Response process and test-retest reliability of the Context Assessment for Community Health tool in Vietnam

BACKGROUND: The recently developed Context Assessment for Community Health (COACH) tool aims to measure aspects of the local healthcare context perceived to influence knowledge translation in low- and middle-income countries. The tool measures eight dimensions (organizational resources, community engagement, monitoring services for action, sources of knowledge, commitment to work, work culture, leadership, and informal payment) through 49 items. OBJECTIVE: The study aimed to explore the understanding and stability of the COACH tool among health providers in Vietnam. DESIGNS: To investigate the response process, think-aloud interviews were undertaken with five community health workers, six nurses and midwives, and five physicians. Identified problems were classified according to Conrad and Blair's taxonomy and grouped according to an estimation of the magnitude of the problem's effect on the response data. Further, the stability of the tool was examined using a test-retest survey among 77 respondents. The reliability was analyzed for items (intraclass correlation coefficient (ICC) and percent agreement) and dimensions (ICC and Bland-Altman plots). RESULTS: In general, the think-aloud interviews revealed that the COACH tool was perceived as clear, well organized, and easy to answer. Most items were understood as intended. However, seven prominent problems in the items were identified and the content of three dimensions was perceived to be of a sensitive nature. In the test-retest survey, two-thirds of the items and seven of eight dimensions were found to have an ICC agreement ranging from moderate to substantial (0.5-0.7), demonstrating that the instrument has an acceptable level of stability. CONCLUSIONS: This study provides evidence that the Vietnamese translation of the COACH tool is generally perceived to be clear and easy to understand and has acceptable stability. There is, however, a need to rephrase and add generic examples to clarify some items and to further review items with low ICC.

From the Members' Perspective: Participants' Perception of the Moderator Role in Educator Communities of Practice

Thesis (Ph.D.)--University of Washington, 2016-08

KANGAROO CARE: MATERNAL PERCEPTION OF THE EXPERIENCE IN THE NEONATAL INTENSIVE CARE UNIT

Objective: To investigate the maternal perception of the experience in the first phase of the Kangaroo Mother Care Method in the Neonatal Intensive Care Unit (NICU). Methods: Descriptive, exploratory and qualitative study, conducted in the period from August to October 2014, with 10 mothers of newborn preterm (NP) infants, who were admitted to the Maternity School Assis Chateaubriand (MEAC) in Fortaleza, Brazil, and had received skin-to-skin contact through the Kangaroo Care Method during hospitalization in the NICU. Data was collected by semi-structured interview, directed by guiding questions. Content analysis was used for processing the data, being established four categories: “The bond and the attachment”, “Maternal competence”, “The fear of losing the baby” and “The importance of the multidisciplinary team”. Results: The Kangaroo Care Method is a safe and pleasurable practice for mothers and relatives, in addition to providing social and psychoaffective benefits, found in the imagery of the method institutionalization and in the mothers’ experience when properly supported. The meanings of the maternal feelings of apprehension as a result of the first physical contact with the hospitalized child can be evidenced. Regarding the evaluation of its clinical practice, this method has provided better development of the newborn infant and a reduction in hospital stay. Conclusion: The study shows relevance, since the evidence of the maternal perception of this method supports its establishment as a mandatory practice in maternity hospitals, in view of the benefits to the mother and the neonate.

Moral disengagement: Towards a context-general category-based measure of the concept

Bandura (1986) developed the concept of moral disengagement to explain how individuals can engage in detrimental behavior while experiencing low levels of negative feelings such as guilt-feelings. Most of the research conducted on moral disengagement investigated this concept as a global concept (e.g., Bandura, Barbaranelli, Caprara, & Pastorelli, 1996; Moore, Detert, Klebe Treviño, Baker, & Mayer, 2012) while Bandura (1986, 1990) initially developed eight distinct mechanisms of moral disengagement grouped into four categories representing the various means through which moral disengagement can operate. In our work, we propose to develop measures of this concept based on its categories, namely rightness of actions, rejection of personal responsibility, distortion of negative consequences, and negative perception of the victims, and which is not specific a particular area of research. Through our measures, we aim at better understanding the cognitive process leading individuals to behave unethically by investigating which category plays a role in explaining unethical behavior depending on the situations in which individuals are. To this purpose, we conducted five studies to develop the measures and to test its predictive validity. Particularly, we assessed the ability of the newly developed measures to predict two types of unethical behaviors, i.e. discriminatory behavior and cheating behavior. Confirmatory Factor analyses demonstrated a good fit of the model and findings generally supported our predictions.

