Comparative Diagnostic Accuracy of Nursing Delirium Screening Scale Versus Confusion Assessment Method for Postoperative Delirium: A Systematic Review and Meta-Analysis.

AIMS: To synthesise the evidence on and to compare the diagnostic accuracy of the Nu-DESC and CAM in detecting postoperative delirium among hospitalised patients. DESIGN: Systematic review and diagnostic meta-analysis. DATA SOURCES: The PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, ProQuest Dissertations and Theses A&I, and PsycINFO databases were systematically searched from their inception to February 10, 2023. RESULTS: In total, 10 (n = 1950) and seven (n = 830) reports were included for the Nu-DESC and CAM, respectively. For Nu-DESC and CAM, the pooled sensitivities were 0.69 and 0.65, respectively, while the summary specificities were 0.99 for Nu-DESC and 0.92 for CAM. The pooled specificity differed significantly between the two tools (p < 0.001), despite comparable pooled sensitivities. The duration of stay in the intensive care unit significantly moderated the summary specificity of Nu-DESC (B = -0.0003, p = 0.009). Regarding CAM, the percentage of female participants showed a positive correlation with its pooled sensitivity (B = 0.005, p = 0.02). Furthermore, studies where clinical specialists served as assessors demonstrated a higher summary sensitivity than those assessed by nurses (0.87 vs. 0.25, p = 0.01). CONCLUSION: The sensitivities of the Nu-DESC and CAM for detecting postoperative delirium did not achieve optimal levels. Therefore, developing more accurate tools to detect postoperative delirium by integrating features from related risk factors or incorporating technology-based algorithms to enhance the screening capability is warranted. REPORTING METHOD: The study has adhered to PRISMA-DTA guideline. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. TRIAL REGISTRATION: The study protocol has been registered on PROSPERO (CRD42023398961).

The Evaluation of Content Relevance and Representativeness of the New Stroke Risk Screening Scales.

Stroke is a leading cause of death and disability worldwide. Early and comprehensive risk identification is essential for identifying individuals at high risk for stroke. This study aimed to evaluate each question in the new Stroke Risk Screening Scales (SRSS) and assess the domains for content relevance and representativeness. Initially, six stroke experts were invited to evaluate the SRSS questions. The content validity index (CVI), including the item-CVI (I-CVI) and the average-CVI (Ave-CVI), was then calculated. In our study, the acceptable standards for I-CVI and Ave-CVI were ≥0.78 and ≥0.9, respectively. The results showed that all invited experts accepted the invitation and evaluated the SRSS questions. The previous version of the SRSS consisted of 33 questions. Of these, 30 questions reached an I-CVI of ≥0.78, indicating good content validity. Three questions had an I-CVI of 0.67 and were considered invalid; thus, they were deleted. The overall instrument achieved an Ave-CVI of 0.95. Comprehensive SRSS are essential for effective stroke prevention planning. By facilitating the early identification of individuals at high risk for stroke, these scales help reduce the incidence and impact of stroke. The high content validity found in this study supports the reliability of the SRSS as a screening tool. In the future, implementing such validated scales in clinical practice can improve early intervention strategies, ultimately enhancing health outcomes and optimizing the use of healthcare resources.

Diagnostic Accuracy of the Recognizing Acute Delirium as Part of Your Routine (RADAR) Scale for Delirium Assessment in Hospitalized Older Adults: A Cross-Sectional Study.

Delirium is highly prevalent among hospitalized older adults and is associated with unfavorable outcomes. However, delirium often remains undiagnosed in the hospital context. Having a valid, simple, and fast screening tool could help in limiting the additional workload for healthcare professionals, without leaving delirium undetected. The aim of this study was to estimate the sensitivity and specificity of the Recognizing Acute Delirium As part of your Routine (RADAR) scale in an Italian hospital. An observational cross-sectional study was conducted. A total of 150 patients aged ≥70 years were enrolled. Receiver operating characteristic (ROC) curves using the Confusion Assessment Method (CAM) criterion-defined delirium as the gold standard were plotted to evaluate the performance of the RADAR scale. The cut-off suggested by previous research was used to estimate the sensitivity, specificity, and positive and negative predictive values of the RADAR scale. The involved patients were mostly females (60%; n = 90), with a median age of 84 years (I-III quartiles: 80-88). According to the CAM and the RADAR scale, 37 (25%) and 58 (39%) patients were classified as experiencing delirium, respectively. The area under the ROC curve of the RADAR scale was 0.916. Furthermore, the RADAR scale showed robust sensitivity (95%), specificity (80%), and positive (60%) and negative predictive values (98%). The RADAR scale is thus suggested to be a valid tool for screening assessment of delirium in hospitalized older adults.

