Objective The first objective was to assess the psychometric properties of the 92-item Dutch Naming Test (DNT-92), developed to assess word finding difficulties in people with aphasia, using Item Response Theory (IRT). The second objective was to select suitable items for a short version with a discriminative purpose. Method This study has a retrospective, psychometric research design, in which 510 DNT-92-forms of people with aphasia and 192 DNT-forms of healthy participants were used for analyses. An IRT analysis was performed and information on the item- and person parameters was obtained. Item selection for the short version was based on a combination of the discriminative ability of the items and their estimated theta or difficulty. Items with the highest information load, and a difficulty parameter in the range of overlap between the sample of people with aphasia and healthy participants were selected. Results A 2-PL IRT analysis showed best fit to the data. Assumptions of unidimensionality, local independence, and monotonicity were met. Items were removed incrementally, whilst checking sensitivity and specificity of the remaining short form. A selection of six items proved optimal in terms of sensitivity and specificity, with an area under the curve value of 0.85. Differences were found between participants younger than 70 and older. Conclusions The IRT assumptions for the DNT-92 were met, indicating that the test has good psychometric properties. A reduction of items to just six items proved possible, leading to a reliable six item short form with a discriminatory purpose.
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Abstract Background: People with severe mental illness (SMI) often suffer from long-lasting symptoms that negatively influence their social functioning, their ability to live a meaningful life, and participation in society. Interventions aimed at increasing physical activity can improve social functioning, but people with SMI experience multiple barriers to becoming physically active. Besides, the implementation of physical activity interventions in day-to-day practice is difficult. In this study, we aim to evaluate the effectiveness and implementation of a physical activity intervention to improve social functioning, mental and physical health. Methods: In this pragmatic stepped wedge cluster randomized controlled trial we aim to include 100 people with SMI and their mental health workers from a supported housing organization. The intervention focuses on increasing physical activity by implementing group sports activities, active guidance meetings, and a serious game to set physical activity goals. We aim to decrease barriers to physical activity through active involvement of the mental health workers, lifestyle courses, and a medication review. Participating locations will be divided into four clusters and randomization will decide the start of the intervention. The primary outcome is social functioning. Secondary outcomes are quality of life, symptom severity, physical activity, cardiometabolic risk factors, cardiorespiratory fitness, and movement disturbances with specific attention to postural adjustment and movement sequencing in gait. In addition, we will assess the implementation by conducting semi-structured interviews with location managers and mental health workers and analyze them by direct content analysis. Discussion: This trial is innovative since it aims to improve social functioning in people with SMI through a physical activity intervention which aims to lower barriers to becoming physically active in a real-life setting. The strength of this trial is that we will also evaluate the implementation of the intervention. Limitations of this study are the risk of poor implementation of the intervention, and bias due to the inclusion of a medication review in the intervention that might impact outcomes. Trial registration: This trial was registered prospectively in The Netherlands Trial Register (NTR) as NTR NL9163 on December 20, 2020. As the The Netherlands Trial Register is no longer available, the trial can now be found in the International Clinical Trial Registry Platform via: https:// trial search. who. int/ Trial2. aspx? Trial ID= NL9163.
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Background: Accurate measurement of health literacy is essential to improve accessibility and effectiveness of health care and prevention. One measure frequently applied in international research is the Short Assessment of Health Literacy (SAHL). While the Dutch SAHL (SAHL-D) has proven to be valid and reliable, its administration is time consuming and burdensome for participants. Our aim was to further validate, strengthen and shorten the SAHL-D using Rasch analysis. Methods: Available cross-sectional SAHL-D data was used from adult samples (N = 1231) to assess unidimensionality, local independence, item fit, person fit, item hierarchy, scale targeting, precision (person reliability and person separation), and presence of differential item functioning (DIF) depending on age, gender, education and study sample. Results: Thirteen items for a short form were selected based on item fit and DIF, and scale properties were compared between the two forms. The long form had several items with DIF for age, gender, educational level and study sample. Both forms showed lower measurement precision at higher health literacy levels. Conclusions: The findings support the validity and reliability of the SAHL-D for the long form and the short form, which can be used for a rapid assessment of health literacy in research and clinical practice.
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Objective: To explore the nature and extent of possible residual complaints among Dutch hypothyroid patients using thyroid replacement therapy, we initiated a comprehensive study measuring health-related quality of life (QoL), daily functioning, and hypothyroidism-associated symptoms in patients and control persons. Methods: An online survey measuring thyroid-specific QoL (ThyPRO), daily functioning, and hypothyroidismassociated symptoms (ThySHI) was distributed among treated hypothyroid patients and control individuals. The advertising text was formulated in an open-ended manner. Patients also provided their most recent thyroid blood values and their thyroid medication. Results: There was a large-sized impairment of QoL (Cohen’s d = 1.04, +93 % ThyPRO score) in hypothyroid patients on thyroid replacement therapy (n = 1195) as compared to controls (n = 236). Daily functioning was significantly reduced i.e., general health (-38 %), problems with vigorous- (+64 %) and moderate activities (+77 %). Almost 80 % of patients reported having complaints despite thyroid medication and in-range thyroid blood values, with 75 % expressing a desire for improved treatment options for hypothyroidism (total n = 1194). Hypothyroid patients experienced 2.8 times more intense hypothyroidism-associated symptoms than controls (n = 865, n = 203 resp). Patients’ median reported serum concentrations were: TSH 0.90 mU/L, FT4 17.0 pmol/L, and FT3 2.67 pmol/L, with 52 % having low T3 levels (<3.1 pmol/L). The QoL was not found to be related to age, sex, BMI, menopausal status, stress, serum thyroid parameters, the origin and duration of hypothyroidism, the type of thyroid medication, or the LT4 dose used. Conclusions: Our study revealed major reductions in quality of life and daily functioning, and nearly three times more intense hypothyroidism-associated symptoms in treated hypothyroid patients as compared to controls, despite treatment and largely in-range serum TSH/FT4 concentrations. The QoL was not associated with serum thyroid parameters. We recommend future research into the origin of persisting complaints and the development of improved treatment modalities for hypothyroidism.
