used in adult attention deficit hyperactivity disorder assessment of college-aged adults.
Saleh A, Fuchs C, Taylor WD, Niarhos F
(2018) J Am Coll Health 66: 98-105
MeSH Terms: Adult, Attention Deficit Disorder with Hyperactivity, Female, Humans, Male, Mass Screening, Psychiatric Status Rating Scales, Retrospective Studies, Self-Assessment, Severity of Illness Index, Students, Universities, Young Adult
Show Abstract · Added March 14, 2018
OBJECTIVE - Neurocognitive evaluations are commonly integrated with clinical assessment to evaluate adult Attention Deficit Hyperactivity Disorder (ADHD). Study goal is to identify measures most strongly related to ADHD diagnosis and to determine their utility in screening processes.
PARTICIPANTS - 230 students who were evaluated at the Vanderbilt University Psychological and Counseling Center between July 2013 and October 2015.
METHODS - We retrospectively examined charts, including clinical diagnosis, family history, childhood parental reported and current self-reported ADHD symptoms, psychiatric comorbidities, and continuous performance test (CPT).
RESULT - Positive report of childhood and current ADHD symptoms, and lack of comorbid psychiatric symptoms were strongly associated with clinical diagnosis. CPT results were not associated with an ADHD diagnosis. The absence of reported childhood and current ADHD symptoms may serve as a contradictory marker for ADHD diagnosis.
CONCLUSION - Clinical assessment of ADHD symptoms and ADHD childhood history, but not CPT, contributes to an accurate diagnosis of ADHD in college-aged adults.
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13 MeSH Terms
A novel approach to supporting relationship-centered care through electronic health record ergonomic training in preclerkship medical education.
Silverman H, Ho YX, Kaib S, Ellis WD, Moffitt MP, Chen Q, Nian H, Gadd CS
(2014) Acad Med 89: 1230-4
MeSH Terms: Adult, Arizona, Clinical Competence, Education, Medical, Undergraduate, Electronic Health Records, Ergonomics, Female, Humans, Linear Models, Male, Patient-Centered Care, Physician-Patient Relations, Self-Assessment
Show Abstract · Added January 20, 2015
PROBLEM - How can physicians incorporate the electronic health record (EHR) into clinical practice in a relationship-enhancing fashion ("EHR ergonomics")?
APPROACH - Three convenience samples of 40 second-year medical students with varying levels of EHR ergonomic training were compared in the 2012 spring semester. All participants first received basic EHR training and completed a presurvey. Two study groups were then instructed to use the EHR during the standardized patient (SP) encounter in each of four regularly scheduled Doctoring (clinical skills) course sessions. One group received additional ergonomic training in each session. Ergonomic assessment data were collected from students, faculty, and SPs in each session. A postsurvey was administered to all students, and data were compared across all three groups to assess the impact of EHR use and ergonomic training.
OUTCOMES - There was a significant positive effect of EHR ergonomics skills training on students' relationship-centered EHR use (P<.005). Students who received training reported that they were able to use the EHR to engage with patients more effectively, better articulate the benefits of using the EHR, better address patient concerns, more appropriately position the EHR device, and more effectively integrate the EHR into patient encounters. Additionally, students' self-assessments were strongly corroborated by SP and faculty assessments. A minimum of three ergonomic training sessions were needed to see an overall improvement in EHR use.
NEXT STEPS - In addition to replication of these results, further effectiveness studies of this educational intervention need to be carried out in GME, practice, and other environments.
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13 MeSH Terms
Assessing the surgical skills of urology residents after preurology general surgery training: the surgical skills learning needs of new urology residents.
Mitchell RE, Clark PE, Scarpero HM
(2011) J Surg Educ 68: 341-6
MeSH Terms: Clinical Competence, Data Collection, General Surgery, Humans, Internship and Residency, Self-Assessment, Urology
Show Abstract · Added May 27, 2014
OBJECTIVE - Resident work-hour restrictions and a reduction in general surgery training have impacted urologic training. We sought to assess the educational needs of urology residents after preurology training in general surgery to compare self-reported outcomes to those of supervising faculty and to determine which aspects of preurology training have an impact on those needs.
DESIGN - A survey was distributed electronically to urology residents and faculty of Accreditation Council for Graduate Medical Education (ACGME) residency programs. Residents evaluated 11 surgical skills with regard to their importance to subsequent urology training and their self-assessed proficiency with those skills. Faculty members evaluated the same skills with regard to their importance and their residents' proficiency with those skills. All individuals evaluated 11 general surgery rotations with regard to their importance to later urology training. The responses were analyzed using the paired Wilcoxon test, and faculty responses were compared with resident responses using the Fisher exact test and the χ(2)-test.
