3 results
Cultural adaptation of the WHO-iSupport intervention for caregivers of persons with ADRD in Uganda
- Joy Louise Gumikiriza-Onoria, Denis Buwembo, Kamada Lwere, Seeher Katrin, Mark Kaddumukasa, Janet Nakugudde, Roy Mayega, Noeline Nakasujja
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, p. 33
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Background:
Family caregivers of persons with ADRD face major stressful emotional, social and economic burdens, and the negative consequences associated with caregiving are well documented. Given the projected global increase in the number of people with dementia (82 million by 2030 and 152 million by 2050), plus a current Dementia prevalence among persons 60 years and older in Uganda, ranging from 5.5% to 20%, there is paucity of information regarding the psychotherapeutic management of challenges that family caregivers of persons with ADRD go through in many settings in sub-Sahara Africa, including Uganda. This study will contribute to the cultural adaptation of the WHO-iSupport that is an appropriate intervention for caregivers of persons with ADRD in Uganda.
Objective:To investigate the current approaches that caregivers use in the support of persons with ADRD, so as to inform the adaptation of the WHO iSupport intervention for Uganda.
Methods:This is a cultural adaptation study involving adaptation and pre-test the WHO-iSupport for family caregivers of persons with ADRD in Wakiso, Uganda. We are using a group consensus method that includes a professional translator and independent groups of bilingual experts. Caregivers of patients with ADRD are being recruited into the study. Data will be collected by the researcher and trained research assistants.
Outcomes:The primary outcome of this study is the adaptation of the WHO-iSupport psychotherapy.
Analysis:Primary analyses will be based on Intention to treat (ITT) principle to avoid any biases that may occur by subjective choice of ineligible subjects. Summary statistics like age will be given as a mean (SD) while for categorical data will be given as a proportion and summarized in tables and graphs.
Utility:The proposed study is instrumental as it will be the first known study in our setting that provides a step-by-step guide in the cultural adaptation of an intervention for care giving of persons with ADRD. The A-iSupport is a caregiver focused intervention, that promises better health and care outcomes for family caregivers of persons with ADRD, thus reducing the health care load on mental health workers.
71 Examining the Psychometric Validity of NeuroScreen to Assess Neurocognition in Hospitalized Psychosis Patients in Uganda
- Nana Asiedu, Corey Morrison, Courtney Kirsch, Rebecca Dunayev, Nour Kanaan, Christopher Ferraris, Anthony Santoro, Daphne Tsapalas, Reuben Robbins, Dan Stein, Dickens H. Akena, Noeline Nakasujja, Nastassja Koen, Emmanuel Mwesiga
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 855-856
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Objective:
People with psychotic disorders often experience neurocognitive deficits, such as neurocognitive impairment (NCI), which can negatively affect their daily activities (e.g., performing independent tasks) and recovery. Because of this, the American Psychology Association advocates integrating neurocognitive testing into routine care for people living with psychotic disorders, especially those in their first episode, to inform treatment and improve clinical outcomes. However, in low-and-middle income countries (LMICs), such as Uganda where the current study took place, administering neurocognitive tests in healthcare settings presents numerous challenges. In Uganda there are few resources (e.g., trained clinical staff, and culturally relevant and normed tests) to routinely offer testing in healthcare settings. NeuroScreen is a brief, highly automated, tablet-based neurocognitive testing tool that can be administered by all levels of healthcare staff and has been translated into indigenous Ugandan languages. To examine the psychometric properties of NeuroScreen, we measured convergent and criterion validity of the NeuroScreen tests by comparing performance on them to performance on a traditional battery of neurocognitive tests widely used to assess neurocognition in people with psychotic disorders, the Matric Consensus Cognitive Battery (MCCB).
Participants and Methods:Sixty-five patients admitted into Butabika Mental Referral Hospital in Uganda after experiencing a psychotic episode and forty-seven demographically similar control participants completed two neurocognitive test batteries: the MCCB and NeuroScreen. Both batteries include tests measuring the neurocognitive domains of executive functioning, working memory, verbal learning, and processing speed. Prior to completing each battery, patients were medically stabilized and could not exhibit any positive symptoms on the day of testing. On the day of testing, medication dosages were scheduled so that patients would not experience sedative effects while testing. To examine convergent validity, we examined correlations between overall performance on NeuroScreen and the MCCB, as well as tests that measured the same neurocognitive domains. To examine criterion validity, an ROC curve was computed to examine the sensitivity and specificity of NeuroScreen to detect NCI as defined by the MCCB.
Results:There was a large correlation between overall performance on NeuroScreen and the MCCB battery of tests, r(110) = .65, p < .001. Correlations of various strengths were found among tests measuring the same neurocognitive domains in each battery: executive functioning [r(110) = .56 p <.001], processing speed [r(110) = .44, p <.001)], working memory [r(110) = .29, p<.01], and verbal learning [r(110) = .22, p < .01]. ROC analysis of the ability of NeuroScreen to detect MCCB defined NCI showed an area under curve of .798 and optimal sensitivity and specificity of 83% and 60%, respectively.
Conclusions:Overall test performance between the NeuroScreen and MCCB test batteries was similar in this sample of Ugandans with and without a psychotic disorder, with the strongest correlations in tests of executive functioning and processing speed. ROC analysis provided criterion validity evidence of NeuroScreen to detect MCCB defined NCI. These results provide support for use of NeuroScreen to assess neurocognitive functioning among patients with psychotic disorders in Uganda, however more work needs to be to determine how well it can be implemented in this setting. Future directions include assessing cultural acceptability of NeuroScreen and generating normative data from a larger population of Ugandan test-takers.
Psychiatric disorders among the elderly on non-psychiatric wards in an African setting
- Noeline Nakasujja, Seggane Musisi, James Walugembe, Daphne Wallace
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- International Psychogeriatrics / Volume 19 / Issue 4 / August 2007
- Published online by Cambridge University Press:
- 30 April 2007, pp. 691-704
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Background: The elderly are vulnerable to illness and particularly to psychiatric illness. Many mentally ill elderly patients end up on non-psychiatric wards owing to somatization of their illnesses. Even for these patients, a psychiatric diagnosis may not be made. The literature on the elderly in Uganda is very scanty. This study aims to establish the prevalence and factors associated with psychiatric disorders among elderly patients admitted to non-psychiatric wards.
Methods: We carried out a descriptive cross-sectional study of 127 consenting elderly patients. They were administered a standardized questionnaire comprising the Self Reporting Questionnaire 25, the Mini-mental State Examination and the Structured Clinical Interview for the Diagnostic and Statistical Manual IV. Study variables included socio-demographic characteristics, physical illnesses, psychiatric disorders and the treatment given.
Results: The rate of psychiatric morbidity was 48%. The sex ratio was 1:1; however, women had a higher rate of psychiatric illness than men, 54.6% and 41.3% respectively. Being widowed or separated and having cancer were associated with SRQ > 5, p = 0.02 and p = 0.04 respectively. Depressive disorders were the most common at 25.2% and were more common in women. Increasing age was associated with dementia (p < 0.00).
Conclusion: There is a high rate of psychiatric morbidity among the elderly in Uganda. Particular attention should be given to the psychological health of elderly people admitted to general hospitals.