THE EFFECT OF PERSON-ENVIRONMENT INTERACTION ON ANXIETY, DEPRESSION, AND SUBJECTIVE DISTRESS OF OPTOMETRY STUDENTS

The purpose of this study was to investigate whether an incongruence between personality characteristics of individuals and concomitant charcteristics of health professional training environments on salient dimensions contributes to aspects of mental health. The dimensions examined were practical-theoretical orientation and the degree of structure-unstructure. They were selected for study as they are particularly important attributes of students and of learning environments. It was proposed that when the demand of the environment is disparate from the proclivities of the individual, strain arises. This strain was hypothesized to contribute to anxiety, depression, and subjective distress.^ Select subscales on the Omnibus Personality Inventory (OPI) were the operationalized measures for the personality component of the dimensions studied. An environmental index was developed to assess students' perceptions of the learning environment on these same dimensions. The Beck Depression Inventory, State-Trait Anxiety Inventory and General Well-Being schedule measured the outcome variables.^ A congruence model was employed to determine person-environment (P-E) interaction. Scores on the scales of the OPI and the environmental index were divided into high, medium, and low based on the range of scores. Congruence was defined as a match between the level of personality need and the complementary level of the perception of the environment. Alternatively, incongruence was defined as a mismatch between the person and the environment. The consistent category was compared to the inconsistent categories by an analysis of variance procedure. Furthermore, analyses of covariance were conducted with perceived supportiveness of the learning environment and life events external to the learning environment as the covariates. These factors were considered critical influences affecting the outcome measures.^ One hundred and eighty-five students (49% of the population) at the College of Optometry at the University of Houston participated in the study. Students in all four years of the program were equally represented in the study. However, the sample differed from the total population on representation by sex, marital status, and undergraduate major.^ The results of the study did not support the hypotheses. Further, after having adjusted for perceived supportiveness and life events external to the learning environment, there were no statistically significant differences between the congruent category and incongruent categories. Means indicated than the study sample experienced significantly lower depression and subjective distress than the normative samples.^ Results are interpreted in light of their utility for future study design in the investigation of the effects of P-E interaction. Emphasized is the question of the feasibility of testing a P-E interaction model with extant groups. Recommendations for subsequent research are proposed in light of the exploratory nature of the methodology. ^

Acceptance of smartphone-based mobile shopping:mobile benefits, customer characteristics, perceived risk and the impact of application context

Despite their generally increasing use, the adoption of mobile shopping applications often differs across purchase contexts. In order to advance our understanding of smartphone-based mobile shopping acceptance, this study integrates and extends existing approaches from technology acceptance literature by examining two previously underexplored aspects. Firstly, the study examines the impact of different mobile and personal benefits (instant connectivity, contextual value and hedonic motivation), customer characteristics (habit) and risk facets (financial, performance, and security risk) as antecedents of mobile shopping acceptance. Secondly, it is assumed that several acceptance drivers differ in relevance subject to the perception of three mobile shopping characteristics (location sensitivity, time criticality, and extent of control), while other drivers are assumed to matter independent of the context. Based on a dataset of 410 smartphone shoppers, empirical results demonstrate that several acceptance predictors are associated with ease of use and usefulness, which in turn affect intentional and behavioral outcomes. Furthermore, the extent to which risks and benefits impact ease of use and usefulness is influenced by the three contextual characteristics. From a managerial perspective, results show which factors to consider in the development of mobile shopping applications and in which different application contexts they matter.

Perception of dysphagia: lack of correlation with objective measurements of esophageal function