SETTING - Urologic surgery residency programs in the United States.
PARTICIPANTS - There were 305 resident responses and 58 faculty responses.
RESULTS - For each surgical skill, residents perceived skills as being more important than their self-assessed proficiency with those skills (p < 0.001). Resident and faculty assessments of surgical skills and of general surgery rotations were similar. More time spent in general surgery training was associated with increased self-assessed proficiency. No difference was found between resident and faculty assessment of global surgical skills (p = 0.76) or general surgery rotation importance (p = 0.87).
CONCLUSIONS - A discrepancy was determined between urology residents' perceptions of the importance of surgical skills and their proficiency with those skills. The duration of general surgery training might have an impact on self-assessed skills proficiency. Concordance was demonstrated between resident and faculty perceptions of residents' surgical skills and of general surgery rotations.
Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
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7 MeSH Terms
Empathy, schizotypy, and visuospatial transformations.
Thakkar KN, Park S
(2010) Cogn Neuropsychiatry 15: 477-500
MeSH Terms: Empathy, Female, Humans, Male, Psychological Tests, Schizotypal Personality Disorder, Self-Assessment, Surveys and Questionnaires, Visual Perception, Young Adult
Show Abstract · Added July 28, 2015
INTRODUCTION - Adopting another person's visuospatial perspective has been associated with empathy, which involves adopting the psychological perspective of another individual. Both reduced empathy and abnormal visuospatial processing have been observed in those with schizophrenia and schizophrenia-related personality traits. In the current study, we sought to explore the relationship between empathy, schizotypy, and visuospatial transformation ability.
METHODS - 32 subjects (16 women) performed a visuospatial perspective-taking task and a mental letter rotation task. Response times and accuracy were analysed in relation to dimensions of self-reported empathy, indexed using the Interpersonal Reactivity Index, and schizotypy, as measured by the Schizotypal Personality Questionnaire.
RESULTS - We found that: (1) greater cognitive and affective empathy were associated with reduced negative schizotypy, and, in men, greater cognitive empathy was associated with reduced positive schizotypy; (2) improved accuracy for imagined self-other transformations in the perspective-taking task was associated with greater self-reported cognitive empathy in women and higher positive schizotypy across genders; (3) faster mental letter rotation was associated with reduced cognitive empathy and increased negative schizotypy in women.
CONCLUSIONS - Together, the findings partially support the commonalities in visuospatial transformation ability, empathy, and schizotypy, and posit an interesting link between spatial manipulations of our internal representations and interactions with the physical world.
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10 MeSH Terms
Self-reported urinary continence outcomes for repeat midurethral synthetic sling placement.
Eandi JA, Tanaka ST, Hellenthal NJ, O'Connor RC, Stone AR
(2008) Int Braz J Urol 34: 336-42; discussion 343-4
MeSH Terms: Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Middle Aged, Postoperative Complications, Quality of Life, Recurrence, Reoperation, Retrospective Studies, Risk Factors, Self-Assessment, Suburethral Slings, Surveys and Questionnaires, Treatment Failure, Urinary Incontinence, Stress, Urodynamics
Show Abstract · Added February 19, 2015
OBJECTIVE - To evaluate our experience with tension-free transvaginal tape (TVT) placement for the management of stress urinary incontinence (SUI) in women who had previously undergone a failed midurethral synthetic sling (MUS) procedure.
MATERIALS AND METHODS - Ten women underwent retropubic TVT insertion for continued or recurrent SUI following a prior MUS procedure. No attempt was made to remove the previously placed sling at the time of surgery. A retrospective chart review was performed to obtain perioperative and follow-up patient information. Post-operatively, each patient completed a mailed incontinence questionnaire to assess self-reported urinary continence outcomes.
RESULTS - All 10 women were available for follow-up at a mean period of 16 months (range 6 to 33). Four of the 10 patients achieved complete continence, and another three patients reported significantly improved continence and quality of life. Three women stated that their continence did not improve.
CONCLUSIONS - TVT placement may be a viable option for the management of women with persistent or recurrent SUI following an initial MUS procedure.
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19 MeSH Terms
Accuracy of patients' reports of comorbid disease and their association with mortality in ESRD.
