Translation, data quality, reliability, validity and responsiveness of the Norwegian version of the Effective Musculoskeletal Consumer Scale (EC-17)

<p>Abstract</p> <p>Background</p> <p>The Effective Musculoskeletal Consumer Scale (EC-17) is a self-administered questionnaire for evaluating self-management interventions that empower and educate people with rheumatic conditions. The aim of the study was to translate and evaluate the Norwegian version of EC-17 against the necessary criteria for a patient-reported outcome measure, including responsiveness to change.</p> <p>Methods</p> <p>Data quality, reliability, validity and responsiveness were assessed in two groups. One group comprising 103 patients received a questionnaire before and at the end of a self-management programme. The second group comprising 96 patients' received the questionnaire two weeks before and on arrival of the program. Internal consistency and test-retest reliability were assessed. Construct validity was assessed through comparisons with the Brief Approach/Avoidance Coping Questionnaire, (BACQ), the Emotional Approach Coping Scale (EAC) and the General Health Questionnaire (GHQ-20). Responsiveness was assessed with the Standardised Response Mean (SRM).</p> <p>Results</p> <p>Respondents included 66 (64%) and 52 (54%) patients from the first and second groups respectively. Levels of missing data were low for all items. There was good evidence for unidimensionality, item-total correlations ranged from 0.59 to 0.82 and Cronbach's Alpha and test-retest correlations were over 0.90. As hypothesised EC-17 scores had statistically significant low to moderate correlations with the BACQ, EAC and GHQ-20 in the range 0.26 to 0.42. Following the self-management program, EC-17 scores showed a significant improvement with an SRM of 0.48.</p> <p>Conclusion</p> <p>The Norwegian version of the EC-17 has evidence for data quality, internal consistency and test-retest reliability, construct validity and responsiveness to change. The EC-17 seems promising as an outcome measure for evaluating self-management interventions for people with rheumatic conditions, but further studies are needed.</p

PENGARUH PENGGUNAAN MEDIA POSTER TERHADAP AKTIVITAS DAN HASIL BELAJAR SISWA (Penelitian Kuasi Eksperimen Kelas V SD Negeri Bojongasih 01 Kecamatan Dayeuhkolot Kabupaten Bandung)

Penelitian ini berjudul “Pengaruh Penggunaan Media Poster Terhadap Aktivitas dan Hasil Belajar Siswa”. Penelitian ini dilakukan di kelas V SD Negeri Bojongasih 01. Penelitian ini dilatar belakangi oleh rendahnya aktivitas dan hasil belajar siswa. Penelitian ini didasari temuan dalam kegiatan observasi pembelajaran dimana pembelajaran kurang melibatkan siswa, kemudian minimnya media pembelajaran yang digunakan ketika kegiatan pembelajaran berlangsung. Metode yang digunakan pada penelitian ini adalah kuasi eksperimen, dimana satu kelas merupakan kelas kontrol, dan satu kelas merupakan kelas eksperimen. Pada kelas eksperimen dilakukan tindakan dengan menggunakan media poster sebagai media pembelajaran. Instrumen yang digunakan pada penelitian ini adalah lembar observasi dan soal tes tertulis. Lembar observasi digunakan untuk mengukur aktivitas siswa di dalam kelas, sedangkan soal tes tertulis digunakan untuk mengukur hasil belajar siswa. Pembelajaran dengan menggunakan media poster dapat meningkatkan aktivitas siswa. Aktivitas siswa pada pembelajaran dengan menggunakan media poster dikategorikan baik, hal tersebut dapat dilihat dari banyaknya jumlah siswa aktif pada saat pembelajaran berlangsung. Kemudian hasil belajar siswa dengan menggunakan media poster menujukkan rata-rata sebesar 79.1 dimana sebanyak 78% siswa dikatakan tuntas. Berdasarkan data yang sudah diperoleh, maka dapat disimpulkan bahwa pembelajaran dengan menggunakan media poster dapat meningkatkan aktivitas dan hasil belajar siswa SD Negeri Bojongasih 01. Kata kunci : Media poster, aktivitas belajar, hasil belaja

