Electronic Physician最新文献_第8页

Factors associated with patient satisfaction in teaching hospitals in Zahedan (Iran) in 2017: a two-level regression model 2017年扎黑丹（伊朗）教学医院患者满意度的相关因素：两级回归模型

Electronic Physician

Pub Date : 2018-11-25 DOI: 10.19082/7325

M. Khosravi, Y. Jahani, M. Mirzaee, A. Payandeh, A. Bahrampour

Background: Since satisfaction is considered the main factor for improving the quality of healthcare organizations, patients’ satisfaction from healthcare services and hospital staff is very important. Objective: The aim of this study was to determine factors associated with patient satisfaction in teaching hospitals. Methods: This cross-sectional study was performed on 440 patients hospitalized in teaching hospitals affiliated with Zahedan University of Medical Sciences in 2017. Patients were selected using stratified sampling from different departments of which the sample size of each department was proportional to the number of patients from each department. The Goldberg General Health Validity Questionnaire that included questions about satisfaction and mental health was completed by patients. The patients’ satisfaction of the hospital was the dependent variable, and mental health, age, gender, education, occupation, type of insurance, marital status, place of residence, length of stay and number of hospitalization were independent variables. The data were analyzed by a linear two-level regression model in Stata 12. Results: The mean age of the patients was 40.79±19.48 years and 51.6% of them were male. The mean score of patient satisfaction (in a range of 0-20) was 14.96±2.47. Age, education, mental health, and interaction between age and mental health had significant effect on satisfaction (p=0.003, p=0.004, p<0.001, p=0.002). The mean score of satisfaction in patients with elementary education was 1.74 less than that of illiterate patients, and the score of satisfaction in patients with higher education was 2.92 less than that of illiterate patients, and the mental health in low age subgroups had a significant effect on patient satisfaction. There was also significant difference in the satisfaction levels of patients between hospital departments (p<0.001). Conclusions: The satisfaction levels of patients in different departments of the hospitals varied. Also, the patients with high mental health had high satisfaction from healthcare services and hospitals.

背景：由于满意度被认为是提高医疗机构质量的主要因素，患者对医疗服务和医院工作人员的满意度非常重要。目的：本研究旨在确定教学医院患者满意度的相关因素。方法：对2017年扎黑丹医科大学附属教学医院住院的440名患者进行横断面研究。采用分层抽样法从不同科室选择患者，每个科室的样本量与每个科室的患者人数成比例。Goldberg一般健康有效性问卷由患者完成，其中包括满意度和心理健康问题。患者对医院的满意度是因变量，心理健康、年龄、性别、教育程度、职业、保险类型、婚姻状况、居住地、住院时间和住院次数是自变量。数据通过Stata 12中的线性两级回归模型进行分析。结果：患者平均年龄为40.79±19.48岁，其中男性占51.6%。患者满意度的平均得分（在0-20之间）为14.96±2.47。年龄、教育程度、心理健康以及年龄与心理健康之间的互动对满意度有显著影响（p=0.003，p=0.004，p<0.001，p=0.002）。基础教育患者的满意度平均得分比文盲患者低1.74分，高等教育患者的满意分比文盲患者少2.92分，低年龄组的心理健康状况对患者满意度有显著影响。不同科室患者的满意度也存在显著差异（p＜0.001）。结论：不同科室患者满意度不同。此外，心理健康状况良好的患者对医疗服务和医院的满意度也很高。

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引用次数: 0

Statistical Issues in Randomized Controlled Trials: an editorial 随机对照试验中的统计问题:社论

Electronic Physician

Pub Date : 2018-11-25 DOI: 10.19082/7293

Umesh Wadgave, M. Khairnar, Yogesh Wadgave

Randomization is the bedrock of randomized controlled trials, which ensures the elimination of selection bias and also to some extent the homogenous distribution of covariates between the intervention arms. Randomization does not always guarantee the baseline balance, and hence makes the statistical analysis more complex. Several published clinical trials have employed test of significance to compare baseline measures between the groups. However, such practice has been criticized by several authors and CONSORT statement also discourages it. This overview discusses various statistical designs that were employed in published trials. Post intervention data (follow up score) comparison between the arms was common practice in published RCTs. However, this approach fails to adjust baseline imbalance. Both Change score and Percentage change methods adjust the baseline imbalance. Both of the approaches give precise estimates when there is a high correlation between baseline and follow-up score. However, when correlation is low they both give biased and less precise estimates of treatment effect. Analysis of covariance (ANCOVA) is a regression method, which maintains high statistical power and gives less biased and more precise estimates of treatment effect regardless of correlation level. Understanding strengths and limitations of different statistical designs of RCTs will prevent statistical errors, which can yield an accurate estimate of treatment effect.