Postpartum Depression Screening Scale: Its Availability for Use.

OBJECTIVE: A silent health crisis in the United States is the underdiagnosed and undertreated mental health of women related to childbirth. This discussion paper describes the Postpartum Depression Screening Scale (PDSS) with its scoring and interpretation along with its psychometric testing and translations. METHOD: In addition to the studies conducted by the instrument developers, databases were searched for studies where other researchers used the PDSS to assess postpartum depressive symptoms. Studies were included that measured the psychometrics of the scale and studies that reported the translation of the PDSS into other languages. RESULTS: Evidence is presented that the PDSS is a reliable and valid screening scale for use by psychiatric mental health nurses and other health care providers. The scale also has been translated into 14 languages, so it is available to screen non-English speaking mothers. CONCLUSION: Childbirth is one of the most powerful triggers of psychiatric illness in a woman's life. Postpartum depression is a treatable mental health condition, but first, women need to be screened so they can be identified and referrals made. Screening for this devastating mood disorder in new mothers is an essential role of psychiatric mental health nurses and other clinicians so that treatment can be started as early as possible to avoid harmful consequences.

A new scale for the screening of childhood early psychotic symptoms.

This study aimed to develop a new scale, the Early Psychotic Symptoms screening scale (EPSy), to assess the prodromes of psychotic symptoms in children aged 4 to 13 years. Two versions were proposed: one to assess the child's current behavior and one to assess the child's behavior when he/she was 2 years old. The second aim of this study was to investigate the presence of these symptoms at the age of 2 years and their evolution up to the child's current age. The analysis of EPSy identified three main factors, namely mistrust/paranoia, perceptual aberrations/hallucinations and disorganized symptoms. It has good psychometric properties. Data also shows that, independently of the participant's age, the total score on the 2-years-old version predicts the total score on the current-age version, and this is also the case for each individual factor. Finally, it is of clinical interest since it makes it possible to describe symptomatology both at age 2 and at the child's present age depending on the group to which the children are assigned (control children, psychotic children, non-psychotic children).

The External Validation of the Nursing Homes Short Depression Inventory in Older Adults with Major Neurocognitive Disorders in Long-Term Care Centers.

INTRODUCTION: Depression is often difficult to detect in long-term care (LTC) patients with major neurocognitive disorders (MNCD), and an observer-rated screening scale could facilitate assessments. This study aimed to establish the external validity and reliability of the Nursing Homes Short Depression Inventory (NH-SDI) in LTC patients with MNCD and to compare its estimates to the Cornell Scale for Depression in Dementia (CSDD), the most used scale for depression in MNCD. METHODS: A focus discussion group of experts assessed the content validity of the NH-SDI. Then, a convenience sample of 93 LTC patients with MNCD was observer-rated by trained nurses with the NH-SDI and CSDD. For 57 patients, a medical assessment of depression was obtained, and screening accuracy estimates were generated. RESULTS: The prevalence of depression was 8.8% as per reference standard. NH-SDI's content validity was judged acceptable with minor item wording modifications and specifications. The NH-SDI (cut-off ≥3) achieved 100% (95% confidence interval [CI]: 46-100%) sensitivity, 83% (95% CI: 69-91%) specificity, and 36% (95% CI: 14-64%) positive predictive value (PPV). The CSDD (cut-off ≥3) achieved 100% (95% CI: 46-100%) sensitivity, 75% (95% CI: 61-86%) specificity, and 28% (95% CI: 11-54%) PPV. No significant differences in areas under the receiver operating characteristic curve were found between scales. The NH-SDI and CSDD were highly correlated (rs = 0.913; p < 0.001) and reliable (ICC = 0.77; p < 0.001). CONCLUSION: The NH-SDI appears valid and reliable in LTC patients with MNCD and quicker than the CSDD to rule out depression in a busy or short-staffed setting.

