In search of parsimony: reliability and validity of the Functional Performance Inventory-Short Form

Nancy Kline Leidy1, Ann Knebel21Center for Health Outcomes Research, United BioSource Corporation, Bethesda, MD, USA; 2Office of the Assistant Secretary for Preparedness and Response, US Department of Health and Human Services, Washington, DC, USAPurpose: The 65-item Functional Performance Inventory (FPI), developed to quantify functional performance in patients with chronic obstructive pulmonary disease (COPD), has been shown to be reliable and valid. The purpose of this study was to create a shorter version of the FPI while preserving the integrity and psychometric properties of the original.Patients and methods: Secondary analyses were performed on qualitative and quantitative data used to develop and validate the FPI long form. Seventeen men and women with COPD participated in the qualitative work, while 154 took part in the mail survey; 54 completed 2-week reproducibility assessment, and 40 relatives contributed validation data. Following a systematic process of item reduction, performance properties of the 32-item short form (FPI-SF) were examined.Results: The FPI-SF was internally consistent (total scale α = 0.93; subscales: 0.76–0.89) and reproducible (r = 0.88; subscales: 0.69–0.86). Validity was maintained, with significant (P < 0.001) correlations between the FPI-SF and the Functional Status Questionnaire (activities of daily living, r = 0.71; instrumental activities of daily living, r = 0.73), Duke Activity Status Index (r = 0.65), Bronchitis-Emphysema Symptom Checklist (r = -0.61), Basic Need Satisfaction Inventory (r = 0.61) and Cantril’s Ladder of Life Satisfaction (r = 0.63), and Katz Adjustment Scale for Relatives (socially expected activities, r = 0.51; free-time activities, r = -0.49, P < 0.01). The FPI-SF differentiated patients with an FEVl% predicted greater than and less than 50% (t = 4.26, P < 0.001), and those with severe and moderate levels of perceived severity and activity limitation (t = 9.91, P < 0.001).Conclusion: Results suggest the FPI-SF is a viable alternative to the FPI for situations in which a shorter instrument is desired. Further assessment of the instrument’s performance properties in new samples of patients with COPD is warranted.Keywords: functional status, health outcomes, activities of daily living, COPD, patient-reported outcomes, chronic pulmonary disease, health-related quality of lif

The Modified Erikson Psychosocial Stage Inventory.

A measure of the strength of psychosocial attributes that arise from progression through Erik Erikson's eight stages of development.The Modified Erikson Psychosocial Inventory (MEPSI) is an 80-item, comprehensive measure of psychosocial development based on Eriksonian theory. It was designed to measure the strength of psychosocial attributes that arise from progression through Erik Erikson's eight stages of development. It evolved in response to the apparent lack of a valid and reliable, yet easily administered survey instrument to measure psychosocial attributes in the adult population within the context of Eriksonian developmental theory (See Darling-Fisher & Kline Leidy, 1988 for details of its development). Data supporting its reliability and validity data was published when it was first developed (Leidy & Darling-Fisher, 1995). Over the years, it has been used in numerous research projects in a variety of fields and continues to be requested on a regular basis. The authors are making the MEPSI instrument and its Guidelines for administration and scoring available via this URL to facilitate future research, critique, and revision.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/111746/1/MEPSI.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/111746/3/Darling-Fisher&LeidyMEPSIDevelopment1988.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/111746/4/Leidy&Darling-Fisher, 1995-MEPSI-Reliability&Validity.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/111746/5/MEPSIGUI010.pdfDescription of MEPSI.pdf : MEPSI InstrumentDescription of Darling-Fisher&LeidyMEPSIDevelopment1988.pdf : Publication describibg the Developemtn of the MEPSIDescription of Leidy&Darling-Fisher, 1995-MEPSI-Reliability&Validity.pdf : Article describing the reliability and validity of the MEPSI in diverse samplesDescription of MEPSIGUI010.pdf : Guide for administering and scoring the MEPS

Measuring cough severity: Perspectives from the literature and from patients with chronic cough

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Responsiveness of PROMIS® to change in chronic obstructive pulmonary disease.

BackgroundChronic obstructive pulmonary disease (COPD) is a progressive chronic disease characterized by airflow obstruction that leads to shortness of breath and substantial negative impacts on health-related quality of life (HRQL). The course of COPD includes periodic acute exacerbations that require changes in treatment and/or hospitalizations. This study was designed to examine the responsiveness of Patient-Reported Outcomes Measurement Information System® (PROMIS®) measures to changes associated with COPD exacerbation recovery.MethodsA longitudinal analysis using mixed-effects models was conducted of people who were enrolled while stable (n = 100) and those who experienced an acute exacerbation (n = 85). PROMIS (physical function, pain interference, pain behavior, fatigue, anxiety, depression, anger, social roles, discretionary social activities, Global Health, dyspnea severity and dyspnea functional limitations) and COPD-targeted HRQL measures were completed at baseline and at 12 weeks.ResultsWe administered PROMIS measures using computer adaptive testing (CAT), followed by administration of any remaining short form (SF) items that had not yet been administered by CAT. Examination of the difference between group differences from baseline to 12 weeks in the stable and exacerbation groups revealed that the exacerbation group changed (improved) significantly more than the stable group in anxiety (p < .001 to p < .01; f2 effect size [ES] = 0.023/0.021), fatigue (p < .0001; ES = 0.036/0.047) and social roles (p < .001 to p < .05; ES = 0.035/0.024). All effect sizes were small in magnitude and smaller than hypothesized. Depression was also statistically significant (p < .05, SF only) but the ES was trivial. For all other PROMIS domains, the differences were not significant and ES were trivial.ConclusionsThis longitudinal study provides some support for the validity of the PROMIS fatigue, anxiety, and social roles domains in COPD, but further evaluation of responsiveness is warranted

