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Screening Scale (screening + scale)
Selected AbstractsThe physical environment influences neuropsychiatric symptoms and other outcomes in assisted living residentsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 10 2010Mark C. Bicket Abstract Objective Although the number of elderly residents living in assisted living (AL) facilities is rising, few studies have examined the AL physical environment and its impact on resident well-being. We sought to quantify the relationship of AL physical environment with resident outcomes including neuropsychiatric symptoms (NPS), quality of life (QOL), and fall risk, and to compare the effects for demented and non-demented residents. Methods Prospective cohort study of a stratified random sample of 326 AL residents living in 21 AL facilities. Measures included the Therapeutic Environmental Screening Scale for Nursing Homes and Residential Care (TESS-NH/RC) to rate facilities and in-person assessment of residents for diagnosis (and assessment of treatment) of dementia, ratings on standardized clinical, cognitive, and QOL measures. Regression models compared environmental measures with outcomes. TESS-NH/RC is modified into a scale for rating the AL physical environment AL-EQS. Results The AL Environmental Quality Score (AL-EQS) was strongly negatively associated with Neuropsychiatric Inventory (NPI) total score (p,<,0.001), positively associated with Alzheimer Disease Related Quality of Life (ADRQL) score (p,=,0.010), and negatively correlated with fall risk (p,=,0.042). Factor analysis revealed an excellent two-factor solution, Dignity and Sensory. Both were strongly associated with NPI and associated with ADRQL. Conclusion The physical environment of AL facilities likely affects NPS and QOL in AL residents, and the effect may be stronger for residents without dementia than for residents with dementia. Environmental manipulations that increase resident privacy, as well as implementing call buttons and telephones, may improve resident well-being. Copyright © 2010 John Wiley & Sons, Ltd. [source] Measuring Physical and Social Environments in Nursing Homes for People with Middle- to Late-Stage DementiaJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2006MSc(A), Susan Slaughter RN OBJECTIVES: To evaluate measures of dementia care environments by comparing a special care facility (SCF) with traditional institutional facilities (TIFs). DESIGN: A cross-sectional comparative study of nursing home environments conducted as part of a longitudinal study on quality of life for residents with dementia. SETTING: Twenty-four traditional nursing homes and one special care facility. PARTICIPANTS: One SCF with six distinct environments, 24 TIFs with 45 distinct environments, and 88 family members. MEASUREMENTS: Therapeutic Environment Screening Scale,2+ (TESS-2+); Special Care Unit Environmental Quality Scale (SCUEQS), a subset of the TESS-2+ items; Composite Above Average Quality Score (CAAQS), a composite score of all items on the TESS-2+; and Models of Care Instrument (MOCI). RESULTS: The SCUEQS did not detect a significant difference between the SCF and the TIFs (30.0 vs 27.2, P=.28). The CAAQS detected a significant difference between the SCF and the TIFs, whereby the SCF environments were rated as having above-average quality in 71.4% of the domains, compared with 57.3% for the TIF environments (95% confidence interval (CI) for difference=2.6,25.6%, P=.02). Using the MOCI, SCF families were 1.8 times as likely to rate the SCF as a home or resort versus a hospital as TIF families rating TIFs (95% CI for odds ratio=1.5,2.1, P<.001). CONCLUSION: The TESS-2+ CAAQS differentiated between physical environments better than the more established SCUQES. The MOCI distinguished between environments using a more holistic approach to measurement. The availability of environmental measures that are able to discriminate between specialized and traditional long-term care settings will facilitate future outcome-based research. [source] Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiativeINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue S1 2010Ronald C. Kessler Abstract Data are reported on the background and performance of the K6 screening scale for serious mental illness (SMI) in the World Health Organization (WHO) World Mental Health (WMH) surveys. The K6 is a six-item scale developed to provide a brief valid screen for Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) SMI based on the criteria in the US ADAMHA Reorganization Act. Although methodological studies have documented good K6 validity in a number of countries, optimal scoring rules have never been proposed. Such rules are presented here based on analysis of K6 data in nationally or regionally representative WMH surveys in 14 countries (combined N = 41,770 respondents). Twelve-month prevalence of DSM-IV SMI was assessed with the fully-structured WHO Composite International Diagnostic Interview. Nested logistic regression analysis was used to generate estimates of the predicted probability of SMI for each respondent from K6 scores, taking into consideration the possibility of variable concordance as a function of respondent age, gender, education, and country. Concordance, assessed by calculating the area under the receiver operating characteristic curve, was generally substantial (median 0.83; range 0.76,0.89; inter-quartile range 0.81,0.85). Based on this result, optimal scaling rules are presented for use by investigators working with the K6 scale in the countries studied. Copyright © 2010 John Wiley & Sons, Ltd. [source] Improving the K6 short scale to predict serious emotional disturbance in adolescents in the USAINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue S1 2010Jennifer Greif Green Abstract Effective screening for emotional and behavioral disorders among youth requires brief screening scales with good validity to identify youth requiring further evaluation and to estimate prevalence of target disorders in populations of interest such as schools or neighborhoods. This paper examines the psychometric properties of a very short (six-item) screening scale, the K6, to assess serious emotional disturbance (SED) among youth. The K6, which is made up of symptoms of depression and anxiety, has been shown in previous research to be a strong predictor of serious mental illness (SMI) in adults, but no information is available on the ability of the scale to screen for SED among youth. The current report examines the K6 as a screen for SED in a national survey of US adolescents, the National Comorbidity Survey Replication Adolescent Supplement (NCS-A). The K6 is shown to provide fairly good prediction of SED [area under curve (AUC) = 0.74] that is somewhat higher for internalizing (AUC = 0.80) than behavior (AUC = 0.75) disorders. Based on this result, we augmented the K6 with questions about symptoms of behavior disorders. This improved prediction of SED (from AUC = 0.74 to AUC = 0.83) as well as of SED associated with pure behavior disorders (from AUC = 0.53 to AUC = 0.78). These results show that although the symptoms of depression and anxiety in the K6 are sufficient to detect SMI among adults, high rates of behavior disorders among adolescents require indicators of behavior disorders to be added to the K6 to screen adequately for adolescent SED. Copyright © 2010 John Wiley & Sons, Ltd. [source] The performance of the Japanese version of the K6 and K10 in the World Mental Health Survey JapanINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2008Toshi A. Furukawa Abstract Two new screening scales for psychological distress, the K6 and K10, have been developed using the item response theory and shown to outperform existing screeners in English. We developed their Japanese versions using the standard backtranslaton method and included them in the World Mental Health Survey Japan (WMH-J), which is a psychiatric epidemiologic study conducted in seven communities across Japan with 2436 participants. The WMH-J used the WMH Survey Initiative version of the Composite International Diagnostic Interview (CIDI) to assess the 30-day Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition (DSM-IV). Performance of the two screening scales in detecting DSM-IV mood and anxiety disorders, as assessed by the areas under receiver operating characteristic curves (AUCs), was excellent, with values as high as 0.94 (95% confidence interval = 0.88 to 0.99) for K6 and 0.94 (0.88 to 0.995) for K10. Stratum-specific likelihood ratios (SSLRs), which express screening test characteristics and can be used to produce individual-level predicted probabilities of being a case from screening scale scores and pretest probabilities in other samples, were strikingly similar between the Japanese and the original versions. The Japanese versions of the K6 and K10 thus demonstrated screening performances essentially equivalent to those of the original English versions. Copyright © 2008 John Wiley & Sons, Ltd. [source] |