Delirium assessment tools among hospitalized older adults: A systematic review and metaanalysis of diagnostic accuracy.

Delirium is a common neuropsychiatric syndrome that is often overlooked in clinical settings. The most accurate instrument for screening delirium has not been established. This study aimed to compare the diagnostic accuracy of the 4 'A's Test (4AT), Nursing Delirium Screening Scale (Nu-DESC), and Confusion Assessment Method (CAM) in detecting delirium among older adults in clinical settings. These assessment tools feature concise item sets and straightforward administration procedures. Five electronic databases were systematically searched from their inception to September 7, 2022. Studies evaluating the sensitivity and specificity of the 4AT, Nu-DESC, and CAM against the Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases as the reference standard were included. Bivariate random effects model was used to summarize the sensitivity and specificity results. A total of 38 studies involving 7378 patients were included. The 4AT, Nu-DESC, and CAM had comparable sensitivity in detecting delirium (0.76, 0.78, and 0.80, respectively). However, the specificity of the CAM was higher than that of the 4AT (0.98 vs 0.89, P = .01) and Nu-DESC 0.99 vs 0.90, P = .003). Diagnostic accuracy was moderated by the percentage of women, acute care setting, sample size, and assessors. The three tools exhibit comparable sensitivity, and the CAM has the highest specificity. Based on the feasibility of the tools, nurses and clinical staffs could employ the Nu-DESC and the 4AT on screening out positive delirium cases and integrate these tools into daily practice. Further investigations are warranted to verify our findings.

Evaluation of factors related to maternal anxiety during pregnancy among women referred to Tabriz primary care centers.

BACKGROUND: Maternal anxiety during pregnancy is sometimes considered a normal mechanism to overcome the mother's mental preoccupation with having a child. However, stress and anxiety might become a medical condition, becoming so severe as to affect the mother's mental health. Therefore, the present study aimed to investigate factors related to maternal anxiety during pregnancy in women referring to prenatal primary care centers in Tabriz. METHODS: The target population in the present cross-sectional study was the pregnant women referring to primary care centers affiliated with Tabriz University of Medical Sciences in 2018-2019 (n = 533). Sampling was carried out using the random cluster technique (separately for municipal centers). The data were collected using the study tools, including a questionnaire on demographic data, prenatal anxiety screening scale (PASS), and researcher-made questions on maternal anxiety during pregnancy. RESULTS: In the present study, 37.5% of pregnant women had anxiety. Of all the demographic and background variables, income (P = 0.015), a history of preterm delivery (P = 0.018), and unintended pregnancy (P = 0.022) were significantly related to anxiety. Of the variables of income, a history of preterm delivery, and unintended pregnancy in the regression model, the odds of anxiety were 41% lower in pregnant women with somewhat adequate income than those with inadequate income after correcting for other variables (P = 0.011). In addition, the variable of unintended pregnancy increased the odds of anxiety up to 49% after correcting for other variables (P = 0.023). CONCLUSION: The present study showed that income and unintended pregnancy significantly affect maternal anxiety during pregnancy. TRIAL REGISTRATION: The protocol of the study was approved by the Ethics Committee of Tabriz University of Medical Sciences under the code (IR.TBZMED.REC.1398.161).

Accuracy of Observer-Rated Measurement Scales for Depression Assessment in Patients with Major Neurocognitive Disorders Residing in Long-Term Care Centers: A Systematic Review.

INTRODUCTION: Depression is often under-detected in long-term care (LTC) patients with major neurocognitive disorders (MNCD) and is associated with important morbidity, mortality, and costs. Observer-rated outcome measures (ObsROMs) could help resolve this problematic; however, evidence on their accuracy is scattered in the literature. This systematic review aimed at summarizing this evidence. METHODS: A literature search was conducted in 7 databases using keywords, MeSHs, and bibliographic searches. We included studies published before January 2022 and reporting on the accuracy of a depression ObsROM used in LTC patients with MNCD. Data extraction, analysis, synthesis, and study methodological quality assessments were done by two authors, and discrepancies were resolved by consensus. RESULTS: Among 9,660 articles retrieved, 8 studies reporting on 11 depression measures were included. Scales were classified as patient-reported outcome measures used as Obs-ROMs or true ObsROMs. Among the first category, the Cornell Scale for Depression in Dementia (CSDD) and the Montgomery-Asberg Depression Rating Scale (MADRS) performed best (area under the curve [AUC]: 0.73-0.87), although both presented with low positive predictive values and high negative predictive values. Among the second category, the Nursing Homes Short Depression Inventory (NH-SDI) performed best, with an AUC of 0.93 and ≥85% sensitivity, specificity, and predictive values. CONCLUSION: The CSDD and MADRS may be useful to rule out depression in LTC patients with MNCD, whereas the NH-SDI may be useful to rule in and out depression within this same population. Before recommending their use, adequately powered studies to further examine their accuracy in different contexts are necessary.