Background The mechanism underlying increased perception of food bolus passage in the absence of esophageal mechanical obstruction has not been completely elucidated. A correlation between the intensity of the symptom and the severity of esophageal dysfunction, either motility (manometry) or bolus transit (impedance) has not been clearly demonstrated. The aim of this study was to analyze the correlation between objective esophageal function assessment (with manometry and impedance) and perception of bolus passage in healthy volunteers (HV) with normal and pharmacologically-induced esophageal hypocontractility, and in patients with gastro-esophageal reflux disease (GERD) with and without ineffective esophageal motility (IEM). Methods Combined manometry-impedance was performed in 10 HV, 19 GERD patients without IEM and nine patients with IEM. Additionally, nine HV were studied after 50 mg sildenafil, which induced esophageal peristaltic failure. Perception of each 5 mL viscous swallow was evaluated using a 5-point scale. Manometry identified hypocontractility (contractions lower than 30 mmHg) and impedance identified incomplete bolus clearance. Key Results In HV and in GERD patients with and without IEM, there was no association between either manometry or impedance and perception on per swallow analysis (OR: 0.842 and OR: 2.017, respectively), as well as on per subject analysis (P = 0.44 and P = 0.16, respectively). Lack of correlation was also found in HV with esophageal hypocontractility induced by sildenafil. Conclusions & Inferences There is no agreement between objective measurements of esophageal function and subjective perception of bolus passage. These results suggest that increased bolus passage perception in patients without mechanical obstruction might be due to esophageal hypersensitivity.

Qualités psychométriques du Consumer satisfaction questionnaire (CSQ-8) et du Helping alliance questionnaire (HAQ) [Psychometric properties of the Consumer Satisfaction Questionnaire (CSQ-8) and the Helping Alliance Questionnaire (HAQ)].

BACKGROUND: This study was based on data from a quality of care assessment survey conducted in 2011 in outpatient polyclinics of the Vaud Canton in Switzerland, comprising questionnaires completed by 568 children over the age often and 672 parents of children of all ages. The objective of this study was to evaluate the psychometric qualities of the eight-item French versions for children of the Helping Alliance Questionnaire (HAQ) and the Consumer Satisfaction Questionnaire (CSQ-8) to allow formal validation and clinical application of these tools in the context of French-speaking child psychiatry. METHODOLOGY: Responses from children over the age often to the HAQ and CSQ-8 questionnaires were submitted to confirmatory factorial analysis (CFA) for ordinal data to verify their good fit with the original long versions. Construct validity (correspondence between scores on the scales and other external criteria considered to evaluate similar concepts) of the child questionnaires was tested by Spearman's correlation with the parents' responses and their feeling of being reassured or in agreement with respect to the first visit, and with the perception of the help provided by individual and family interviews. RESULTS: CFA showed an acceptable fit with the one-dimensional model of the original scales, both for the HAQ and the CSQ-8. Significant positive correlations of the scales with the parents' responses and with other convergent external criteria confirmed the good construct validity. CONCLUSIONS: These psychometric analyses provide a basis for the validation and clinical application of the abridged French versions of the HAQ and CSQ-8 in quality of care assessment in child psychiatry.

Nursing Supervision: Studying the “Case” of the phenomenon of interorganizational articulation Nursing School and Hospital

The history of this research found a suitable ethos not only by the route of the researcher, but also by the current public policies of modernization and reform that are capable of regulating and transforming the educational and health systems, as well as their professional groups. The reflection meantime developed had raised a clear perception of the organizational change processes by which they interfered with the interorganizational coordination between School of Nursing and Hospital, where internship supervision would be the main protagonist, supported by the meanings that intervening actors have assigned to them. In this context, the search for explicit epistemological and methodological choices leads to look more attentively at the problem, ascertaining it, taking into account the organizational dimensions. In this regard, the choice of a case study was related to the fact that the method allowed to answer the purpose of knowing and understanding the interorganizational coordination phenomenon between School of Nursing and Hospital, namely through the supervision of internships.

Confirmatory factor analysis of an inventory of perception of insecurity and fear of crime

This paper focuses on the study of the factorial structure of an inventory to estimate the subjective perception of insecurity and fear of crime. Made from the review of the literature on the subject and the results obtained in previous works, this factor structure shows that this attitude towards insecurity and fear of crime is identified through a number of latent factors which are schematically summarized in (a) personal safety, (b) the perception of personal and social control, (c) the presence of threatening people or situations, (d) the processes of identity and space appropriation, (e) satisfaction with the environment, and (f) the environmental and the use of space. Such factors are relevant dimensions to analyze the phenomenon. Method: A sample of 571 participants in a neighborhood of Barcelona was evaluated with the proposed inventory, which yielded data from the distributions of all the items provided. The administration was conducted by researchers specially trained for it and the results were analyzed by using standard procedures in the confirmatory factor analysis (CFA) from the hypothesized theoretical structure. The analysis was performed by decatypes according to the different response scales prepared in the inventory and their ordinal nature, and by estimating the polychoric correlation coefficients. The results show an acceptable fit of the proposed model, an appropriate behavior of the residuals and statistically significant estimates of the factor loadings. This would indicate the goodness of the proposed factor structure.

