Diagnosing delirium in elderly Thai patients: Utilization of the CAM algorithm

<p>Abstract</p> <p>Background</p> <p>Delirium is a common illness among elderly hospitalized patients. However, under-recognition of the condition by non-psychiatrically trained personnel is prevalent. This study investigated the performance of family physicians when detecting delirum in elderly hospitalized Thai patients using the Thai version of the Confusion Assessment Method (CAM) algorithm.</p> <p>Methods</p> <p>A Thai version of the CAM algorithm was developed, and three experienced Thai family physicians were trained in its use. The diagnosis of delirium was also carried out by four fully qualified psychiatrists using DSM-IV TR criteria, which can be considered the gold standard. Sixty-six elderly patients were assessed with MMSE Thai 2002, in order to evaluate whether they had dementia upon admission. Within three days of admission, each patient was interviewed separately by a psychiatrist using DSM-IV TR, and a family physician using the Thai version of the CAM algorithm, with both sets of interviewers diagnosing for delirium.</p> <p>Results</p> <p>The CAM algorithm tool, as used by family physicians, demonstrated a sensitivity of 91.9% and a specificity of 100.0%, with a PPV of 100.0% and an NPV of 90.6%. Interrater agreement between the family physicians and the psychiatrists was good (Cohen's Kappa = 0.91, p < 0.0001). The mean of the time the family physicians spent using CAM algorithm was significantly briefer than that of the psychiatrists using DSM-IV TR.</p> <p>Conclusions</p> <p>Family physicians performed well when diagnosing delirium in elderly hospitalized Thai patients using the Thai version of the CAM algorithm, showing that this measurement tool is suitable for use by non-psychiatrically trained personnel, being short, quick, and easy to administer. However, proper training on use of the algorithm is required.</p

FACTORS AFFECTING LOW ACADEMIC ACHIEVEMENT OF MEDICAL STUDENTS IN THE FACULTY OF MEDICINE, CHIANG MAI UNIVERSITY

Abstract The objective of this study was to determine the related factors influencing low academic achievement of medical students at the Faculty of Medicine, Chiang Mai University during 2000. Method The data was collected by interviewing parents and medical students from the first to sixth year, who had low academic achievement, i.c. who failed or had to re-take the exam. The results were analyzed by descriptive statistical methods. Results found that 69 medical students had low academic achievement (6.6% of the total). The male to female ratio was 2:1. Three groups of factors associated with low academic achievement were identified. The first factor was related to the students themselves (79.3%). They included frequent absence from classes, male, old age students, students from the Rural Doctor Project, mental illness, lack of academic motivation in studying medicine and personality disorders. The second factor was related to the university environment (15.5%) and consisted of numerous extra-curricular activities, bad attitude towards the course, and relationships with and adjustment to teachers and friends. The last factor (5.2%) was associated with the students&apos; family (5.2%) and consisted of attitude toward up-bringing such as overprotection and overcontrol. The medical study program takes six years in the university, which is longer than other curricula. The nation has to spend a lot of money to produce eac

Psychometric properties of a Thai version internet addiction test

Abstract Objective The aim was to assess the reliability and validity of a Thai version internet addiction test. Results Cronbach’s alpha for the Thai version of the internet addiction test was 0.89. A three-factor model showed the best fit with the data for the whole sample, whereas the hypothesized six-factor model, as well as a unidimensional model of the internet addiction test, failed to demonstrate acceptable fit with the data. Three factors, namely functional impairment, withdrawal symptoms and loss of control, exhibited Cronbach’s alphas of 0.81, 0.81, and 0.70, respectively. Item 4, ‘to form new relationships with online users’, yielded the lowest loading coefficient of all items. Positive correlations between the internet addiction test and UCLA loneliness scores were found. The Thai version of the internet addiction test was considered reliable and valid, and has sufficient unidimensionality to calculate for total score in screening for excessive internet use

MOESM1 of Psychometric properties of a Thai version internet addiction test

Additional file 1: Figure S1. Eigenvalues among participants with Internet addiction. From the third component on, the line is almost flat, indicating each successive factor is accounting for smaller and smaller amounts of the total variance