Study on the value of Michigan nerve screening scale, pain and tactile temperature detection and vibration perception threshold in diagnosing diabetic peripheral neuropathy / 中国医师进修杂志

Objective:To analyze the diagnostic value of Michigan nerve screening Scale (MNSI), pain, touch and temperature detection combined with vibratory perception threshold (VPT) in diabetic peripheral neuropathy (DPN).Methods:A total of 500 patients with type 2 diabetes mellitus (T2DM) who received inpatient treatment in Xinhua Hospital Chongming Branch Affiliated of Shanghai Jiao Tong University School of Medicine from January to December 2018 were selected. Sixty four patients with DPN were enrolled in the DPN group, and the remaining 436 patients were enrolled in the no-DPN group. The clinical data and the results of MNSI scale, pain, touch and temperature detection thresholds and VPT of the two groups were compared. Receiver operating characteristic (ROC) curve was drawn to analyze the clinical value of single and combined examination indicators in the diagnosis of DPN.Results:MNSI symptom questionnaire score and MNSI physical examination score in DPN group were higher than those in no-DPN group: (3.00 ± 1.35) scores vs. (1.69 ± 0.52) scores, (1.57 ± 0.50) scores vs. (1.01 ± 0.24) scores; the proportion of touch regression, pain regression and temperature regression was significantly higher than that in no-DPN group; and the levels of VPT in the DPN group was higher than that in the no-DPN group: (26.34 ± 5.03) V vs. (17.97 ± 6.82) V, there were statistical differences ( P<0.01). When the single index was diagnosed, the area under the curve (AUC) value of VPT was the highest (0.825), and significantly higher than the pain, touch and temperature detection ( P<0.01). The AUC value of VPT + MNSI in combined diagnosis was the highest (0.738), and the sensitivity and specificity of DPN diagnosis were 51.56% and 96.10%, respectively. Conclusions:Compared with MNSI scale score, sensory detection such as pain, touch and temperature, VPT has the best diagnostic efficiency for DPN, while combined with MNSI, the specificity can be further improved, but the sensitivity decreases, which is worthy of clinical attention.

Prevalence of Stress, Anxiety, and Depression Among Pregnant Women in Jeddah.

OBJECTIVES: To estimate the prevalence of depression, anxiety, and stress among pregnant women living in Jeddah, Saudi Arabia, and to assess associated risk factors. METHODS: The study, which was a cross-sectional design, was conducted under the supervision of King Abdulaziz University Hospital, a tertiary care center in Jeddah, Saudi Arabia, in May and June of 2021. The sample consisted of 200 pregnant women who completed an online questionnaire that included sociodemographic variables, obstetric information, pregnancy-related depression, stress, and anxiety symptoms, which were evaluated using the Depression Anxiety Stress Scale (DASS-21) and the Perinatal Anxiety Screening Scale (PASS). RESULTS: DASS-21 scores indicated the prevalence of depression, anxiety, and stress were 37.5%, 54.0%, and 25.0%, respectively. The PASS revealed that 29.5% of participants had minimal anxiety symptoms, 44.5% had mild-to-moderate anxiety symptoms, and 26.0% had severe anxiety symptoms. The three psychological health conditions were significantly associated with family/husband support, history of caesarean section, parity, and abortion. CONCLUSIONS: Pregnant women should be screened routinely for any psychological disturbances, and women who are at high risk for mental illness should receive proper psychological care. Pregnant women, their families, and members of society should receive health-related education in order to prevent prenatal psychological issues as much as possible.