随机化是随机对照试验的基础，它确保消除选择偏差，并在一定程度上确保干预组之间协变量的均匀分布。随机化并不总是保证基线平衡，因此使统计分析更加复杂。一些已发表的临床试验采用了显著性检验来比较两组之间的基线测量。然而，这种做法受到了几位作者的批评，CONSORT的声明也不鼓励这种做法。本综述讨论了已发表试验中使用的各种统计设计。在已发表的随机对照试验中，两组之间的干预后数据（随访得分）比较是常见的做法。然而，这种方法未能调整基线失衡。更改分数和百分比更改方法都会调整基线失衡。当基线和随访得分之间存在高度相关性时，这两种方法都给出了精确的估计。然而，当相关性较低时，它们都会对治疗效果做出有偏差和不太精确的估计。协方差分析（ANCOVA）是一种回归方法，无论相关水平如何，它都能保持较高的统计能力，并对治疗效果做出偏差较小、更精确的估计。了解随机对照试验不同统计设计的优势和局限性将防止统计误差，从而准确估计治疗效果。

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引用次数: 1

Antiemetic effects of metoclopramide with and without dexamethasone in children with minor head trauma: a single blind randomized clinical trial 甲氧氯普胺加和不加地塞米松对轻度头部创伤儿童的止吐效果:一项单盲随机临床试验

Electronic Physician

Pub Date : 2018-11-25 DOI: 10.19082/7307

Meisam Moezzi, Ali Delirrooyfard, H. Motamed, M. Mortazavi

Background: Trauma in the head is one of the most common childhood injuries. Children with minor head trauma are at higher risk of intracranial injury (ICI). Vomiting is one of the most common signs after minor head trauma in children, and different treatments are suggested for managing it. Objective: To determine the antiemetic effects of dexamethasone in children with minor head trauma. Methods: This single blind randomized clinical trial study was carried out during the period from September 2015 to August 2016 in Imam Khomeini and Golestan Hospitals in Ahvaz, Iran, on 64 children (2-8 years old) with minor head trauma (Minor head trauma was considered as GCS 14-15) who were admitted to the hospitals’ emergency departments. In the intervention group, metoclopramide (0.15 mg/kg) and dexamethasone (0.15 mg/kg) were injected. In the placebo group, patients received metoclopramide (0.15 mg/kg) and placebo. Nausea severity was measured using Rhodes Index of Nausea and Vomiting. The data were analyzed using SPSS version 19. We used descriptive statistics, Chi-squared, t-test, and ANOVA for the analyses of the data. P-value of less than 0.05 was defined as the level of significance. Results: Finally, 62 patients (mean age of 56.4 and 62% male gender) attended the study and were equally divided into intervention and placebo groups. The Rhodes Index of Nausea and Vomiting on the intervention and placebo groups was 4.9±3.73 and 7.19±3.79, respectively (p=0.021). Conclusion: Collectively, our results indicated that dexamethasone can be used as an effective medication along with metoclopramide to control vomiting in children with minor head trauma. Trial registration: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2016081128944N1. Funding: The authors received no financial support for the research, authorship, and/or publication of this article.