The difference of disease perception by juvenile idiopathic arthritis patients and their parents : analysis of the JAMAR questionnaire.

BACKGROUND: The JAMAR (Juvenile Arthritis Multidimensional Assessment Report) has been developed to evaluate the perception of the patient and his parents on different items: well-being, pain, functional status, quality of life, disease activity, disease course, side effects of medication, therapeutic compliance and satisfaction with illness outcome. Our aim was to compare disease's perception by JIA patients and their parents. METHODS: We included into the study 100 consecutive patients over 7 years of age. We asked both parent and child to complete the JAMAR questionnaire. For each patient we recorded demographic and disease related data. We examined the level of disagreement between children and parents for the quantitative items of the JAMAR: VAS Pain, VAS Disease Activity, VAS Well Being, Juvenile Arthritis Functional Score, HRQoL. Then we looked for a relation between discordance-rate and demographic and clinical variables. RESULTS: Children and parents' median scores for all five items were similar. Individual dyads agreement was low, with a large amount of pairs (80) discordant for at least one item. We found higher MD VAS and JADAS in more discordant dyads, suggesting that when the disease is more active discordance between child and parent increase. CONCLUSION: The JAMAR questionnaire is an important tool that helps clinicians to detect divergent child and parent's disease perceptions. It is essential that both patients and parents fill the JAMAR questionnaire for a complete clinical and psychosocial evaluation.

Modulation of the perception of temporal order by attentional and pre-attentional factors

When two stimuli are presented simultaneously to an observer, the perceived temporal order does not always correspond to the actual one. In three experiments we examined how the location and spatial predictability of visual stimuli modulate the perception of temporal order. Thirty-two participants had to report the temporal order of appearance of two visual stimuli. In Experiment 1, both stimuli were presented at the same eccentricity and no perceptual asynchrony between them was found. In Experiment 2, one stimulus was presented close to the fixation point and the other, peripheral, stimulus was presented in separate blocks in two eccentricities (4.8º and 9.6º). We found that the peripheral stimulus was perceived to be delayed in relation to the central one, with no significant difference between the delays obtained in the two eccentricities. In Experiment 3, using three eccentricities (2.5º, 7.3º and 12.1º) for the presentation of the peripheral stimulus, we compared a condition in which its location was highly predictable with two other conditions in which its location was progressively less predictable. Here, the perception of the peripheral stimulus was also delayed in relation to the central one, with this delay depending on both the eccentricity and predictability of the stimulus. We argue that attentional deployment, manipulated by the spatial predictability of the stimulus, seems to play an important role in the temporal order perception of visual stimuli. Yet, under whichever condition of spatial predictability, basic sensory and attentional processes are unavoidably entangled and both factors must concur to the perception of temporal order.

Perception of thickness, mouth-coating and mouth-drying of dairy beverages by younger and older volunteer

Sensory perception has been found to change during ageing. The perception of mouth feel by older adults, and the role of ageing on the sensory perception of texture attributes is uncertain. . This study investigated perception of the textural attributes of thickness, mouth-coating and mouth-drying, in the context of dairy beverages, by older and younger adults. Just noticeable differences (JND) of a starch thickener and for cream concentration within milk were established for thickness and mouth-coating perception, finding no age-related differences between participant groups. Mouth-drying was assessed through the directional paired comparison of a mouth-drying milk beverage to a skimmed milk sample. The older adults were found to be more sensitive to mouth-drying (p=0.03) than the younger adults. This study found no age-related decline in texture perception with older adults finding perception of some attributes such as mouth-drying enhanced by ageing.

The Impact of Domestic Politics and International Changes on the Brazilian Perception of Regional Integration

This article aims to analyze the impact of domestic politics and international changes that influence Brazilian positions regarding regional integration processes in South America, particularly the Southern Common Market, Mercosur. The dynamics of the international system and their impact on the evolution of the elite's perception of the role the country should play in the world are important variables for understanding these positions. The state's postures in relation to integration were and are based on a real interest, but this interest is also linked with the objective of ensuring better conditions for participation in other international arenas. Starting with the hypothesis that transformations in the international setting have strongly influenced Brazil's positioning, the elements of continuity and change in the country's behavior toward Mercosur are identified, with domestic politics as the main explanation.