Evaluación de las propiedades psicométricas de la Escala de Ansiedad Perinatal en una muestra de madres en Chile / Psychometric properties of the Spanish version of the Perinatal Anxiety Screening Scale (PASS) in a sample of Chilean mothers

Background and Aim: Maternal mental health difficulties during the perinatal period are prevalent and have a negative impact on both women and their infants. Universal perinatal mental health screening has focused primarily on symptoms of depression, with limited attention given to anxiety, despite its high prevalence. This is partly due to the lack of valid maternal anxiety symptom screening tools. The aim of this study was to assess the factor structure, validity, and reliability of the Spanish version of the Perinatal Anxiety Screening Scale.Participants and Method: 265 women participated in the study, 138 of them were assessed during their third trimester of pregnancy and 127 at 3 months postpartum. An Exploratory Factor Analysis was used to examine the factor structure of the PASS, the number of factors was determined using a Velicer MAP test. Results: A four-factor solution was obtained, which slightly differed from the original version of the instrument. High reliability for the subscales and the global score, as well as adequate validity, and test-retest reliability were observed. Conclusions: The Spanish version of the Perinatal Anxiety Screening Scale has good psychometric properties, which warrants its use in Chile. Future studies are needed to assess the validity of the instrument in other Latin-American contexts.

Antecedentes y objetivo: Las dificultades de salud mental materna durante el periodo perinatal son prevalentes y tienen graves consecuencias para las madres y sus bebés. Las iniciativas de pesquisa temprana se han centrado en la sintomatología depresiva y han puesto menor atención a los síntomas de ansiedad, pese a su alta prevalencia. Uno de los factores que contribuye a la escasez de protocolos para la pesquisa de sintomatología ansiosa es la falta de instrumentos validados para tal fin. El objetivo de esta investigación fue evaluar la estructura factorial, validez concurrente y confiabilidad de la Escala de Ansiedad Perinatal, desarrollada para facilitar la pesquisa de sintomatología ansiosa en mujeres embarazadas y puérperas. Participantes y métodos: Las participantes fueron 265 mujeres, 138 de las cuales fueron evaluadas durante el tercer trimestre de gestación y 127, a los 3 meses postparto. La estructura factorial del instrumento fue analizada mediante un Análisis Factorial Exploratorio, el número de factores se definió con el test MAP de Velicer. Resultados: Se obtuvo una solución de cuatro factores con algunas diferencias en relación a la escala original. Se observó una alta consistencia interna para las subescalas del instrumento y para el puntaje global, además de una adecuada validez concurrente y confiabilidad test-retest. Conclusiones: Se concluye que la versión en español de la Escala de Ansiedad Perinatal posee características psicométricas adecuadas para su uso en Chile. Futuros estudios son requeridos para evaluar la validez de este instrumento en otros contextos latinoamericanos.

Correlation of serum homocysteine level with psychiatric symptoms and social ability in patients with schizophrenia / 中国基层医药

Objective:To correlate serum homocysteine (Hcy) level with psychiatric symptoms and social ability in patients with schizophrenia.Methods:A total of 143 patients with schizophrenia who received treatment in the Third Hospital of Quzhou from January 2018 to January 2020 were included in this study. They were randomly divided into abnormal Hcy group (Hcy ≥ 10) μmol/L, n = 46) and normal Hcy group (Hcy < 10 μmol/L, n = 97) according to different serum Hcy levels. Baseline data, the scores of the Brief Psychiatric Rating Scale (BPRS), the Positive and Negative Syndrome Scale (PANSS), and the Substance Dependence Severity Scale (SDSS) were compared between the two groups. The correlation between serum Hcy level and psychiatric symptoms and social ability was analyzed using the Pearson correlation analysis. Results:PANSS total score and BPRS total score were (77.86 ± 8.37) points and (94.47 ± 9.36) points, respectively in the abnormal Hcy group, and (74.37 ± 7.94) points and (90.35 ± 9.26) points, respectively in the normal Hcy group. There were significant differences in PANSS total score and BPRS total score between the two groups ( t = 2.41, 2.47, both P < 0.05). SDSS total score was significantly higher in the abnormal Hcy group than in the normal Hcy group [(11.75 ± 2.38) points vs. (10.53 ± 2.28) points, t = 2.88, P < 0.05]. Pearson correlation analysis showed that serum Hcy level was positively correlated with PANSS positive subscale score ( r = 0.73, P < 0.001), general mental symptom score ( r = 0.43, P = 0.032) and PANSS total score ( r = 0.53, P = 0.027), but it was not correlated with PANSS negative symptom score ( P > 0.05). Serum Hcy level was positively correlated with BPRS excitement subscale score ( r = 0.42, P = 0.037) and hostility subscale score ( r = 0.37, P = 0.047), but it was not correlated with anxiety, blunted affect, unusual thought content subscale scores and BPRS total score (all P > 0.05). Conclusion:Serum Hcy level is correlated with psychiatric symptoms and social ability in patients with schizophrenia. The higher the level of Hcy, the more severe the psychiatric symptoms, and the higher the degree of social disability.