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Living independently is an important component of quality of life. Cardiovascular diseases are prominent among the chronic conditions that predispose elderly people to functional limitations and disability, which impair quality of life. Insight into factors that play a role in the development process of limitations and disability of patients with subclinical cardiovascular diseases will aid in the development of preventive interventions. The aim of this study was to investigate the association of vascular status with muscle strength and physical functioning in middle aged and elderly men.
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BACKGROUND: The FI-35 is a valid multidimensional Chinese frailty assessment instrument. Like other scales, functional measures rely on the information the total score provides. Our research aimed to analyze the contribution of each item.METHODS: Descriptive statistics were used to summarize the sample characteristics. The expected item score (EIS) was used to determine how the items contribute to the generic measure of frailty.RESULTS: This study showed that most of the EIS curves increased across the entire range of frailty levels, and most of the items discriminate relatively well over the entire frailty range. Items differentially contributed to the total frailty score and differentially discriminated between frailty levels.CONCLUSIONS: Although nearly all items monotonically increased with frailty levels, there were large differences between items in their ability to differentiate between persons being either weakly, moderately or highly frail.
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Immersive journalism (IJ) is often assumed to be inherently emotion-inducing. Through using inclusive technology, interaction possibilities and immersive narratives, the audience should ideally experience what feels like to be in a certain situation. However, for the most part we do not know to which extent and in what form IJ influences the experience of emotions. We wanted to investigate, whether, and if so, which characteristics of IJ are related to the experience of emotions, and which role the personality trait empathy tendency plays in this respect. This is important, as the evaluation of IJ often relies on the emotion-inducing assumption thereof. Four different experiments comparing one immersive journalistic characteristic (level of inclusion, interaction possibilities, immersive narratives) to the respective non-immersive counterpart were conducted. Results indicate that while the level of inclusion and interaction possibility increase the intensity of the experience, the immersive narrative influences the valence dimension of emotions. Additionally, empathy tendency is found to be a relevant moderator for these effects. Conclusions are threefold. First, the narrative form of IJ is key; second, the analysis of IJ needs to go beyond the level of inclusion; third, including emotions when assessing IJ is fundamental to understand its impact.
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A loss of physical functioning (i.e., a low physical capacity and/or a low physical activity) is a common feature in patients with chronic obstructive pulmonary disease (COPD). To date, the primary care physiotherapy and specialized pulmonary rehabilitation are clearly underused, and limited to patients with a moderate to very severe degree of airflow limitation (GOLD stage 2 or higher). However, improved referral rates are a necessity to lower the burden for patients with COPD and for society. Therefore, a multidisciplinary group of healthcare professionals and scientists proposes a new model for referral of patients with COPD to the right type of exercise-based care, irrespective of the degree of airflow limitation. Indeed, disease instability (recent hospitalization, yes/no), the burden of disease (no/low, mild/moderate or high), physical capacity (low or preserved) and physical activity (low or preserved) need to be used to allocate patients to one of the six distinct patient profiles. Patients with profile 1 or 2 will not be referred for physiotherapy; patients with profiles 3–5 will be referred for primary care physiotherapy; and patients with profile 6 will be referred for screening for specialized pulmonary rehabilitation. The proposed Dutch model has the intention to get the right patient with COPD allocated to the right type of exercise-based care and at the right moment.
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Grounded in self-determination theory, the present study examines the explanatory role of students' perceived need satisfaction and need frustration in the relationship between performance grading (versus non-grading) and students' motivation and fear in a real-life educational physical education setting. Grading consisted of teacher judgments of students' performances through observations, based on pre-defined assessment criteria. Thirty-one classes with 409 students (Mage = 14.7) from twenty-seven Flemish (Belgian) secondary schools completed questionnaires measuring students' perceived motivation, fear and psychological need satisfaction and frustration, after two lessons: one with and one without performance grading. After lessons including performance grading, students reported less intrinsic motivation and identified regulation, and more external regulation, amotivation and fear. As expected, less need satisfaction accounted for (i.e., mediated) the relationship between performance grading and self-determined motivational outcomes. Need frustration explained the relationship between performance grading and intrinsic motivation, as well as less self-determined motivational outcomes. Theoretical and practical implications are discussed.
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The purpose of this study was to provide more insight into how the physical education (PE) context can be better tailored to the diverse motivational demands of secondary school students. Therefore, we examined how different constructs of student motivation in the context of PE combine into distinct motivational profiles, aiming to unveil motivational similarities and differences between students’ PE experiences. Participants were 2,562 Dutch secondary school students, aged 12–18, from 24 different schools. Students responded to questionnaires assessing their perception of psychological need satisfaction and frustration, and perceived mastery and performance climate in PE. In order to interpret the emerging profiles additional variables were assessed (i.e. demographic, motivational and PE-related variables). Two-step cluster analysis identified three meaningful profiles labelled as negative perceivers, moderate perceivers and positive perceivers. These three profiles differed significantly with regard to perceived psychological need satisfaction and frustration and their perception of the motivational climate. This study demonstrates that students can be grouped in distinct profiles based on their perceptions of the motivational PE environment. Consequently, the insights obtained could assist PE teachers in designing instructional strategies that target students’ differential motivational needs.
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