ABSTRACT
Team-based care has become a cornerstone of care delivery to meet the demands of high-quality patient care. Yet, there is a lack of valid and reliable instruments to measure the effectiveness of co-management between clinician dyads, particularly physicians and registered nurses (RNs). The purpose of this study was to adapt an existing instrument, Provider Co-Management Index (PCMI), previously used among primary care providers into a new version to scale RN-physician co-management (called PCMI-RN). We also aimed to explore preliminary associations between RN-physician co-management and burnout, job satisfaction, and intention to leave current job. Face, cognitive, and content validity testing, using mixed methods approaches, were preceded by initial pilot testing (n = 122 physicians and nurses) in an acute care facility. The internal consistency reliability (α=.83) was high. One-quarter of participants reported burnout, 27% were dissatisfied with their job, and 20% reported intention to leave their job. There was a weak significant correlation between co-management and burnout (p = .010), and co-management and job satisfaction (p = .009), but not intention to leave current position. Construct validity testing is recommended. Future research using PCMI-RN may help to isolate factors that support or inhibit effective physician-nurse co-management.
Subject(s)
Burnout, Professional , Nurses , Nursing Staff, Hospital , Physicians , Humans , Job Satisfaction , Psychometrics , Reproducibility of Results , Cross-Sectional Studies , Surveys and Questionnaires , Interprofessional Relations , Burnout, Professional/psychology , Nursing Staff, Hospital/psychologySubject(s)
Bulbar Palsy, Progressive/etiology , Facial Paralysis/etiology , Guillain-Barre Syndrome/physiopathology , Muscle Weakness/etiology , Gangliosides/cerebrospinal fluid , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/diagnosis , Humans , Male , Middle Aged , Paresthesia/etiologyABSTRACT
INTRODUCTION: Generic health-related quality-of-life (HRQOL) patient-reported outcome measures have been used in patients with chronic immune-mediated polyneuropathies. We have created a disease-specific HRQOL instrument. METHODS: The chronic acquired polyneuropathy patient-reported index (CAP-PRI) was developed and validated in multiple steps. Items were initially generated through patient and specialist input. The performance of the preliminary 20 items was analyzed via a prospective, 5-center study involving chronic immune-mediated polyneuropathy patients. RESULTS: Data analysis suggested modification to a 15-item scale with 3 response categories rather than 5. The final CAP-PRI was validated in another prospective, 5-center study. The CAP-PRI appeared to be a unidimensional outcome measure that fit the Rasch model in our multicenter cohort. It correlated appropriately with outcome measures commonly used in this patient population. CONCLUSIONS: The CAP-PRI is a simple disease-specific HRQOL measure that appears to be useful for clinical care and possibly also for clinical trials. Muscle Nerve 54: 9-17, 2016.
Subject(s)
Polyneuropathies/diagnosis , Polyneuropathies/psychology , Psychometrics , Quality of Life/psychology , Female , Humans , Male , Prospective Studies , Reproducibility of Results , Retrospective Studies , Statistics, Nonparametric , Surveys and QuestionnairesABSTRACT
Metabolic myopathies encompass a group of rare disorders arising from defects in glycogen breakdown (glycogenolysis), glucose utilization (glycolysis), fatty acid transport and oxidation, and energy production along the mitochondrial respiratory chain. The authors review the ancillary testing used in the workup of metabolic myopathies and provide a detailed discussion of these individual disorders and how to approach patients suspected to have such diagnoses.