Preliminary study on Beijing norm of Memory and Executive Screening scale / 中华神经科杂志

Objective:To develop a Beijing norm of Memory and Executive Screening (MES) scale to facilitate its further promotion and application in the future.Methods:Study subjects were selected based on the inclusion and exclusion criteria, including patients who visited the memory clinic of Xuanwu Hospital of Capital Medical University from March 20, 2017 to January 6, 2021, and normal people recruited simultaneously from community, and trained and qualified investigators conducted questionnaire surveys through face-to-face interviews. Then strict quality control, data collection and statistical analysis were performed.Results:A total of 607 participants were included, including 239 normal people, 293 individuals with subjective cognitive decline (SCD), and 75 individuals with mild cognitive impairment (MCI). There was a negative correlation between the scores of MES and age ( r=-0.19, P<0.001), but a positive correlation between scores of MES and education level ( r=0.29, P<0.001). The optimal cut-off value of this scale in Beijing was 86 points, the area under curve (AUC) of the cut-off value to distinguish MCI was 0.847 (normal people vs MCI) and 0.826 (SCD vs MCI), and after adding demographic variables, AUC showed slight increase (0.847 to 0.850 and 0.826 to 0.847), whereas the differences were not statistically significant ( Znormal peoplevsMCI=0.49, ZSCDvsMCI=1.21, P>0.05). And there was no statistically significant difference between MES and Montreal Cognitive Assessment scales in diagnostic power for normal people and people with MCI ( Zscale alone=1.03, Zafter adding demographic variables=1.13, P>0.05). Conclusions:The MES scale has a better distinguishing power for MCI, and its optimal cut-off value in Beijing is 86 points, which is different from previous studies. In the future, the sample size needs to be further expanded to verify this norm.

The Polish Version of the Nursing Delirium Screening Scale (NuDESC PL)-Experience of Using in Nursing Practice in Cardiac Surgery Intensive Care Unit.

INTRODUCTION: Delirium is a common complication of patients hospitalized in Intensive care units (ICU). The risk of delirium is estimated at approximately 80% in intensive care units. In the case of cardiac surgery ICU, the risk of delirium increases due to the type of procedures performed with the use of extracorporeal circulation. The aim of this study was to provide an official translation and evaluation of Nursing Delirium Screening Scale (NuDESC) into Polish. The NuDESC scale is a scale used by nurses around the world to detect delirium at an early stage in treatment. METHODS: The method used in the study was the NuDESC tool, which was translated into Polish. The study was conducted by Cardiac ICU nurses during day shift (at 8 a.m.), night shift (at 8 p.m.) and in other situations where the patients showed delirium-like symptoms. RESULTS: Statistically significant differences were observed between the first and second day in the studied group of patients in the case of illusions/hallucinations. Delirium occurred more frequently during the night, but statistical significance was demonstrated for both daytime and nighttime shifts. It was not demonstrated in relation to the NuDESC scale in the case of insomnia disorders. The diagnosis of delirium and disorientation was the most common diagnosis observed in patients on the first day of their stay in the ICU, followed by problems with communication. Delirium occurred on the first day, mainly at night. On the second day, delirium was much less frequent during the night; the biggest problem was disorientation and problems with communication. CONCLUSION: This study contributed to the development of the Polish version of the scale (NuDESC PL) which is now used as the Polish screening tool for delirium detection. The availability of an easy-to-use nurse-based delirium instrument is a prerequisite for widespread implementation.

