The Center for Epidemiologic Studies Depression scale (CES-D) : is it suitable for use with older adults?

With the aim of verifying the suitability of the CES-D scale for use in long-term care institutions for older adults, the CES-D questionnaire was used to collect patient-reported assessments, and two well-known psychometric instruments – the Hospital Anxiety and Depression Scale (HADS) and the Barthel Index of Abilities of Daily Living – were used to collect nurse-reported assessments, based on observations of patients’ behaviours. With regard to possible frequent cases of cognitive impairment and/or insufficient motivation to give sensible responses to CES-D questions, the patient-reported responses were collected from patients during one-on-one sessions with a nurse. The reliability, concurrent validity, and the trustworthiness of the obtained data were supported with proper values of the Cronbach’s alpha coefficient, 0.70 < alpha < 0.85, with significant correlation between CES-D and HADS-Depression, R = 0.50, p < 0.001, and with significant correlation between scores of particular CES-D items vs. final CES-D evaluations of depression, proved by significance p < 0.001 for 18 of 20 CES-D items. These findings supported the effectiveness of the one-on-one session methodology in questionnaire surveys for older adults. The postulation that cases of self-reported depression included somewhat different information about the patient than nurse-reported depression concerning the same patient was supported with the evidence that, in spite of the significant correlation between the Barthel Index and HADS-Depression, R = −0.17, p = 0.016, and in spite of the significant correlation between CES-D and HADS-Depression, the correlation between the Barthel Index and CES-D, equal to R = −0.08 was insignificant at p = 0.244. The findings of this study, considered jointly, support the valuableness of the CES-D scale for use in one-on-one surveys for older adults

Kognitywistyczne spojrzenie na skale psychometryczne: kiedy trudne jest łatwiejsze od łatwego

The Cognitive Approach Towards Psychometric Scales: When Difficult is Easier than EasyPsychometric scales are used in situations in which a certain feature of the tested person cannot be measured directly, but can be estimated (as a so-called hidden – or implicit – construct or variable) on the basis of the answers to the questions (items) on a scale. The cognitive approach enables us to have a more profound insight into the psychometric measurement process which is in fact a complex process of communication between people involved in the measurement. It does not require abandoning the standard statistical methods, including Rasch procedures based on the IRT psychometric measurement theory (Item Response Theory), but enables statistics to again perform its proper role of a tool used to confirm the validity of the conclusions of the psychological examination

The scope of acceptance by patients motherly and friendly style of nurse's supporting behaviour in palliative care

The patients' reactions to care-providers, as well as patients' demographic and clinical features, not always provide the sufficient basis for concluding about their preferences, because of patents' specific situation. At this study the subject was restricted to easy observable nurse’s touch. Evidence on patients’ acceptance of motherly and friendly style of behaviour in palliative care. The answers 35-item questionnaire were obtained at study group of 55 patients in the terminal stage of cancer. Each patient under study expected and experienced the nurse’s touch; 55 (95%) patients are satisfied with obtaining an instrumental touch, 51 (93%) - with caring touch, 50 (91%) - with communicating touch, 53 (96%) - with healing touch. Similar results were obtained for the kin's and doctors' touch. Considering the healing touch, 32 (58%) patients accept friendly style but don’t accept motherly touch, 19 (35%) accept both styles. The above patients' groups don't differ significantly in their demographic and clinical features. Among patients in terminal stage of cancer, there are significant differences in individual preferences concerning the style and form of supporting behaviour of care-providers. The patient's demographic and clinical features, his reaction to experiencing touch don't provide sufficient basis for conclusions about their preferences, therefore, the interviews carried out at another time by other persons are necessary. Thus, the obtained results confirm the necessity of continuation of the studies of the means of achieving compliance between the nurses’ behaviour and patients' preferences

The occurrence of pressure ulcers and psychophysical efficiency in patients with cognitive disorders provided with long-term institutional care in Poland

Number of people requiring long-term institutional care is increasing in Poland. Older age, cognitive impairment, multidisease, falls, pressure ulcers, deficits in psychophysical efficiency often occur in patients benefiting from this type of service. The aim of the research was to evaluate the association between pressure ulcers and psychophysical efficiency in patients with cognitive disorders provided long-term institutional care. Study involved 160 persons with cognitive disorders (125 women and 35 men), age between 61–100 years. The study group included 80 patients of long-term care institution and 80 inhabitants of the social welfare home. The standardized Cognitive Assessment Scale (CAS), the Barthel scale, the Edmonton Functional Assessment Tool (EFAT) and the Observational Anxiety and Depression Scale were used as the research tools. The assessment was repeated three times: at the beginning, after three and six months. Respondents who experienced pressure ulcers (N = 28, 17.5%) were characterized by more severely impaired cognitive function (p < 0.001); dysfunction of functional status (p < 0.001), higher symptoms of tension, and anxiety (p = 0, 02) and a lower physical mobility (p < 0.001) than other patients without pressure ulcers. Patients with cognitive disorders provided with a long-term stationary care need systematic assessment of psychophysical activity, as a part of the of the pressure ulcer prevention program

Changes of physical mobility among patients with cognitive disorders provided with long-term institutional care in Poland

Demographic changes in European countries result in population aging, higher number of people with disabilities and chronic illness, thus lead to an increase in demand for care services. Currently there are no Polish publications and limited international works dealing with the evaluation of needs of long term care persons with cognitive disorders and other coexisting diseases. Assessment of physical mobility changes among patients with cognitive disorders provided with long-term institutional care in Poland. Study involved 160 persons with cognitive disorders (125 women and 35 men), age between 61-100 years. The study group included 80 patients of long-term care institution and 80 inhabitants of the social welfare home. The standardized Cognitive Assessment Scale (CAS) and the Barthel scale were used as the research tools. The analysis of physical mobility changes revealed that mean values did not show significant differences (p > 0.005) in either of the institution. However, high individual variability of physical mobility was observed. Some patients' health condition deteriorated significantly. Presented results indicate that patients with cognitive disorders provided with a long-term stationary care show diversified physical mobility in each of analyzed institution. These patients need individual and systematic assessment, which is a principal condition to provide an adequate long-term care in institutional settings

Factors identified with higher levels of career satisfaction of physicians in Andalusia, Spain

The satisfaction of physicians is a worldwide issue linked with the quality of health services; their satisfaction needs to be studied from a multi-dimensional perspective, considering lower- and higher-order needs. The objectives of this study were to: i) measure the career satisfaction of physicians; ii) identify differences in the dimensions of career satisfaction; and iii) test factors that affect higherand lower-order needs of satisfaction among physicians working in Andalusian hospitals (Spain). Forty-one percent of 299 eligible physicians participated in a study conducted in six selected hospitals. Physicians reported higher professional, inherent, and performance satisfaction than personal satisfaction. Foreign physicians reported higher levels of personal and performance satisfaction than local physicians, and those who received nonmonetary incentives had higher professional and performance satisfaction. In conclusion, physicians in the selected Andalusian hospitals reported low levels of personal satisfaction. Non-monetary incentives were more relevant to influence their career satisfaction. Further investigations are recommended to study differences in the career satisfaction between foreign and local physicians