2 results
Psychological distress across the lifespan: examining age-related item bias in the Kessler 6 Psychological Distress Scale
- Matthew Sunderland, Megan J. Hobbs, Tracy M. Anderson, Gavin Andrews
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- Journal:
- International Psychogeriatrics / Volume 24 / Issue 2 / February 2012
- Published online by Cambridge University Press:
- 21 September 2011, pp. 231-242
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- Article
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Background: Old age respondents may differ systemically in their responses to measures of psychological distress over and above their actual latent distress levels when compared to younger respondents. The current study aimed to investigate the potential for age-related bias(es) in the Kessler 6 Psychological Distress Scale (K6) items.
Methods: Data from the 2007 Australian National Survey of Mental Health and Wellbeing were analyzed using Item Response Theory to detect the presence of item bias in each of the K6 items. The potential for item bias was assessed by systematically comparing respondents classed as young (16–34 years), middle aged (35–64 years), and old aged (65–85 years). The significance and magnitude of the item bias between the age groups was assessed using the log-likelihood ratio method of differential item functioning.
Results: After statistical adjustment, there were no biases of significant magnitude influencing the endorsement of K6 items between young and middle-aged respondents or between middle-aged and old age respondents. There was a bias of significant magnitude present in the endorsement of the K6 item addressing levels of fatigue between young and old age respondents.
Conclusions: Despite the identification of significant item bias in the endorsement of K6 items between the age groups, the magnitude and influence of the bias on total K6 scores is likely to have little influence on the overall interpretation of group data when comparing psychological distress across the lifespan. Researchers should be cautious, however, when examining individual levels of fatigue related to psychological distress in older individuals.
86 - Diazepam as rescue medication in epilepsy
- from VII - Treatment
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- By Asit B. Biswas, Leicestershire Partnership NHS Trust, Tracy Hobbs, Winstanley Drive Health Centre, Leicester, Anthony Bailey, Leicestershire Partnership NHS Trust, Dave Ball, Winstanley Drive Health Centre, Leicester, Gordon Walker, Winstanley Drive Health Centre, Leicester, Sabyasachi Bhaumik, Leicestershire Partnership NHS Trust, Agnes Hauck, Leicestershire Partnership NHS Trust
- Edited by Clare Oakley, Floriana Coccia, Neil Masson, Iain McKinnon, Meinou Simmons
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- Book:
- 101 Recipes for Audit in Psychiatry
- Published online:
- 02 January 2018
- Print publication:
- 01 March 2011, pp 203-204
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- Chapter
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Summary
Setting
This audit is particularly relevant where family carers and professional care staff look after people with intellectual disability and epilepsy, at home, in day care, in respite care and in the community.
Background
Epileptic seizures occur in a third of patients with severe intellectual disability. Previously it was common practice to attempt to treat status epilepticus with diazepam per rectum, but this can be difficult without appropriate training for carers and be embarrassing and undignified for the patient.
Standards
No national standards were available at the time. Seven good-practice standards were set, after discussion with professionals and carers:
ᐅ Adequate information is provided to carers regarding
▹ identification of a prolonged seizure
▹ identification of repeated seizures
▹ recognition of seizure type
▹ assessment of level of consciousness.
ᐅ The rationale for use of diazepam per rectum is explained.
ᐅ Clear written guidelines are provided for the timely administration of per rectum diazepam in relation to the first and second doses.
ᐅ Adequate training is given on the administration and dose of per rectum diazepam.
ᐅ Adequate information is provided on recognising the following complications after prolonged or repeated seizures:
▹ convulsive status epilepticus
▹ non-convulsive status epilepticus
▹ cyanosis
▹ aspiration and breathing difficulties
▹ in addition, adequate explanation is given on monitoring pulse, temperature and breathing after prolonged or repeated seizures.
ᐅ Adequate information is provided on when to call 999 for an ambulance.
ᐅ From the guidelines provided and training received, does the carer feel confident
▹ in identifying when per rectum diazepam is indicated
▹ with the procedure
▹ in identifying any complications that may result from administration of this drug
▹ in timing the decision to seek emergency help (dial 999).
Method
Data collection
All patients with intellectual disability and epilepsy identified as receiving or being prescribed diazepam per rectum for prolonged and/or repeated seizures over the audit period were included. Questionnaires were sent out to home carers, the day centre key worker or other staff and staff of respite care homes. An explanatory letter was provided explaining the aims and scope of the audit.
Data analysis
The percentage of the sample meeting each standard was calculated.