Development of a Short Form Depression Screening Questionnaire for Korean Soldiers.

BACKGROUND: The frequencies of South Korean soldiers' depression and resulting suicide are increasing every year. Thus, this study aimed to develop and confirm the reliability and validity of a simple short form depression screening scale for soldiers. METHODS: This study was conducted as part of a 2013 research project named 'The Epidemiological Study on the Prevalence of Depression in Military Service and a Search for High Risk Group Management.' Clinical depression was diagnosed using the Korean version of the Mini International Neuropsychiatric Interview and suicide risk was assessed through the Korean version of the Composite International Diagnostic Interview. Furthermore, the Center for Epidemiological Studies for Depression Scale (CES-D), the Stress Response Inventory, and the Barret Impulsiveness Scale were employed. Of the 20 CES-D items, three of the most correlated items with clinical diagnosis were derived to form the short form scale. Analyses for internal consistency, concurrent validity, and factor analysis were implemented for its validation. We performed a receiver operating curve (ROC) analysis using a clinical diagnosis of depression as a gold standard to calculate the area under the curve (AUC) value, cut-off score, and corresponding sensitivity and specificity to that cut-off score. RESULTS: According to the results of the correlation analysis, 7, 18, and 4 were selected to be on our scale. The three-item scale was reliable with a Cronbach's alpha value of 0.720, and a factor was derived from the factor analysis. The ROC analysis showed a high discriminant validity, with an AUC value of 0.891. The sensitivity and specificity were 84.8% and 78.2%, and 71.7% and 91.6%, respectively, for each when the selected cut-off scores were 2 and 3, respectively. Depression screened through the scale when the cut-off score was 2 or 3 was significantly associated with suicidality, stress, and social support. CONCLUSION: The depression screening questionnaire for Korean soldiers developed through this study demonstrated high reliability and validity. Since it comprises only three items, it can be utilized easily and frequently. It is expected to be employed in a large-scale suicide prevention project targeting military soldiers in the future; it will be beneficial in selecting high-risk groups for depression.

Stroke Risk Screening Scales (SRSS): Identification of Domain and Item Generation.

BACKGROUND: Stroke is a principal cause of mortality and disability in Thailand and globally. Early and comprehensive risk identification would be critical to identify people at high risk for stroke. Therefore, a comprehensive stroke risk screening tool is needed to assess all possible stroke risks and potential at-risk populations. In the future, such an instrument would benefit early detection and stroke prevention planning. OBJECTIVE: The objective of the Stroke Risk Screening Scales (SRSS) development is to identify the domains and generating appropriate questions for the new SRSS. METHODS: Using deductive methods suggested by Godfred Boateng and colleagues (2018), the domains were classified based on the existing literature. The questions were generated based on a comprehensive analysis of existing stroke risk screening scales and their representativeness of each domain. Five existing stroke risk screening tools including 1) the Stroke RiskometerTM, 2) the Framingham 10-Year Risk Score, 3) the Stroke Risk Screening Tool (The Department of Disease Control of Thailand), 4) the My Risk Stroke Calculator, and 5) QStroke were included and identified. RESULTS: Overall, 18 domains were included, and each domain was represented with at least one or more questions. Eight domains (44.44 %) are consisting of a dichotomous question alone, another eight domains (44.44 %) consist of multiple questions, which combined between dichotomous, categorical, or fill-in-the-blank questions, one domain (5.55 %) consists of a fill-in-the-blank question, and another one (5.55 %) include only one categorical question. CONCLUSIONS: Developing a comprehensive tool to be used for stroke risk screening by extending the knowledge of stroke, stroke risk factors, and the best practice for tool development is necessitated for further practical stroke prevention planning.

