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      • Dysphagia Associated with Risk of Depressive Symptoms among Stroke Survivors after Discharge from a Cluster of Inpatient Rehabilitation Facilities

        Kevin T. Pritchard,Kimberly P. Hreha,Ickpyo Hong 대한연하재활학회 2020 Swallowing Rehabilitation Vol.3 No.1

        Objectives: To examine the association of stroke-induced dysphagia during an inpatient rehabilitation facility (IRF) stay and depressive symptoms at a 3-month follow-up. Methods: A retrospective cross-sectional design using the Stroke Recovery in Underserved Populations 2005-2006 study database. Hierarchical logistic regression models were utilized to examine if stroke-induced dysphagia is a significant predictor for depressive symptoms at 3-month follow-up across the stepwise introduction of the demographics and clinical characteristics at the IRF discharge and 3-month follow-up. Multiple imputations with Markov-chain Monte Carlo method was used to address the covariates with missing observations. Results: In a total of 1,045 stroke survivors, 335 (32.1%) stroke survivors had dysphagia and 710 (67.9%) stroke survivors did not have dysphagia during the IRF stay. The adjusted logistic regression model and multiple imputation method revealed that stroke survivors with dysphagia are more likely to have depressive symptoms at 3-month follow-up (Odds ratio [OR] 3.169, 95% confidence interval [CI] 1.379-7.283; OR 1.746, 95% CI 1.153-2.642, respectively). A high level of functional and cognitive status, functional support, and community participation at the 3-month follow-up was inversely associated with depressive symptoms (OR 0.973, 95% CI 0.951- 0.995; OR 0.884, 95% CI 0.829-0.942; OR 0.793, 95% CI 0.714-0.882). Discussion: Stroke survivors experiencing dysphagia during the IRF stay had a higher risk of developing depressive symptoms compared to those without dysphagia at 3-month follow-up. Healthcare providers should pay attention to dysphagia care in IRFs which might prevent the development of depressive symptoms when the stroke survivors are discharged and back in their communities.

      • KCI등재

        Psychometric Properties of the Modified Barthel Index for Children With Rare Disorders

        Yoonjeong Lim,Kevin T. Pritchard,Sanghun Nam,Ickpyo Hong 대한작업치료학회 2020 대한작업치료학회지 Vol.28 No.4

        Objective: The Modified Barthel Index (MBI) measures individuals’ level of independence in performing activities of daily living. The purpose of this study was to examine the internal consistency and construct validity of the MBI for children with rare disorders. Methods: The study participants are children with rare disorders who have muscle weakness including Barth syndrome and congenital muscular dystrophy (N = 113). The MBI was completed by participants in either an online format utilizing the UF Qualtrics system or a pencil-and-paper format. Statistical analysis was conducted to examine the psychometric properties of the MBI. Results: The MBI showed excellent internal consistency for children with Barth syndrome (Cronbach’s α = .91) and congenital muscular dystrophy (Cronbach’s α = .93). Construct validity was supported by a significant difference in MBI scores among participants grouped by diagnoses. MBI score was significantly different between the unaffected group and congenital muscular dystrophy (p < .0001) as well as between the unaffected group and Barth syndrome (p < .0001). Conclusion: The psychometric properties of the MBI present good reliability and construct validity suggesting suitability for use as an outcome measure for children with rare disorders.

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        Item-Level Psychometrics of the 12 Items of the Coping Orientation to Problems Experienced Scale

        남상훈,Hilton, Claudia L.,이미정,Pritchard, Kevin T.,배수영,홍익표 대한신경계작업치료학회 2022 재활치료과학 Vol.11 No.3

        Objective : This study examined the psychometric properties of the 12-item Coping Orientation to Problems Experienced Scale (COPE) using Rasch analysis. COPE is one of the instruments used to measure stress-coping skills. Methods : The study participants were 480 community-dwelling older adults. We tested the instrument’s unidimensionality assumption using principal component analysis (PCA). Item fit was examined using infit-and-outfit mean-square (MnSq) and standardized fit statistics (ZSTD). The precision and item difficulty hierarchies of the instrument were examined. The item-difficulty hierarchy was investigated to identify the easy and difficult items. We tested differential item functioning (DIF) for sex and age groups. Results : PCA revealed that the instrument met the unidimensionality assumption (eigenvalue = 1.78). Among the 12 items, item 2 was removed because of misfit (Infit MnSq = 1.33, Infit ZSTD = 5.05, Outfit MnSq = 1.56, Outfit ZSTD = 7.15). The remaining 11 items demonstrated a conceptual item-difficulty hierarchy. The person strata value was 3.10, which is equivalent to a reliability index value of 0.81. There was no DIF for the sex and age groups (DIF contrast <0.27). Conclusion : The findings indicated that the revised COPE-11 has adequate item-level psychometric properties and can accurately measure stress coping skills.

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