El rol de la mujer en Pedro Páramo

El presente trabajo consiste en un análisis de la novela Pedro Páramo del escritor mexicano Juan Rulfo. El tema que pretendemos analizar es el de la mujer y los roles que ella cumple en la obra. Las obras cumbres de Rulfo, Pedro Páramo y El Llano en llamas, se convierten en dos aportes fundamentales a las letras en lengua castellana. Tanto en la novela como en su colección de cuentos, Rulfo nos transporta de una manera muy sutil de lo real a lo fantástico con un modo riguroso, critico, poético y maravilloso

Influencia de la gestión del fondo social en la aceptación de viabilidad del proyecto minero La Granja en el distrito Querocoto, Chota-2019

RESUMEN En la presente investigación se evaluó y conocio la influencia que tiene la gestión del Fondo Social La Granja en el nivel de aceptación del Distrito de Querocoto, para la viabilidad del proyecto minero La Granja. Asimismo, identificar las necesidades del Distrito de Querocoto, lo cual nos ayuda a determinar propuestas y alternativas de mejora a tomar en cuenta para poder dar una viabilidad social sostenible al proyecto, que aún en el momento de culminación de la presente tesis, sigue sin iniciar sus operaciones. Así, las hipótesis que sirvieron de base para plantear el presente estudio es que el Fondo social si y no influye en el nivel de aceptación del Distrito de Querocoto, para la viabilidad del proyecto minero La Granja. Se empleó como herramienta principal de recolección de datos una encuesta presencial realizada en el distrito de Querocoto; concentrándose más en las áreas de influencia social directa e indirecta del proyecto minero La Granja, provincia Chota – Cajamarca. Con lo cual se adquirió una línea estudio de percepción para conocer la posición de aprobación para la viabilidad del proyecto minero La Granja, identificando la perspectiva de aprobación de las comunidades en torno a la gestión que realiza el Fondo Social La Granja para un desarrollo sostenible del señalado proyecto minero. El diseño de la investigación fue determinado como no experimental – transversal desde un enfoque mixto. Se pudo concluir, que el factor principal de la no aceptación de la viabilidad del proyecto minero La Granja por parte del Distrito de Querocoto es principalmente la oposición del Ex Alcalde que cuenta con un porcentaje de 69% y sobrevalorización de proyectos por parte del Fondo Social 62%, ya que ellos no tienen hasta el momento ningún proyecto culminado en su totalidad; y esto se debe a la falta de capacitación a la población para dar a conocer sus principales prioridades y funciones como mejora del Distrito

Exacerbation Recovery Patterns in Newly Diagnosed or Maintenance Treatment-Naïve Patients with COPD: Secondary Analyses of TICARI 1 Trial Data

Background: Little is known about the recovery patterns from acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in newly diagnosed or maintenance treatment-naïve patients with COPD. This study describes the course of AECOPD in these patients at the time of treatment for the symptoms of acute respiratory tract infection (RTI). Methods: This study was a secondary analysis of data from a 12-week, randomized clinical trial (TICARI 1) testing the efficacy and safety of once-daily tiotropium 18 µg maintenance therapy versus placebo in newly diagnosed or maintenance treatment-naïve COPD patients with acute RTI symptoms for ≤7 days. Patients received standard care for AECOPD and RTI. Due to under-recruitment, the trial ended early and hence was underpowered to detect treatment differences. Data were pooled and exacerbation recovery patterns examined by using the EXAcerbation of Chronic Pulmonary Disease Tool (EXACT), forced expiratory volume in 1 second, rescue medication use, COPD Assessment Test™, Functional Assessment of Chronic Illness Therapy-Short Form, and Work Productivity and Activity Impairment Questionnaire: Respiratory Symptoms. Results: Of 140 patients, 73.6% had a prior COPD diagnosis without maintenance therapy; 80.0% had moderate-to-severe airflow obstruction. In addition to study drug, 40.0% were prescribed pharmacologic therapy (corticosteroids [34.3%], antibiotics [16.4%], and short-acting β2-adrenergic agonists [5.0%]) within ±7 days of randomization. Over 12 weeks, 78.6% exhibited symptomatic recovery (EXACT score) in a median of 5.0 days. Across all patients, 49.3% recovered without relapse, 29.3% recovered and then relapsed, and 21.4% had persistent symptoms (recovery criteria unmet). Conclusion: A substantial portion of newly diagnosed or maintenance treatment-naïve patients with COPD experience relapse or persistent symptoms following a clinic visit for AECOPD with symptoms of RTI. Whether initiating maintenance therapy could improve outcomes and reduce exacerbation risk requires further study

Diseño del identificador visual para inEvent

Este proyecto gráfico consiste en el diseño y creación del identificador visual para una empresa cuya actividad principal es la realización de escenografías temáticas para eventos, en el municipio de Melgar Tolima. La cual se propone ofrecer a sus clientes una experiencia inolvidable creando ambientes que involucran el color, decoración, recreación, con el sello personal del cliente, buscando ser líder en el campo del entretenimiento en la región

Diseño del identificador visual para inEvent

Este proyecto gráfico consiste en el diseño y creación del identificador visual para una empresa cuya actividad principal es la realización de escenografías temáticas para eventos, en el municipio de Melgar Tolima. La cual se propone ofrecer a sus clientes una experiencia inolvidable creando ambientes que involucran el color, decoración, recreación, con el sello personal del cliente, buscando ser líder en el campo del entretenimiento en la región