Work-related quality of life scale among Singaporean nurses.

Background: The Work-Related Quality of Life Scale (WRQLS) was developed for health-care workers in England but might be useful, if valid, in other parts of the world or for other professions. Objective: We test the construct validity and reliability of the WRQLS as applied to nurses in Singapore. Methods: A descriptive study was undertaken in 2009 on a sample of 811 nurses at the National University Hospital (NUH) of Singapore who had at least one year’s work experience. The WRQLS was used in order to test its construct validity. Exploratory factor analysis was performed to reduce the factors used to determine WRQLS variance. The Pearson’s correlation was used to evaluate the relationship between the WRQLS and the 12-item short form health survey (SF-12) in order to substantiate conclusions regarding construct validity while Cronbach’s alpha was calculated to test WRQLS reliability. Results: The median age of the respondents was 31 (IQR=12) and the majority were female (96.9%). The median duration of work experience was seven years (IQR=10). Following the exploratory factor analysis, a five-factor model with 22 items was selected, including; 1) job and career satisfaction, 2) general well-being, 3) home-work interface, 4) stress at work, and 5) working conditions. The correlation coefficient showed a moderate relationship between the WRQLS and mental component scale (MCS-12) (r=0.495); and a weak relationship between the WRQLS and physical component scale (PCS-12) (r=0.149). The Cronbach’s alpha revealed good reliability (r=0.92). Conclusion: The WRQLS test among nurses in Singapore showed good construct validity and reliability. It could be useful in a working environment in Asia but further testing might be warranted.

Validity and reliability study of the Thai version of WHO schedules for clinical assessment in neuropsychiatry: sections on psychotic disorders.

OBJECTIVE: To determine the validity and reliability of the Thai version of the WHO Psychotic Disorders Sections of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) Version 2.1 MATERIAL AND METHOD: The SCAN interview version 2.1 Psychotic Symptoms Sections (Section 16: Perceptual disorders other than hallucinations, Section 17: Hallucinations, Section 18: Experiences of thought disorder and replacement of will, and Section 19: Delusions) were translated into Thai. The content validity of the translation was established by comparing a back-translation of the Thai version to the English original. Whenever inconsistencies were encountered, the Thai version was adapted to convey the meaning of the original. The revised Thai version was then field-tested in 4 regions (Suanprung Psychiatric Hospital, Jitavejkhonkaen Hospital, Srithanya Hospital and Suansaranrom Psychiatric Hospital, each place comprised 20 volunteers ) for comprehensibility of the relatively technical language. Between October 2004 and July 2006, thirty persons were recruited for the reliability study (16 males; 14 females). Sixteen persons were schizophrenic patients (9 males; 7 females) and 14 (7 males; 7 females) were normal persons or nonpsychotic psychiatric patients. Education and occupations varied widely. The subjects were interviewed by a psychiatrist competent in using the Thai version of SCAN and these interviews were recorded on video for later re-rating. RESULTS: Based on the response from Thai subjects and consultations with competent psychiatrists, content validity was established The time taken to interview a schizophrenic patient averaged 140.2 +/- 36.0 minutes (range, 75-193) vs. 81.9 +/- 25.9 minutes (range, 48-124) for a comparison subject. The respective mean +/- SD of inter-rater reliability (kappa) of Section 16, 17, 18 and 19 was 0.66 +/- 0.17, 0.71 +/- 0.16, 0. 70 +/- 0.22 and 0.64 +/- 0.23. Some items in some sections had 100 percent agreement between raters. The respective intra-rater reliability was 0.65 +/- 0. 11, 0. 74 +/- 0.17, 0.86 +/- 0.17 and 0.80 +/- 0.18. Some sections had items with 100 percent agreement from the same rater even when rated 2 weeks apart. More than half of the items in each section had kappa values, both inter-rater and intra-rater, at least in substantial level. CONCLUSION: The Thai version of the Psychotic Disorders Sections of SCAN version 2.1 proved to be a valid and reliable tool for assessing psychotic symptoms among Thais.

The incidence of clozapine-induced leukopenia in patients with schizophrenia at Srinagarind Hospital.

OBJECTIVE: Define the incidence of clozapine-induced leukopenia, neutropenia, and agranulocytosis in patients with schizophrenia at Srinagarind Hospital. MATERIAL AND METHOD: A descriptive study was done by retrospective reviews of the medical records of schizophrenic outpatients at psychiatric clinic in Srinagarind Hospital who had received clozapine from January 1st, 2003 to December 31st, 2005. The demographic data, incidence rate, and incidence density of leukopenia, neutropenia, and agranulocytosis were collected. RESULTS: One hundred and seventeen medical records were reviewed, 65 patients met the inclusion criteria. One patient developed neutropenia. The incidence rate of neutropenia was 1.5% and the incidence density of neutropenia was 0.01/year. No leukopenia or agranulocytosis was found in the present study. The complete blood counts were not obtained regularly due to the problems of patient's adherence and variations in practice among the physicians. CONCLUSION: Neutropenia is uncommon. No leukopenia and agranulocytosis were found. According to variations of incidence reports among different studies, the monitoring of white blood count should be continued.

