Introduction The Integrated Recovery Scales (IRS) was developed by the Dutch National Expertise board for routine outcome monitoring with severe mental illnesses. This board aimed to develop a multidimensional recovery measure directed at 1. clinical recovery, 2. physical health, 3. social recovery (work, social contacts, independent living) and 4. existential, personal recovery. The measure had to be short, suited for routine outcome monitoring and present the perspective of both mental health professionals and service users with severe mental illnesses. All aspects are assessed over a period of the pas 6 months. Objectives The objective of this research is validation of the Integral Recovery Scales and to test the revelance for clinical practice and police evaluation. Methods The instrument was tested with 500 individuals with severe mental illnesses (80% individuals with a psychotic disorder), of whom 200 were followed up for 1 year. For the questions concerning clinical recovery, physical health and social recovery mental health care workers conducted semi structured interviews with people living with serious illnesses. The questions concerning personal health were self-rated. We analyzed interrater reliability, convergent and divergent validity and sensitivity to change. Results The instrument has a good validity and is easy to complete for service users and mental health care workers and appropriate for clinical and policy evaluation goals. Conclusions The Integrated Recovery Scales can be a useful instrument for a simple and meaningful routine outcome monitoring. Page: 121
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BACKGROUND: To evaluate the effect of (new) treatments or analyse prevalence and risk factors of contractures, rating scales are used based on joint range of motion. However, cut-off points for levels of severity vary between scales, and it seems unclear how cut-off points relate to function. The purpose of this study was to compare severity ratings of different rating scales for the shoulder and elbow and relate these with functional range of motion.METHODS: Often used contracture severity rating scales in orthopedics, physiotherapy, and burns were included. Functional range of motion angles for the shoulder and elbow were derived from a recent synthesis published by our group. Shoulder flexion and elbow flexion range of motion data of patients three months after a burn injury were rated with each of the scales to illustrate the effects of differences in classifications. Secondly, the shoulder and elbow flexion range of motion angles were related to the required angles to perform over 50 different activities of daily living tasks.RESULTS: Eighteen rating scales were included (shoulder: 6, elbow: 12). Large differences in the number of severity levels and the cut-off points between scales were determined. Rating the measured range of motions with the different scales showed substantial inconsistency in the number of joints without impairment (shoulder: 14-36%, elbow: 26-100%) or with severe impairment (shoulder: < 10%-29%, elbow 0%-17%). Cut-off points of most scales were not related to actual function in daily living.CONCLUSION: There is an urgent need for rating scales that express the severity of contractures in terms of loss of functionality. This study proposes a direction for a solution.
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Self-efficacy and outcome expectations regarding client activation determine professionals’ level of actively engaging clients during daily activities. The Client Activation Self-Efficacy and Outcome Expectation Scales for nurses and domestic support workers (DSWs) were developed to measure these concepts. This study aimed to assess their psychometric properties. Cross-sectional data from a sample of Dutch nurses (n=150) and DSWs (n=155) were analysed. Descriptive statistics were used to examine floor and ceiling effects. Construct validity was assessed by testing research-based hypotheses. Internal consistency was determined with Cronbach’s alpha. The scales for nurses showed a ceiling effect. There were no floor or ceiling effects in the scales for domestic support workers. Three out of five hypotheses could be confirmed (construct validity). For all scales, Cronbach’s alpha coefficients exceeded 0.70. In conclusion, all scales had moderate construct validity and high internal consistency. Further research is needed concerning their construct validity, testretest reliability and sensitivity to change.
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The aim of part 3 is the development of basic instruments to measure respondent resilience to disinformation. Cases and examples of disinformation that will be used in the instruments will be taken from a COVID-19 context when applicable. People who are resilient to COVID-19 disinformation are supposed to be ‘media or information literate’. Therefore, the construct that is aimed to be measured with the instruments is Media and Information Literacy, abbreviated as MIL. Instruments that will be developed must be adaptable for different target groups (pupils, library staff and teachers). The basic instruments will therefore contain for instance scales that can be modified to measure the effectiveness of the train-the-trainer workshops as well as that of fake news workshops in secondary education. Final instruments will be used in the IO3 phase to make recommendations for improvement. Analyses of results of those final assessments will be performed for each country separately. Because the basic instruments that will be developed in output 1 are intended to be used as pre- and post-tests in output 2, the focus will be on the impact of the interventions. For evaluating the processes during the interventions and the participant experiences, extra instruments should be developed.
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This study utilized the Dutch translation of the Adjustment Scales for Early Transition in Schooling (ASETS), assessed in 323 kindergarten children across 30 regular schools in the Netherlands. Culturally-tailored, context-informed assessments are essential to address childhood adaptation challenges in early schooling. The analysis included EFA and CFA, revealing three behavioral problem categories: Aggressive/Oppositional (α = .86), Withdrawal/Low energy (α = .87), and Hyperactive/Attention seeking (α = .92). In addition, three situational contexts were identified: Contexts Requiring Discipline (α = .84), Contexts of Teaching and Learning (α = .85), and problems in Contexts Requiring Engagement (aka Disengagement) (α = .80). The 3-factor situational model demonstrated a good fit, RMSEA = .056, CFI = .97, and Pearson correlations highlighting distinct associations between behavioral dimensions and situational requirements.