背景：头部创伤是儿童最常见的损伤之一。轻微头部创伤的儿童发生颅内损伤（ICI）的风险更高。呕吐是儿童轻微头部创伤后最常见的症状之一，建议采取不同的治疗方法。目的：观察地塞米松对儿童轻微头部损伤的止吐作用。方法：这项单盲随机临床试验研究于2015年9月至2016年8月在伊朗阿瓦兹的伊玛目霍梅尼和戈勒斯坦医院进行，研究对象为64名（2-8岁）入住医院急诊科的轻度头部创伤（轻度头部创伤被认为为GCS 14-15）儿童。干预组注射甲氧氯普胺0.15mg/kg和地塞米松0.15mg/kg。在安慰剂组中，患者接受甲氧氯普胺（0.15 mg/kg）和安慰剂治疗。使用罗兹恶心呕吐指数测量恶心的严重程度。使用SPSS 19版对数据进行分析。我们使用描述性统计学、卡方检验、t检验和方差分析对数据进行分析。P值小于0.05被定义为显著性水平。结果：最后，62名患者（平均年龄56.4岁，62%为男性）参加了研究，并被平均分为干预组和安慰剂组。干预组和安慰剂组的恶心和呕吐罗兹指数分别为4.9±3.73和7.19±3.79（p=0.021）。试验注册：该试验在伊朗临床试验注册处注册(http://www.irct.ir)Irct ID:IRCT2016081128944N1。资助：作者在研究、撰写和/或发表这篇文章方面没有得到任何资助。

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引用次数: 3

Effect of pre-operative statin administration on delirium rate after coronary artery bypass grafting (CABG): a prospective cohort study 术前他汀类药物对冠状动脉搭桥术后谵妄发生率的影响：一项前瞻性队列研究

Electronic Physician

Pub Date : 2018-11-25 DOI: 10.19082/7299

M. Golmohammadi, Z. Yekta, B. Askari, Sepideh Rahnema

Background: Statins have recently been suggested to exert protective cerebral effects in patients undergoing cardiac surgery. Objective: The aim of this study was to determine the association between pre-operative statin administration and the rate of post-operative delirium (POD) in patients undergoing coronary artery bypass grafting (CABG). Methods: This prospective cohort study was conducted at Seyedoshohada Hospital (Urmia, Iran) from June 2017 through April 2018. Patients, before undergoing CABG may have two different approaches by clinicians; administrating statins vs. those who do not receive statins. Participants in this study were selected among each of the two approaches. Therefore, Group A (n=200) (exposure group) received statins 10 mg or 20 mg in the preoperative period and Group B (n=200) did not receive statins before admission to hospital. During their intensive care unit (ICU) stay, Confusion Assessment Method (CAM) was performed every 8 hours to assess delirium. The data were analyzed by STATA version 13. The rate of POD were determined across the groups using independent samples t-test and Chi-square tests. Study covariates were adjusted and the association between the outcome of delirium incidence and clinical interventions was examined using multiple logistic regression. Results: Demographic data was similar between the two groups. Of the four hundred patients analyzed, 57 patients (14.5%) had delirium at some time during their cardiovascular ICU stay; nine (4.5%) in the patients group with use of statins and forty-eight (24%) in the patients group without use of statins had POD. There was a significant difference in the occurrence of delirium across the two groups (p=0.001). Incidence of POD in patients ≥ 60 years in Group A was significantly lower than in the patients in Group B, 4.2% and 32.3% respectively (p=0.001). Conclusion: Statin Pretreatment reduces the occurrence of post-operative delirium after coronary artery bypass surgery.

背景：他汀类药物最近被认为对接受心脏手术的患者具有保护大脑的作用。目的：本研究的目的是确定冠状动脉旁路移植术（CABG）患者术前服用他汀类药物与术后谵妄（POD）发生率之间的关系。方法：这项前瞻性队列研究于2017年6月至2018年4月在Seyedoshohada医院（伊朗乌尔米亚）进行。患者在接受冠状动脉旁路移植术之前，临床医生可能有两种不同的方法；服用他汀类药物与不接受他汀类药物的患者。这项研究的参与者是从两种方法中选择的。因此，A组（n=200）（暴露组）在术前接受了10mg或20mg的他汀类药物治疗，而B组（n=20）在入院前没有接受他汀类药物。在他们的重症监护室（ICU）期间，每8小时进行一次困惑评估法（CAM）来评估谵妄。数据通过STATA版本13进行分析。使用独立样本t检验和卡方检验确定各组POD的发生率。对研究协变量进行了调整，并使用多元逻辑回归检验了谵妄发生率结果与临床干预之间的相关性。结果：两组的人口学数据相似。在分析的400名患者中，57名患者（14.5%）在心血管ICU期间曾出现谵妄；使用他汀类药物的患者组中有9人（4.5%）患有POD，未使用他汀类药的患者组有48人（24%）患有POD。两组患者的谵妄发生率有显著差异（p=0.001）。a组≥60岁患者的POD发生率显著低于B组，分别为4.2%和32.3%（p=0.001。

