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EN
Outcome assessment of carpal tunnel release has relied upon objective measurements including grip strength and sensory testing as well as subjective parameters such as relief from pain and improvement of hand function. The latter can be obtained by the use of standardized questionnaires.The aim of the study was to assess the usefulness of Patient Evaluation Measure (PEM) questionnaire as an outcome measure after carpal tunnel surgery.Material and methods. Fifty patients, 43 women and 7 men with an average age of 55 years with carpal tunnel syndrome received mini-invasive carpal tunnel release. Patients were examined before the operation, and at 1 and 6 months after, according the same protocol. They had measured a total grip and key-pinch strengths and sensation by the filament test. They completed also the PEM questionnaire. The following parameters of the questionnaire were determined: responsiveness, concurrent validity and internal consistency.Results. Over a half-year follow-up, the sensation improved statistically significantly during the first month after operation. Power of the hand decreased initially comparing to baseline values, following by further gradual increasing throughout the follow-up. PEM scores showed continuous improvement of the hand status at each assessment. The PEM questionnaire showed excellent responsiveness to change of considered parameters, comparing to baseline values. The PEM showed also high concurrent validity with total grip and pinch strengths, as well as with Sensory Index, but only at 6 months assessment. However, the PEM showed a discordance with total grip and key-pinch strength at 1 month assessment. The instrument showed excellent internal consistency.Conclusion. The PEM questionnaire is, with some exceptions, a good and useful instrument for outcome measurement after carpal tunnel treatment surgery.
EN
Introduction. Patient satisfaction surveys are still popular tools for obtaining feedback on the quality of health care. Nonetheless, there is a paucity of data to indicate whether health care providers even want patients to assess the quality of care delivered. Neither it is certain whether patients are interested in participating in such surveys. Aim. To present and compare the perspectives of doctors, nurses, and patients on the validity of health care customer satisfaction surveys. Material and methods. A cross-sectional survey design was used. The questionnaires were administered to doctors, nurses and patients in three hospitals of different sizes (small, medium, and large), all in the north-east of Poland. Each sample group was given 200 questionnaires; responses were received from 95 doctors (47.5%), 190 nurses (95%), and 182 patients (91%), and included in the final analyses. Results. Most respondents (doctors - 64.2%; nurses - 61.6%; patients - 87.4%) answered ‘Yes’ to the question ‘Do you think that patients should evaluate the quality of health care?’ Analysis of data allowed to identify the following main reasons why patients should evaluate the quality of health care: 1. to enhance the quality of care; 2. to recognise patients as evaluators; 3. to motivate providers to work more efficiently; and 4. to emphasise the impact of evaluation on a core value, i.e. health. Doctors and nurses outlined reasons why they did not advocate conducting patient satisfaction surveys: satisfaction surveys are redundant; negative evaluations; unwillingness to be evaluated by patients; satisfaction surveys hamper effective work with patients; surveys are not objective; survey results are not communicated to providers. Conclusions. Patient satisfaction surveys are desirable tools for evaluating the quality of health care delivery despite the fact that they frequently raise concerns amongst providers and patients. There is, therefore, a definite need for providers to experience the benefits of measuring patient satisfaction. Another important practical implication is that patients need to be convinced that their opinions do matter and contribute to improving the quality of services.