Development and psychometric analysis of the negative emotion screening scale for inpatients / 中华行为医学与脑科学杂志

Objective:To develop a negative emotion screening scale for inpatients(NESSI) and test its validity and reliability.Methods:Based on our previous studies and the theory model of psychological stress, the original item pool was established through literature review, expert interviews and patient consultation.The first version of NESSI was constructed by Delphi method, then initially tested in 421 inpatients followed by the project analysis and reliability test. After those above, the formal scale was developed and tested in 318 inpatients followed by confirmatory factor analysis and reliability test.Finally, 7-item generalized anxiety disorder scale (GAD-7), 9-item patient health questionnaire (PHQ-9), anger state expression scale (SAS) and simplified Chinese version of fear of disease progression scale(FoP-Q-SF) were used to test the criterion validity.Results:After exploratory factor analysis, 17 items were retained in the final scale, which can be categorized into four dimensions: fear of illness, depression, somatization and anger, which could explain 63.49% of the total variation.Confirmatory factor analysis showed that the fitting degree of each factor model was good and met the requirements of reference value (χ 2/ df=2.949, RMR=0.044, CFI=0.929, NFI=0.897, IFI=0.930, TLI=0.915, PGFI=0.655, RMSEA=0.078). The Cronbach's α coefficient of the total scale was 0.925, and the Cronbach's α coefficient of the four factors ranged from 0.762 to 0.898.The criterion validity showed that there was a significant positive correlation between the scale and the four criterion scales ( r= 0.574-0.805, all P<0.01). Conclusion:The NESSI scale has good reliability and validity, and can be used as a psychological problem screening tool among non-psychiatric inpatients.

Psychometric evaluation of the pregnancy-related anxiety scale: Acceptance of pregnancy, avoidance, and worry about self subscales.

BACKGROUND: Increasingly pregnancy-related anxiety is acknowledged as a distinct anxiety type, characterised by specific fears/worries. The Pregnancy-related Anxiety Scale (PrAS) screens for this distinct anxiety and refinements to the scale have prompted further validity examination. This study aims to: replicate findings that distinguished pregnancy-related anxiety from general anxiety/depression using the PrAS; confirm the PrAS's factor structure, and examine the validity of the PrAS subscales: Acceptance of Pregnancy, Avoidance and Worry About Self. METHODS: Pregnant women (N = 608) were recruited online and completed the PrAS, Pregnancy Acceptance Questionnaire, Ways of Coping Questionnaire, Cambridge Worry Scale, Parenting Sense of Competence Scale, State Trait Anxiety Inventory and the Edinburgh Depression Scale. RESULTS: Multiple regression analysis confirmed general anxiety/depression contributed little to the PrAS's variance, supporting the scale's validity and distinctiveness of pregnancy-related anxiety. Structural equation modelling confirmed the PrAS's factor structure, and the three PrAS subscales generally correlated more highly with convergent measures than the discriminant measures. LIMITATIONS: Limitations included the cross-sectional design of the study and the use of some convergent/discriminant measures that lacked validity evidence for prenatal use. CONCLUSIONS: This study provides evidence of the distinctiveness of pregnancy-related anxiety from state/trait anxiety and depression and also adds to the psychometric properties of the PrAS. The PrAS is a useful screening scale that can be used for antenatal screening potentially reducing the risk of adverse outcomes associated with pregnancy-related anxiety. The PrAS is also a useful research tool providing a more comprehensive assessment of pregnancy-related anxiety.

A systematic review of EPDS cultural suitability with Indigenous mothers: a global perspective.

The Edinburgh Postnatal Depression Scale (EPDS) is used extensively as the "gold standard" perinatal depression and anxiety screening tool. This study contributes to an emerging discussion about the tool's shortcomings, specifically around cultural suitability for use with Indigenous women. A systematic search was conducted in ProQuest, PsycINFO, MEDLINE (Web of Science), PubMed, Scopus, Informit, and CINAHL research databases, and grey literature. The quality of the body of evidence was assessed using the NHMRC Level of Evidence framework. Three studies supported the cultural validation of the EPDS with Indigenous groups in Canada (n = 2) and the USA (n = 1). The remaining eleven Australian studies demonstrated that cultural concerns were suggested by either Indigenous mothers, healthcare professionals (Indigenous and non-Indigenous), or both, though cultural concerns were more weighted from the perspectives of healthcare professionals. The quality of the evidence was not strong, and thus, there is a critical and urgent need for targeted research in this area. This review identified and recommended Indigenous-specific methodologies that can be adopted for more trustworthy, culturally safe, and effective research in this area. Given that the EPDS is currently considered gold standard in routine perinatal mental health screening practice in countries around the world, these findings raise significant concerns. Using culturally relevant research methodologies, such as the use of mixed-methods design, could lay stronger groundwork for further investigation of the broader utility and cultural relevance of the tool.