Measuring quality of life from the point of view of HIV-positive subjects: the HIV-QL31

Assessment of the quality of life (QoL) of human immunodeficiency virus (HIV)-infected subjects is often based on questionnaires in which the items or questions are not seen to be relevant by patients, nor by the users of the data obtained. It therefore seemed appropriate to return to the issue. The methodological and bibliographical research as well as the consultations we conducted convinced us that the elaboration of a new questionnaire was both necessary and possible. In order to do so, we adopted methodological principles based on the Sickness Impact Profile development methodology. First a bibliographical research was conducted in order to study instruments already used for HIV infection. Then, experts concerned with HIV infection and members of patients' associations were interviewed to assess how opportune the development of a new instrument could be. Following this, a methodology was established for the design and construction of the new instrument. One hundred and eighteen candidate questions were generated from an analysis of the content of 20 patients' interviews, which were subsequently submitted to 102 patients, to obtain finally a set of 31 questions from the interpretation of the results obtained from classic psychometric analysis and also from non-classic methods (item response theory and Rasch model). The concept being measured is the impact of illness being experienced by HIV-infected subjects from their own perspective. The range of health states covered by this questionnaire relates to fairly mild conditions. Rasch analysis of this set of 31 questions (HIV-QL31) shows that it corresponds to one unidimensional construct. A single score can be calculated by simple summation of dichotomous response options. This score is highly reliable (Cronbach's coefficient = 0.93) and is also discriminant regarding the severity of clinical status.     

Stress, attachment and skin diseases: a case-control study

Objectives In this case-control study we tested the hypothesis of an association between some psychosomatic skin diseases, attachment style and stress. Patients and methods A total of 177 cases and 194 controls seen between November 1992 and November 1993 at the Istituto Dermopatico dell'lmmacolata (IDD) in Rome, were enrolled into the study. Cases were outpatients with first diagnosis of hyperidrosis, chronic urticaria, generalized pruritus or alopecia areata. Controls were outpatients seen in the same period of time with first diagnosis of pigmenled nevi, keratosis or mycosis. The presence and weight of life stress events were assessed by u standard precoded questionnaire based on the Schedule of Recent Experiences (SRE) and on the Life Experiences Survey (LES). The attachment style was assessed by a modified version of the Shaver and Hazan questionnaire about feelings in a love relationship. We calculated 3 scores for each individual and classified study subjects in 2 groups: 1) "free" (= secure attachment); 2) "not free" (not secure attachment: anxious-ambivalent or avoidant). Questionnaires were self-administered in the presence of a trained psychologist. Adjusted odds ratios (OR) were calculated using a multiple logistic function. Results No association was found between the different stress scores and the skin diseases considered. The crude odds ratio for life stress events in the previous year was 1.4 (95% CI 0.8–2.7). After multiple adjustment for age, sex, marital status and education, the estimated OR was 1.6 (95% CI 0.8–3.0). One significant association emerged between the adult attachment style defined as “not free” and psychosomatic skin diseases: the adjusted OR was 4.0 (95% CI 1.4–12).     

Correlation of quantitative measures with the modified Ashworth scale in the assessment of plantar flexor spasticity in patients with traumatic brain injury

This study of plantar flexor spasticity describes relationships among a traditional qualitative spasticity scale, three potential quantitative spasticity measures and a measure of voluntary ankle muscle function. Thirty-four volunteer adult patients with traumatic brain injuries participated. There were 28 males and 6 females; the mean age was 30.3 years. A battery of five randomly sequenced tests was performed for each subject on one ankle. Tests were: modified Ashworth scale (MAS) scoring; H-reflex testing with and without Achilles tendon vibration; H-reflex testing with and without dorsiflexor contraction; reflex threshold angle and timed toe tapping (TTT). Twenty-six subjects returned to have the second ankle tested, resulting in 60 ankles for the analyses. Spearman's coefficients for correlation of quantitative spasticity measures with MAS scores ranged from 0.39 to 0.49 with associated probabilities 0.002. Pearson coefficients for correlation of quantitative spasticity measures with TTT scores were lower but also significant (P 0.07). Multiple correlation for the set of quantitative measures yieldedR = 0.614 (P < 0.001) with MAS scores andR = 0.365 (P = 0.045) with TTT scores. These findings reveal statistically significant relationships of low to moderate strength among potential quantitative spasticity measures, a traditional qualitative spasticity scale and a simple measure of voluntary ankle muscle function. Understanding these relationships is an essential part of the ongoing search for quantitative spasticity measures.The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.     