EN
Aim: Research into quality of life has become very important recently, since quality of life is increasingly used to characterise diseases and estimate the efficiency of therapeutics. The aim of this study was to determine significant factors that are associated with the quality of life of patients with schizophrenia accommodated in social welfare institutions. Material and methods: The study was conducted at the Institution for the Accommodation of Adults “Male Pcelice,” Kragujevac, Serbia. It was designed as a cross-sectional study. The quality of life was measured by using five distinct scales. The data on factors that might be associated with the quality of life were obtained from case records and the patients’ questionnaires. The association of every single factor was evaluated by using comparative analysis and the method of multiple linear regression. Results: Multiple linear regression shows that EuroQoL Five-dimensions – Five-Level scale score was associated with gender (B = −0.059 ± 0.021; p = 0.006) and daily dose (B = −0.051 ± 0.015; p = 0.001); Quality of Life Enjoyment and Satisfaction Questionnaire score was associated with the patient’s level of education (B = 2.873 ± 1.054; р = 0.007); the number of prescribed antipsychotics was associated with the Brief Psychiatric Rating Scale score (B = 3.150 ± 1.111; р = 0.007); the physical domain of the World Health Organization Quality of Life-BREF was associated with the year of disease onset (B = −0.142 ± 0.055; р = 0.011) and the daily dose (B = −2.335 ± 0.787; р = 0.004); the psychological domain of the World Health Organization Quality of Life-BREF was associated with gender (B = −2.686 ± 1.216; р = 0.029); the social relationship domain of the World Health Organization Quality of Life-BREF was associated with the level of education (B = 3.109 ± 1.289; р = 0.017) and the number of prescribed antipsychotics (B = −3.297 ± 1.516; р = 0.031); the environment domain of the World Health Organization Quality of Life-BREF was associated with the number of prescribed antipsychotics (B = −1.420 ± 0.653; р = 0,031). Conclusion: The quality of life of patients with schizophrenia was higher in males with a university degree, when the duration of the disease was shorter, negative symptoms were less pronounced, and with fewer side effects. Efforts to improve the quality of life in patients with schizophrenia accommodated in social welfare institutions should be made that could contribute to the prevention of adverse outcomes.
PL
Cel pracy: Badania nad jakością życia nabrały ostatnio szczególnej wagi – coraz częściej kategoria ta jest stosowana do opisu chorób oraz oceny skuteczności leczenia. Celem badania była określenie istotnych czynników związanych z jakością życia pacjentów chorych na schizofrenię przebywających w placówkach psychiatrycznych stałego pobytu. Materiał i metoda: Badanie o charakterze przekrojowym zostało przeprowadzone wśród pacjentów Centrum Pobytu dla Osób Dorosłych „Male Pcelice” w miejscowości Kragujevac w Serbii. Jakość życia chorych na schizofrenię zmierzono za pomocą pięciu skal. Dane dotyczące czynników, które mogły mieć wpływ na jakość życia badanych, zostały pozyskane z dokumentacji medycznej pacjentów oraz z wypełnianych przez nich ankiet. W ocenie zależności pomiędzy jakością życia pacjentów a poszczególnymi czynnikami wykorzystano analizę porównawczą oraz metodę regresji wielorakiej. Wyniki: Metodą regresji wielorakiej wykazano, iż wynik skali EuroQoL Five-dimensions – Five-Level korelował z płcią pacjentów (B = −0,059 ± 0,021; p = 0,006) oraz dzienną dawką przyjmowanych leków (B = −0,051 ± 0,015; p = 0,001), wynik Quality of Life Enjoyment and Satisfaction Questionnaire – z poziomem wykształcenia (B = 2,873 ± 1,054; р = 0,007), liczba przyjmowanych leków przeciwpsychotycznych – z wynikiem skali Brief Psychiatric Rating Scale (B = 3,150 ± 1,111; р = 0,007), domena fizyczna skali World Health Organization Quality of Life-BREF – z czasem trwania choroby (rokiem wystąpienia choroby) (B = −0,142 ± 0,055; р = 0,011) oraz dzienną dawką przyjmowanych leków (B = −2,335 ± 0,787; р = 0,004), domena psychologiczna skali World Health Organization Quality of Life-BREF – z płcią (B = −2,686 ± 1,216; р = 0,029), domena społeczna skali World Health Organization Quality of Life-BREF – z poziomem wykształcenia (B = 3,109 ± 1,289; р = 0,017) oraz liczbą przyjmowanych leków przeciwpsychotycznych (B = −3,297 ± 1,516; р = 0,031), zaś domena środowiskowa skali World Health Organization Quality of Life-BREF – z liczbą przyjmowanych leków przeciwpsychotycznych (B = −1,420 ± 0,653; р = 0,031). Wnioski: Jakość życia chorych na schizofrenię objętych badaniem była wyższa u pacjentów płci męskiej z wyższym wykształceniem, o krótszym przebiegu choroby, z mniej dotkliwymi objawami oraz mniejszą liczbą skutków ubocznych. Poprawa jakości życia osób chorujących na schizofrenię przebywających w placówkach psychiatrycznych stałego pobytu pozwoli zapobiec niepomyślnym wynikom leczenia psychiatrycznego.