Cavanaugh KL, Merkin SS, Plantinga LC, Fink NE, Sadler JH, Powe NR
(2008) Am J Kidney Dis 52: 118-27
MeSH Terms: Cardiovascular Diseases, Cohort Studies, Comorbidity, Confidence Intervals, Female, Health Knowledge, Attitudes, Practice, Humans, Kaplan-Meier Estimate, Kidney Failure, Chronic, Male, Medical Records, Neoplasms, Patient Participation, Peritoneal Dialysis, Probability, Proportional Hazards Models, Prospective Studies, Pulmonary Disease, Chronic Obstructive, Renal Dialysis, Risk Assessment, Self-Assessment, Sensitivity and Specificity, Stroke, Surveys and Questionnaires, Survival Analysis
Show Abstract · Added March 7, 2014
BACKGROUND - Patient awareness of chronic diseases is low. Unawareness may represent poor understanding of chronic illness and may be associated with poor outcomes in patients with end-stage renal disease (ESRD).
STUDY DESIGN - Concurrent prospective national cohort study.
SETTING & PARTICIPANTS - Incident hemodialysis and peritoneal dialysis patients enrolled in the Choices for Healthy Outcomes in Caring for ESRD Study and followed up until 2004.
PREDICTOR - Inaccurate patient self-report of 8 comorbid diseases compared with the medical record.
OUTCOMES & MEASUREMENTS - All-cause mortality was the primary outcome. Cox proportional hazard models were used to assess the contribution of demographics and clinical measures in the relation of inaccurate self-report to mortality.
RESULTS - In 965 patients, the proportion of inaccurate self-reporters ranged from 3% for diabetes mellitus to 35% for congestive heart failure. Generally, inaccurate self-reporters were older and had more chronic diseases. Greater risk of death was found for inaccurate self-reporters of ischemic heart disease (hazard ratio [HR], 1.34; 95% confidence interval, 1.12 to 1.59; P = 0.001), coronary intervention (HR, 1.46; 95% confidence interval, 1.08 to 1.97; P = 0.01), and chronic obstructive pulmonary disease (HR, 1.40; 95% confidence interval, 1.14 to 1.70; P = 0.001). The greater risk of death remained significant for chronic obstructive pulmonary disease (HR, 1.36; 95% confidence interval, 1.11 to 1.66; P = 0.003) after adjustment for age, sex, and race. In patients receiving peritoneal dialysis, greater risk of death (HR, 2.06; 95% confidence interval, 1.34 to 3.15; P = 0.001) was found for inaccurate self-reporters of ischemic heart disease.
LIMITATIONS - Includes potential for residual confounding, medical record error, misclassification of patient accuracy of self-report, and low inaccurate self-report of some chronic diseases, reducing the power to measure associations.
CONCLUSIONS - Accuracy of self-report depends on the specific comorbid disease. Patients with ESRD, especially those receiving peritoneal dialysis, who inaccurately report heart disease may be less aware of their chronic comorbid disease and may be at greater risk of mortality compared with those who accurately report their comorbid disease.
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25 MeSH Terms
Memory for fatigue in chronic fatigue syndrome: the relation between weekly recall and momentary ratings.
Friedberg F, Sohl SJ
(2008) Int J Behav Med 15: 29-33
MeSH Terms: Adult, Fatigue, Fatigue Syndrome, Chronic, Female, Humans, Male, Medical Records, Mental Recall, Middle Aged, Reproducibility of Results, Self-Assessment, Severity of Illness Index, Statistics, Nonparametric, Time Factors
Show Abstract · Added March 5, 2014
BACKGROUND - Understanding how patients with chronic fatigue syndrome (CFS) recall their fatigue is important because fatigue is a core clinical dimension of this poorly understood illness.
PURPOSE - This study assessed the associations between momentary fatigue ratings and weekly recall of fatigue in 71 participants with CFS.
METHOD - During the three-week data collection period, fatigue intensity was recorded six times a day in electronic diaries. At the end of each week, participants were asked to recall their fatigue intensity for that week. Statistical analyses were done with t-tests and Pearson's and intraclass correlations.
RESULTS - Average weekly recall of fatigue intensity was significantly higher than average momentary ratings. Furthermore, moderate to high Pearson's correlations and intraclass correlations (consistency and absolute agreement) between recall and momentary fatigue ratings were found.
CONCLUSION - Individuals with CFS recalled consistently higher levels of fatigue in comparison to real-time momentary ratings, yet the level of agreement between the two measures was moderate to high. These findings may have implications for the conduct of office examinations for CFS.
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14 MeSH Terms
Memory for fatigue in chronic fatigue syndrome: relationships to fatigue variability, catastrophizing, and negative affect.