Health status of male preparatory school students lodging at a dormitory in Japan

An investigation on the health status of 79 male preparatory school students lodging at a dormitory in Japan was carried out by questionnaire on lifestyles, subjective symptoms and mental status, as compared with two control groups: 73 medical students and 36 new employees. About 83 % of them slept less than 6 hours and 70 % of them did not exercise. Many students are troubled with back pain or lumbago(47%), sensation of incomplete bladder emptying(l6%), loss of visual acuity(55%) and eye fatigue(65%). Self-rating depression scale score of preparatory school students was not significantly higher than those of the control groups. The lifestyles of preparatory school students found to be very restricted and strained. However, no significant differences on mental adverse health effects was found among three groups.     

围产期心理量表的信度、效度评定及围产期心理行为特征的研究

对围产期心理量表的信度和效度进行评定,采用重测信度和同质信度进行信度分析,采用结构效度对量表进行效度分析,经评定本量表有较好的信度和效度。孕期妇女的主要心理特点为依赖心理或幸福感及常见的妊娠反应与饮食习惯改变而带来的忧虑心理;分娩期不良心理特征,主要为紧张不安和烦躁焦虑心理,疼痛难忍等主观感受,及不吃少喝体力消耗严重行为特点;产褥期不良心理主要为产后忧郁心理,感到难以承担母亲责任的消极悲观状态。     

中国地鼠情绪唤醒水平评定量表的制定

为建立一套适合于中国地鼠情绪唤醒水平观测的评定方法,并验证其可靠性,在Ａｄｅｒ 情绪唤醒评定方法基础上进行修订,对中国地鼠进行试测,建立情绪唤醒水平划界分。结果显示总分以５ 分为界,能区分高／ 低情绪唤醒水平的中国地鼠;条目与量表总分呈中高度相关（ ｒ ＝ ０ ．３２６８ ～０ ．７３４７） ,量表总分重测信度良好（ ｒ ＝ ０ ．５８７４ ～０ ．６１０５） ,评定者评分一致性高,符合率达９５－２ ％     

Humiliation: Assessing the Impact of Derision, Degradation, and Debasement

This paper describes the development of a self-report scale to assess the internal experience of humiliation. After defining the construct, an item pool of 149 items was generated, utilizing a five-point Likert scale response format. A sample of 253 individuals ages 15 to 51 (M= 20.66) was used to conduct the item trial. The item pool was evaluated through item and factor analyses. Factor analysis identified two correlated factors accounting for 58% of scale variability. The 20 items loading on factor one were labeled the Fear of Humiliation Subscale and the 12 items loading on factor two were labeled the Cumulative Humiliation Subscale. The full scale of 32 items is called the Humiliation Inventory. Reliability analyses indicate that the subscales and the full scale have high internal consistency. Exploratory analyses of mean scores across six demographic groups indicate significant differences between male and female mean scores on the total scale and the two subscales.     

学习障碍儿筛检测试的应用研究

目的：为在我国开展学习障碍的研究提供筛查工具,对日本PRS在江苏省进行标准化研究。方法：采用PRS测试江苏省12市城乡5～15岁普通学校中小学生和幼儿园儿童6676名,进行标准化研究。结果：PRS项目测试具有较高的可靠性,言语性以及非言语性领域Cronbach’sa系数均大于093,全项目则达到096;因子分析则间接提示本次测试的有效性;各项目得分比日本样本更接近正态分布,各项目以及各领域得分均略高于日本。作为筛查学习障碍界值是合适的。结论：PRS在江苏省可用于筛俭学习能力障碍,需进一步加强应用研究。     

The vigilance scale: An analysis of elicited behavioral responses

Summary The Vigilance Scale (VS) is a 12-step additive scale (Guttman scale) that allows assessment of the behavioral deficit in the unconscious state and the state of clouding of consciousness. Despite restrictions on its applicability, which are discussed in detail, the VS seems to be a useful measuring device that indicates the level of brain function a patient with a disturbance of consciousness can actually attain. There are two categories of scale errors to be found, the first being caused by various instrumental disorders, i.e., severe motor deficits, the second resulting from the probabilistic approach of the VS to a Guttman scale.     

A rating scale for tardive dyskinesia

A rating scale for tardive dyskinesia was developed, consisting of nearly all signs seen by two groups of investigators over a 5-year period. Thirty-four items were included in the scale with a possibility of writing in idiosyncratic signs. The scale was shown to have good reliability and validity in studies carried out by both the New York and Boston groups. It is recommended as a suitable instrument for describing the breadth of tardive dyskinesia syndrome and also for quantifying the disorder. A second scale, the abbreviated dyskinesia scale, contains 13 items which are more global than the items in the original scale. It also has been shown to be both reliable and valid. Its use is suited to situations requiring less extensively detailed assessments.