EN
It is commonly known that dysphagia is associated with primary (malnutrition, dehydration, aspiration pneumonia) as well as secondary consequences (longer hospital stay, increased treatment cost, higher risk of mortality). Therefore, screening tests in swallowing disorders, especially done in at-risk groups, are essential. The aim of screening is identification of patients at risk of dysphagia and referring patients to further instrumental methods. The test should be noninvasive, quick, easy to perform by medical staff, with highest sensitivity and specificity. An example is the Viscosity – Volume Screening Test (VVST) with 3 different consistencies at 3 volumes (5, 10 and 20 ml), with wider possibilities of this tool in safe consistency and volume indication.
EN
Achenbach System of Empirically Based Assessment (ASEBA) comprises family forms which are constructed according to the same basic idea and designed for assessing adaptive functioning and maladaptive functioning. All ASEBA forms have been constructed on the empirically based approach to taxonomy and assessment of adaptive functioning and problem behaviours. This approach is called in other words the “bottom-up”. The ASEBA includes forms for assessing adaptive and maladaptive behaviour for ages 1.5 to 90+ years. This article characterises the forms for adult persons: Adults Self-Report (ASR) and Adult Behaviour Checklist (ABCL). The questionnaires are designed for assessing adaptive behaviour and internalising problems and externalising problems. The eight empirically based scales are as follows: Anxiety/Depression, Withdrawal, Somatic Complaints, Thought Problems, Attention Problems, Aggressive Behaviour, Rule Breaking Behaviour, Obsession-Compulsion. In 2003 the ASR and ABCL and the manual for them were published. This paper presents theoretical aspects of these forms, their structure and psychometric evaluation. The data are presented which refer to establishment of the reliability (internal consistency and test-retest reliability) and the validity (content validity, criterion-related validity and construct validity) of these two forms of ASEBA for adults. The conclusion is as follows: the Adult Self-Report and the Adult Behaviour Checklist appeared to be a reliable and valid measure to assess psychopathology in 18-59 aged persons.
PL
System Pomiaru Opartego na Empirii opracowany przez Thomasa Achenbacha to zbiór zbudowanych na tej samej zasadzie narzędzi pomiaru funkcjonowania przystosowawczego i nieprzystosowawczego osoby. Koncepcją teoretyczną służącą jako podstawa do budowy tych narzędzi jest paradygmat pomiaru i taksonomii oparty na empirii (innymi słowy podejście to określa się jako „z dołu do góry”). Istniejące wersje narzędzi tego systemu służą do pomiaru funkcjonowania osób od 1,5 roku życia do ponad 90 lat. W artykule przedstawiono charakterystykę kwestionariuszy dla osób dorosłych w wieku 18-59 lat, tj. wersję samoobserwacyjną, czyli Kwestionariusz Samoobserwacyjny (ASR), i wersję obserwacyjną, czyli Kwestionariusz Obserwacyjny (ABCL). Kwestionariusze te służą do pomiaru funkcjonowania adaptacyjnego i zachowań problemowych natury internalizacyjnej oraz eksternalizacyjnej. Wyróżnione zagadnienia tworzą 8 skal zachowań problemowych: Lęk/Depresja, Wycofywanie się, Skargi Somatyczne, Zaburzenia Myślenia, Zaburzenia Uwagi, Zachowania Agresywne, Łamanie Norm, Natręctwa. Zostały one opublikowane wraz z podręcznikiem w 2003 roku. W niniejszej pracy przedstawiono założenia, sposoby konstrukcji i budowę tych kwestionariuszy oraz wyniki prac dotyczące oceny właściwości psychometrycznych oryginalnych ich wersji, czyli dane odnoszące się do określenia rzetelności (zgodności wewnętrznej i stabilności bezwzględnej) oraz trafności (treściowej, teoretycznej i diagnostycznej). Dane te wskazują na to, że dwie wersje systemu ASEBA dla dorosłych spełniają wymogi psychometryczne w zastosowaniu do pomiaru zachowań adaptacyjnych i zachowań problemowych.
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