Journal of evaluation in clinical practice
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To evaluate the Patient Participation in Rehabilitation Questionnaire (PPRQ) according to Rasch measurement theory. ⋯ The PPRQ-17 showed that a ruler with a reasonable and clinical hierarchy can be constructed, although the expectations of dimensionality and local dependency need to be evaluated further. Despite room for further development, PPRQ-17 nevertheless shows improved measurement precision in terms of patient leniency compared with previous evaluations with classical test theory. In turn, this can play a crucial role when comparing different rehabilitation programs and planning tailored care development activities.
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The challenges of becoming a mature adult may distract young adults with type 1 diabetes from disease self-management, increasing risks for premature morbidity and mortality. Despite the importance of young adults with type 1 diabetes engaging with preventative diabetes-related health care services, few studies report health care professionals' experiences and perceptions of the support that is available, including during the period of transition. This study sought to determine these factors across diverse contexts in one health jurisdiction. ⋯ Findings identify opportunities for development in the planning and provision of specialist multidisciplinary health care support for this population. New ideas are needed for policy and practice innovation and for the infrastructure to facilitate this, to ensure that young adults with type 1 diabetes have access to consistent and coordinated diabetes health care services, particularly in nonmetropolitan settings.
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Clinical research activity in hospitals is associated with reduced mortality and improved overall care quality. In England, the latter is a compound score of several elements and both staff and inpatient feedback form part of the Care Quality Commission (CQC) ratings. The objective of this study was to determine if NHS Trusts' National Institute for Health Research (NIHR) study activity data correlates with specific outcomes from national NHS staff and patient surveys. ⋯ Survey elements of the CQC appraisal of English NHS Hospital Trusts are significantly associated with increased clinical research activity levels; it appears to drive better information provision to inpatients-particularly around medicine management-and contribute to a better inpatient experience overall, whilst staff are more likely to recommend their own organization. Despite clinical research activity forming a very small fraction of overall NHS activity, it has an indirect positive effect on staff and Trust performance that is measurable at patient level.
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While frailty status is an attractive risk stratification tool, the evaluation of frailty in acute care can be challenging as some inpatients are unable to complete performance-based tests as part of frailty assessment and some tools may lack discriminative ability and categorize majority of cohorts as "frail". In this study, we evaluated the feasibility of frailty screening with the simple clinical frailty scale (CFS) by different clinicians, and its association with mortality and rehospitalization in a geriatric acute care setting. ⋯ Frailty status determined by CFS adds to disease severity and comorbidity in predicting short-term mortality but not rehospitalization in older inpatients who received geriatric acute care in our setting. CFS is reliable and has the potential to be incorporated into routine screening to better identify, communicate, and address frailty in the acute settings.
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Consumer-based activity trackers aim at quantifying physical activity in a wide range of contexts. Nevertheless, they need to be validated before they are confidently used. This study assessed the concurrent validity of the Nokia Go against reference devices, according to different sensor locations, in two measurement conditions: during a walking task and during a 24-hour free-living condition. ⋯ There are high discrepancies in step count between devices because of the different types of activities in daily life. The Nokia Go may be confidently used for step counting during pure walking tasks, at different locations. However, the lack of concurrent validity with ActiGraph call for caution regarding their use in daily living conditions.