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Aim and method: To examine in obese people the potential effectiveness of a six-week, two times weekly aquajogging program on body composition, fitness, health-related quality of life and exercise beliefs. Fifteen otherwise healthy obese persons participated in a pilot study. Results: Total fat mass and waist circumference decreased 1.4 kg (p = .03) and 3.1 cm (p = .005) respectively. The distance in the Six-Minute Walk Test increased 41 meters (p = .001). Three scales of the Impact of Weight on Quality of Life-Lite questionnaire improved: physical function (p = .008), self-esteem (p = .004), and public distress (p = .04). Increased perceived exercise benefits (p = .02) and decreased embarrassment (p = .03) were observed. Conclusions: Aquajogging was associated with reduced body fat and waist circumference, and improved aerobic fitness and quality of life. These findings suggest the usefulness of conducting a randomized controlled trial with long-term outcome assessments.
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The task of risk assessment is a central feature of probation work and a core activity of probation officers. Risk assessment forms the basis for subsequent interventions and management of offenders so that the likelihood of reoffending is reduced. A primary difficulty for probation workers is the ability to predict the risk of probation violations which could facilitate prevention. The main objective of the present study was to investigate the value of the 61-item Dutch diagnostic and risk assessment tool Recidivism Assessment Scales (RISc) with respect to predicting probation supervision violations of male probationers (N = 14,363). Because all RISc assessments included in the study were completed before the start of the supervision period, they could not have been influenced by behavior of the offenders or other circumstances during this period. It was found that the predictive accuracy of the RISc, with regard to supervision violation, was supported. All RISc subscales and the total score significantly predicted probation supervision violation. The AUC demonstrating the strength of the relationship of the RISc total score (AUC = .70) is satisfactory. Logistic regression analyses resulted in a fitting model, demonstrating that a selection of only 17 items from the total of 61 RISc items was sufficient to predict probation violation while preserving predictive accuracy (AUC = .73). For one of the possible cut-off sum scores used to select groups at high risk for probation violation, it was shown that is possible to double the percentage of correctly identified future violators when compared to the base rate of probation violation.
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Pain in critically ill adults with burns should be assessed using structured pain behavioural observation measures. This study tested the clinimetric qualities and usability of the behaviour pain scale (BPS) and the critical-care pain observation tool (CPOT) in this population. This prospective observational cohort study included 132 nurses who rated pain behaviour in 75 patients. The majority of nurses indicated that BPS and CPOT reflect background and procedural pain-specific features (63–72 and 87–80%, respectively). All BPS and CPOT items loaded on one latent variable (≥0.70), except for compliance ventilator and vocalisation for CPOT (0.69 and 0.64, respectively). Internal consistency also met the criterion of ≥0.70 in ventilated and non-ventilated patients for both scales, except for non-ventilated patients observed by BPS (0.67). Intraclass correlation coefficients (ICCs) of total scores were sufficient (≥0.70), but decreased when patients had facial burns. In general, the scales were fast to administer and easy to understand. Cut-off scores for BPS and CPOT were 4 and 1, respectively. In conclusion, both scales seem valid, reliable, and useful for the measurement of acute pain in ICU patients with burns, including patients with facial burns. Cut-off scores associated with BPS and CPOT for the burn population allow professionals to connect total scores to person-centred treatment protocols.
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Rationale, aims, and objectives: The current study and previous research have called the six-component model of Lützen's 30-item Moral Sensitivity Questionnaire (MSQ) into question. For this reason, we re-examined the construct validity of this instrument. Methods: In this cross-sectional study, which was based on a convenience sample of Dutch nurse practitioners (NPs) and physician assistants (PAs), we tested the validity of MSQ items using exploratory and confirmatory factor analyses (EFA and CFA, respectively). Results: The EFA revealed a two-component model, which was then tested as a target model with CFA and was found to have good model fit. Some items were correlated with two uncorrelated latent constructs, which we labelled as “paternalistic” and “deliberate” attitudes towards patients. Conclusions: As in previous studies, the analyses in the current study, which was conducted among PAs and NPs, did not reveal six dimensions for the 30 items. Two new latent dimensions of moral sensitivity were psychometrically tested and confirmed. These two components relate to studies investigating ethical behaviour, and they can be used to describe the moral climate in healthcare organizations. The scales are indicators of the extent to which health professionals behave in a deliberate (sensitive) or paternalistic (insensitive) manner towards the opinions of patients within the context of medical decision-making.
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