Incentivized digital outcomes collection.

The objective of this study was to assess the feasibility of digital patient satisfaction outcomes collection using the Internet and interactive voice response technology. Patients, health care providers, and industry sponsors were provided with incentives to participate. The participants included the practitioners and patients in medical and surgical practices who used Project Quality Card (patent pending) and the Practice Improvement Program. The study subjects were convenience samples of new and established patients seen between September 1999 and December 2000. There were 3 different pilot projects: QC1, QC2, and QC3. Patients were provided with a 20-minute prepaid phone card as an incentive for completing an interactive voice response call. Patients answered the 9-item visit rating questionnaire used to measure patient satisfaction. Patients responded on a 5-point scale, with 5 being excellent, and responses were totaled in the categories of patient access and physician attributes and in an overall score for the visit. A total of 998 patients from 77 physician offices participated. The activation responses, or percentage of patients using the Quality Cards, ranged from 12.8% in group 2 (QC2) to 26.6% in group 1 (QC1) to 34.8% in group 3 (QC3). This study demonstrates that incentivized digital outcomes collection can be successfully implemented in multisite community-based medical and surgical offices. The use of Project Quality Card (interactive voice response technology) and the Practice Improvement Program provides opportunities for user-friendly, benchmarked, real-time data collection. The percentage of patient activations is linked to provider participation in quality improvement programs. Patient participation is improved as the frequency of contact with a peer-directed database increases.

Adaptation as a mediator of intimate abuse and traumatic stress in battered women.

The purpose of this research was to test one aspect of a proposed middle-range theory synthesized from the Roy adaptation model and linked with the framework of post-traumatic stress. A predictive-correlational design was used to examine adaptation as a mediator of traumatic stress in battered women. Analysis included regression and path analytic procedures. Results indicated (a) direct relationships between the focal stimuli of abuse and the response of post-traumatic stress disorder and (b) adaptation in the physiologic, self-concept, and interdependence modes partially mediated the relationship between the focal stimuli of abuse and the response of post-traumatic stress disorder in battered women.

Validity testing of the Dutch translation of the appraisal of the self-care agency A.S.A.-scale.

The purpose of this study was translation and construct validity testing of the appraisal of the self-care agency ASA-scale. This scale measures operability of self-care agency. The original English version of the scale was translated into Dutch. Subsequently the Dutch version was retranslated into English and compared with the original for semantic and cross-cultural differences. Construct validity of the translated scale was tested on 140 elderly in the Netherlands. The scale was administered to 40 randomly selected patients of a nursing home, 30 residents of a personalized care facility, 30 residents of a service flat and 40 randomly selected elderly who lived independently in the adjacent community. As hypothesize, mean ASA scores of the four groups of elderly differed significantly. The less dependent on institutionalized nursing care the higher the operability of the self-care agency scores of the elderly.

Cross-cultural testing of the "appraisal of self-care agency: ASA scale" in Norway.

The purpose of this study was to test the discriminant validity and interrater reliability of an instrument that measures aspects of self-care agency using Norwegian populations. The ASA scale forms A and B, which had been tested in the Netherlands previously, were translated into Norwegian and administered to two groups of elderly subjects and to a sample of geriatric nurses and nursing assistants in Norway. The subjects, one group from two geriatric rehabilitation units, and another from those living independently who were attending activity centres, completed the ASA-A scale. The nurses filled out the ASA-B scale. The results were supportive of the validity and reliability. Discriminant validity of the ASA scales was demonstrated.

The Norwegian, Danish and Dutch version of the Appraisal of Self-care Agency Scale; comparing reliability aspects.

This study was designed to test reliability aspects of a scale that was developed to measure the theoretical concept of self-care agency (Orem 1985). Equivalence and internal consistency of the scale were studied with populations of elderly patients and their nurses in The Netherlands, Norway and Denmark. Data was provided by 120 patients and 233 nurses. Not all criteria for reliability could be met for the Danish and the Norwegian versions of the scale. Nevertheless it is concluded that the results are indications for the reliability of the Dutch, as well as the Danish and Norwegian versions of the scale.

Medical-surgical differences in hospital stress factors.

Psychosocial stress due to the experience of hospitalization was ascertained for 535 medical and surgical patients in a community hospital, using a Hospital Stress Rating Scale, Medical-surgical differences along nine dimensions of stress as measured by this scale were examined, using analysis of covariance to control for the effects of patient characteristics known to be associated with scores on the Hospital Stress Rating Scale. The controlled variables were age, education, number of previous hospitalizations, number of years since last hospitalization, and seriousness of illness (Seriousness of Illness Rating Scale). The analysis of covariance results indicated higher perceived stress for surgical patients on the dimensions of unfamiliarity of surroundings, loss of independence, and threat of severe illness. Medical patients scored higher on the dimensions of stress due to financial problems and lack of information. The authors discuss how these findings might be incorporated in experimental studies designed to reduce stress among hospital patients.