Sohl SJ, Friedberg F
(2008) Behav Med 34: 29-38
MeSH Terms: Adult, Fatigue, Fatigue Syndrome, Chronic, Female, Humans, Longitudinal Studies, Male, Mental Recall, Middle Aged, Self-Assessment, Sick Role
Show Abstract · Added March 5, 2014
Fatigue in chronic fatigue syndrome (CFS) is usually assessed with retrospective measures rather than real-time momentary symptom assessments. In this study, the authors hypothesized that in participants with CFS, discrepancies between recalled and momentary fatigue would be related to catastrophizing, anxiety, and depression and to variability of momentary fatigue. They also expected that catastrophizing, anxiety, and depression would be associated with momentary fatigue. The authors asked 53 adults with CFS to carry electronic diaries for 3 weeks and record their experiences of momentary fatigue. The authors assessed participants' fatigue recall with weekly ratings and administered questionnaires for catastrophizing, depression, and anxiety. Recall discrepancy was significantly related to the variability of momentary fatigue. In addition, catastrophizing, depression, and momentary fatigue were all significantly related to recall discrepancy. Catastrophizing, depression, anxiety, and momentary negative affect were all significantly associated with momentary fatigue. The findings suggest that momentary fatigue in patients with CFS is related to modifiable psychological factors.
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11 MeSH Terms
Agreement of self-reported comorbid conditions with medical and physician reports varied by disease among end-stage renal disease patients.
Merkin SS, Cavanaugh K, Longenecker JC, Fink NE, Levey AS, Powe NR
(2007) J Clin Epidemiol 60: 634-42
MeSH Terms: Age Factors, Angioplasty, Cerebrovascular Disorders, Comorbidity, Coronary Artery Bypass, Diabetes Complications, Female, Heart Failure, Humans, Hypertension, Kidney Failure, Chronic, Male, Medical Records, Middle Aged, Myocardial Infarction, Neoplasms, Prevalence, Pulmonary Disease, Chronic Obstructive, Self-Assessment, Sensitivity and Specificity, Sex Factors
Show Abstract · Added March 7, 2014
OBJECTIVE - To compare self-report of eight diseases with review of medical records and physician reports.
STUDY DESIGN AND SETTING - In a cohort of 965 incident end-stage renal disease (ESRD) patients (Choices for Healthy Outcomes in Caring for End-stage renal disease study), data on existing medical conditions were obtained from medical record abstraction, physician report (CMS Form 2728), and self-report in a baseline questionnaire. We evaluated agreement with kappa statistics (k) and sensitivity of self-report. Regression models were used to examine characteristics associated with agreement.
RESULTS - The results showed excellent or substantial agreement between self-report and the medical record for diabetes (k=0.93) and coronary artery intervention (k=0.79), and poor agreement for chronic obstructive pulmonary disease (k=0.20). Physician-reported prevalence for all diseases was equal or lower than that by self-report. Male patients were more likely to inaccurately report hypertension. Compared to white patients, African American patients were more likely to inaccurately report cardiovascular diseases.
CONCLUSION - In ESRD patients, self-report agreement with the medical record varies with the specific disease. Awareness of diseases of the cardiovascular system appears to be low. African American and male ESRD patients are at risk of low awareness of disease and educational interventions are needed in this high-risk population.
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21 MeSH Terms
Health-related quality of life in children with sickle cell disease: child and parent perception.
Panepinto JA, O'Mahar KM, DeBaun MR, Loberiza FR, Scott JP
(2005) Br J Haematol 130: 437-44
MeSH Terms: Adolescent, Adult, Anemia, Sickle Cell, Child, Child Behavior, Child, Preschool, Educational Status, Female, Health Status Indicators, Humans, Male, Parents, Perception, Quality of Life, Regression Analysis, Self Concept, Self-Assessment, Sickness Impact Profile, Surveys and Questionnaires
Show Abstract · Added November 27, 2013
Health-related quality of life (HRQL) is an outcome that may be used to measure the impact of sickle cell disease on the child and their family but has not been routinely assessed in this disease. The objective of this study was to describe the HRQL of children with sickle cell disease as reported by the parent and the child, to compare the relationship between the two, and to determine the association of parent, child and disease characteristics on HRQL. Ninety-five parents completed the Child Health Questionnaire (CHQ)-Parent Form28 and 53 children completed the CHQ-Child Form87. Compared with the child report, parents reported worse HRQL in the overall perception of health, physical functioning, behaviour and self esteem domains of HRQL (P < 0.005). Parent and child reports of HRQL correlated strongly in assessment of the impact of bodily pain (r = 0.58) on HRQL and moderately in physical functioning (r = 0.44), behaviour (r = 0.45), general health (r = 0.44), self esteem (r = 0.40) and changes in health (r = 0.33) domains. Disease status, neurobehavioral co-morbidities, and parent education were associated with the HRQL of the child. Both the parent and child perspectives are needed to fully understand the impact of sickle cell disease on the HRQL of the child and effect of this disease on the family.
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19 MeSH Terms