Feasibility and effectiveness of offering a solution-focused follow-up to employees with psychological problems or muscle skeletal pain: a randomised controlled trial

BACKGROUND: Long-term sick leave has been of concern to politicians and decision-makers in Norway for several years. In the current study we assess the feasibility and effectiveness of offering a voluntary, solution-focused follow-up to sick-listed employees. METHODS: Employees on long-term sick leave due to psychological problems or muscle skeletal pain were randomly allocated to be offered a solution-focused follow-up (n = 122) or "treatment as usual" (n = 106). The intervention was integrated within 2 social security offices' regular follow-up. The intervention group was informed about the offer with letters, telephone calls and information meetings. Feasibility was measured by rate of uptake to the intervention, and effectiveness by number of days on sick leave. RESULTS: In general, few were reached with the different information elements. While the letter was sent to all, only 31% were reached by telephone and 15% attended the information meetings. Thirteen employees (11.5%) in the intervention group participated in the solution-focused follow-up. Intention to treat analysis showed no difference in mean length of sick leave between the intervention group (217 days) and the control group (189 days) (p = 0,101). CONCLUSION: Even if the information strategy might be improved, it is not likely that a voluntary solution-focused follow-up offered by the social security offices would result in measurable reduction in length of sick leave on a population level. However, the efficacy of a solution-focused follow-up for the persons reporting a need for this approach should be further investigated

Multidisciplinary and multifaceted outpatient management of patients with osteoarthritis: protocol for a randomised, controlled trial

<p>Abstract</p> <p>Background</p> <p>Osteoarthritis (OA) is a prevalent joint disorder with a need for efficient and evidence-based management strategies.</p> <p>Objectives</p> <p>The primary purpose of this study is to compare the effects of a multidisciplinary outpatient clinic, including a brief group-based educational programme, with a traditional individual outpatient clinic for patients with hip, knee, hand or generalized OA. A secondary purpose is to investigate the effects of a telephone follow-up call.</p> <p>Methods</p> <p>This is a pragmatic randomised single-blind controlled study with a total of 400 patients with hip, knee, hand or generalized OA between 40 and 80 years referred to an outpatient rheumatology hospital clinic. The randomisation is stratified according to the diagnostic subgroups. The experimental group is exposed to a multidisciplinary and multifaceted intervention, including a 3.5 hour group-based patient education programme about OA in addition to individual consultations with members of a multidisciplinary team. The control intervention is based on regular care with an individual outpatient consultation with a rheumatologist (treatment as usual). Primary outcomes are patient satisfaction measured at 4 months and cost-effectiveness measured at 12 months. Secondary outcomes are pain and global disease activity measured on a numeric rating scales (NRS), generic and disease specific functioning and disability using Short Form-36 (SF-36) health survey, the Western Ontario and McMaster Universities Osteoarthritis Index 3 (WOMAC), the Australian/Canadian Osteoarthritis Hand Index (AUSCAN), and a patient-generated measure of disability (Patient-Specific Functional scale, PSFS). Global perceived effect of change in health status during the study period is also reported. At 4-month follow-up, patients in both groups will be randomly allocated to a 10-minute telephone call or no follow-up ("treatment as usual"). After additional 8 months (12-month follow-up) the four groups will be compared in a secondary analysis with regard to health outcomes and health care costs.</p> <p>Discussion</p> <p>This trial will provide results on how multidisciplinary and multifaceted management of patients with OA affects health outcomes and health care costs.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN25778426</p

Fra vesen til virksomhet: Et tilbakeblikk på erfaringene med fristilte statlige virksomheter