The validity and reliability of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version): anxiety disorders section.

BACKGROUND: Anxiety disorders are some of the most prevalent psychiatric disorders, have early onset, are chronic and can cause functional impairment. It is, therefore, crucial to establish an accurate diagnosis for treatment and research purposes. OBJECTIVE: To test the validity and reliability of the W.H.O. Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version): Anxiety Disorders Section. MATERIAL AND METHOD: The linguistic clarity of the psychiatric schedules for Thais was tested by psychiatrists from the country's four regions. The psychiatrists were competent in the use of the schedules and their underlying objectives. Then between October 2004 and August 2005, Reliability of SCAN: anxiety disorder section was tested among 30 participants, including patients with anxiety disorders and normal volunteers. RESULTS: Based on reactions from Thais and consultations from competent psychiatrists, content validity was established. The duration of interviews for anxiety disorders section averaged 45.1 min (SD = 13.5). The reliability determined by Cohen's kappa coefficient for the 83 items that related to anxiety disorders in the SCAN were in Section 3, 4, 5. This overall inter-rater reliability was 0.79 (SD = 0.22), which were in substantial level of agreement. The overall intra-rater reliability was rated by the same psychiatrist 2 weeks apart. The result was 0.84 (SD = 0.21), which was near perfect agreement. There were three items (3.6%) of fair agreement and five items (6%) of moderate agreement that were caused from discrepancy of item definitions and the subjectivity of raters. CONCLUSION: The Anxiety Disorders Sections of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version) were an effective tool for assessing symptoms of anxiety disorders among Thais.

Validity and reliability study of the Thai version of WHO SCAN: somatoform and dissociative symptoms section.

OBJECTIVES: To determine the validity and reliability of the Thai version of the WHO Somatoform and Dissociative Symptoms Section of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) Version 2.1 MATERIAL AND METHOD: The SCAN interview version 2.1 Somatoform and Dissociative Symptoms Section was translated into Thai. The content validity of the translation was verified by comparing a back-translation (to English) of the Thai version to the English original. Whenever inconsistencies were encountered, the Thai version was adapted so that it correctly conveyed the meaning of the original English version. The revised Thai version was then field-tested nationwide for the comprehensibility of the relatively technical language. Between October 2003 and August 2004, 30 persons were recruited for the reliability study (16 males; 14 females) Fifteen subjects had somatoform disorders and 15 were normal. The number of years of formal education varied widely and occupations were diverse. Subjects were interviewed by a psychiatrist competent in using the Thai version of SCAN. The interviews were recorded on video so that the material could be rerated. RESULTS: Based on the response from Thai subjects and consultations with competent psychiatrists, the content validity was established. The time taken to interview a somatoform patient averaged 57.1 +/- 12.1 minutes while it was 42.1 +/- 13.9 minutes for a normal subject. The inter-rater reliability (kappa) of the 113 Items were: 0.81-1.0, 0.61-0.80 and 0. 00-0.20 in 49.6, 30.0 and 8.9 percent, respectively. Kappas could not be calculated for 11.5% of the Items. The intra-rater reliabilities were. 0.81-1.0, 0.61-0.80 and 0.00-0.20 in 54.9, 26.5 and 2.7 percent, respectively. Kappas could not be calculated for 15.9% of the Items. CONCLUSION: The Thai version of the Somatoform and Dissociative Symptoms Section of SCAN version 2.1 proved to be a valid and reliable tool for assessing somatoform and dissociative symptoms among Thai speakers.

Prescription pattern for treatment of hemorrhoids under the universal coverage policy of Thailand.

The Universal Coverage Policy (UCP) or "30 Baht Scheme" was launched in Thailand in 2001. The policy caused a cutback in the budgets of all public hospitals and health service centers. Traditional medicine was then viewed as an alternative to save costs. This study examines whether this had any influence on hemorrhoid treatment prescription patterns, ratio of traditional/modern medicine, or the cost of hemorrhoid treatment after the UCP was implemented at a community hospital. The traditional medicine prescribed was Petch Sang Kart and the modern alternative was Proctosedyl. All hemorrhoid prescriptions at a community hospital from October 2000 to January 2003 were surveyed. Segmented Regression Analysis was applied to evaluate prescription trends, the ratios between the types of medicine, and the hemorrhoid treatment cost. A total of 256 prescriptions were analyzed. The average number of traditional medicine prescriptions per month were more than modern medicine (41 versus 16). During the study period, the trend of modern medicine use and the treatment cost was decreased (p < 0.01). The ratio of traditional/modern medicine increased 0.2 times (p = 0.02).