I årene fra 1992 til 2003 ble en lang rekke statlige forvaltningsorganer omdannet til juridisk selvstendige virksomheter. Etter denne reformbølgen har det vært påfallende stille om bruken av fristilling som moderniserings- og fornyelsesstrategi for statlig virksomhet. På denne bakgrunn belyser rapporten tre spørsmål: 1) Hvordan har det gått med de nye foretakene, sett ut fra bedriftsøkonomiske synsvinkler? Har brukere og borgere fått bedre tjenester? 2) Hva har vært samfunnsvirkningene på ressursbruk og politisk måloppnåelse? 3) Og, hvordan skal vi forstå dages stillstand? Blåser det andre ideologiske vinder, eller er potensialet uttømt for forsatte gevinster gjennom fristilling av forvaltningsvirksomhet? Rapporten konsentrer seg om selskapene Statnett, Statkraft, Posten, Telenor, virksomhetene i jernbanesektoren, Avinor, Mesta og Entra Eiendom. Gjennom årsmeldinger, rapporter og andre offentlige dokumenter analyseres politikernes motiver for fristillingen, og foretakets utvikling følges så langt fram i tid som datamaterialet muliggjør

Quality of hip and knee osteoarthritis management in primary health care in a Norwegian county: a cross-sectional survey

Background Osteoarthritis (OA) is one of the most common causes of pain and disability in the adult population. Several studies have documented discordance between general practioners (GP) practice and management recommendations, but there is limited published information about patient reported experience of quality of care. The primary aim of this study was to assess the patient perceived quality of OA management in primary health care. Secondly, we wanted to explore the factors associated with the perceived quality of OA care. Methods A cross-sectional survey in six general practices in the county of Nord-Trøndelag in Norway, patients with radiologically diagnosed OA, according to ICPC codes L89, L90 or L91 or clinical signs and symptoms corresponding to OA in the hip or knee and patient-reported quality of OA care on the 17-item OsteoArthritis Quality Indicator questionnaire (OA-QI). OA-QI summary pass rates were calculated, in which the numerator represents the number with indicators passed and the denominator represents the total number of eligible persons. Associations with summary pass rates were explored with demographic, disease related and health care related factors as independent variables. Results A total of 119 patients were included (response rate 42%). The median summary QI pass rate for all 17 QIs was 47% (Inter Quartile Range 33-65%), but there were large variation between the different items. The referral for weight reduction had the lowest pass rate (8%), whereas the highest pass rate was having received information about the importance of physical activity and exercise (84%). The median summary QI pass rates for both non-pharmacological- (QIs 1–11) and pharmacological (QIs 13–16) treatments were 50% (IQR 25–75). In bivariate regression analyses, only overall treatment satisfaction was significantly associated with QI pass rate (p = 0.001), with unstandardized beta = 6.1 (95% CI 2.7 to 9.5), i.e. a one-point increase on the five-point satisfaction scale was associated with a 6% increase in pass rate. Conclusion Considering that the median summary QI pass rate was 47%, there might be room for improvement in OA care. Advice and the referral of OA patients in need of weight reduction seem to have the greatest potential for improvement

Effects of a one week multidisciplinary inpatient self-management programme for patients with fibromyalgia: a randomised controlled trial

Background Self-management programmes (SMP) are recommended for patients with fibromyalgia. The purpose of this study was to evaluate effects of a one week multidisciplinary inpatient self-management programme on psychological distress, skills as a consumer of health services, self-efficacy, and functional and symptomatic consequences of fibromyalgia (FM). Methods A randomised controlled two-armed, assessor-blinded trial with three-week follow-up to evaluate SMP. Primary outcomes were the General Health Questionnaire (GHQ-20) and the Effective Musculoskeletal Consumer Scale (EC-17), while secondary outcomes included the Fibromyalgia Impact Questionnaire (FIQ) and Self-efficacy scales for pain, function and symptoms (ASES). Results 150 patients with FM were randomised to one week one SMP (n = 75) or to a waiting list control group (n = 75). Of these, 58 participants in the treatment group and 60 in the control group completed the study. At three weeks’ follow up there was a significant difference in EC-17 (0-100) in favour of the treatment group (mean difference 4.26, 95 CI 0.8 to 7.7, p = 0.02). There were no differences between the groups for any of the other outcomes. Conclusion This study shows that in patients with FM the SMP had no effect on psychological distress, functional and symptomatic consequences and self-efficacy, except for a small short-term effect on skills and behaviour that are important for managing and participating in health care (EC-17). Clinical Trials.gov Id: NCT01035125. Trial registration Clinical Trials.gov Id: NCT0103512