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引用次数: 0

Factors influencing dentists’ choices of restorative materials in Saudi Arabia: a web-based online cross-sectional study 影响牙医在沙特阿拉伯选择修复材料的因素:一项基于网络的在线横断面研究

Electronic Physician

Pub Date : 2018-11-25 DOI: 10.19082/7341

Lujain Hatem Alsughair, E. Youssif

Background: There is a variety of restorative materials, from dental amalgam to the more recent introduction of resin and tooth-colored restorations, which makes choosing the most suitable restorative material a complex task for dentists. Dentists evaluate each case individually and make their selection decision based on several factors which have different degrees of clinical significance. Objective: The aim of this study was to identify the patients’ teeth, and dentist’s factors related to the selection of restorative materials among dentists working in Saudi Arabia. Methods: A web-based cross-sectional survey was conducted using simple random sampling method in Saudi Arabia in 2018. The questionnaire was adopted from other studies, which were pretested using pilot studies to ensure reliability. The questionnaire consisted of demographic data, multiple-choice questions measuring the most commonly used materials and the reasons behind that, along with 5-point Likert-scale questions identifying the attitudes of dentists regarding the factors influencing their choices of restorative materials. The questionnaire was completed by 229 dentists. Using IBM-SPSS version, the data were analyzed in descriptive statistics and Chi square test. A p-value of less than 0.05 was considered statistically significant in examining the study hypotheses. Results: Composite was the most commonly used material to restore primary carious lesions in class I, class II and class V. Conservative preparation was the main reason for using composite (55.9%). Esthetics was the main limitation of using amalgam (52%). The number of male dentists not using amalgam was significantly higher than their female peers (p=0.032). Conclusion: The trend of using composite is increasing in Saudi Arabia and has been reported worldwide in various conditions even in the more challenging circumstances such as large cavities and molars, mainly because its preparation is conservative. However, composite is still not preferred for patients with high caries activity and poor oral hygiene. Further research is required to negotiate more factors such as the material factors and socioeconomic status of the patient.

背景:有各种各样的修复材料，从牙科汞合金到最近引入的树脂和牙色修复材料，这使得选择最合适的修复材料成为牙医的一项复杂任务。牙医对每个病例进行单独评估，并根据具有不同程度临床意义的几个因素做出选择决定。目的:本研究的目的是确定在沙特阿拉伯工作的牙医中与患者牙齿和牙医选择修复材料相关的因素。方法:2018年在沙特阿拉伯进行网络横断面调查，采用简单随机抽样方法。问卷采用其他研究，并采用先导研究进行预试，以确保信度。调查问卷包括人口统计数据，多项选择题，衡量最常用的材料及其背后的原因，以及5点李克特量表问题，确定牙医对影响他们选择修复材料的因素的态度。229名牙医完成了问卷调查。采用IBM-SPSS版本对数据进行描述性统计和卡方检验。在检验研究假设时，p值小于0.05被认为具有统计学意义。结果:复合材料是I、II、v类原发性龋齿修复中最常用的材料，保守预备是使用复合材料的主要原因(55.9%)。美学是使用汞合金的主要限制(52%)。男性牙医不使用汞合金的人数明显高于女性牙医(p=0.032)。结论:在沙特阿拉伯使用复合材料的趋势正在增加，并且在世界范围内已被报道在各种条件下，甚至在更具有挑战性的情况下，如大腔和磨牙，主要是因为它的制备是保守的。然而，对于高龋活跃度和口腔卫生较差的患者，复合材料仍然不受欢迎。需要进一步的研究来探讨更多的因素，如物质因素和患者的社会经济地位。

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引用次数: 1

Common Mistakes in Statistical Analysis Reporting: an interview with Amy Frances Moore 统计分析报告中的常见错误:对艾米·弗朗西斯·摩尔的采访

Electronic Physician

Pub Date : 2018-11-18 DOI: 10.19082/statstical_analysis_interview

Amy Frances Moore

引用次数: 0

Inter-rater and intra-raters' variability in evaluating complete dentures insertion procedure in senior undergraduates' prosthodontics clinics. 评分者间和评分者内在评估高年级本科生口腔修复临床全口义齿植入过程中的变异性。

Electronic Physician

Pub Date : 2018-09-09 eCollection Date: 2018-09-01 DOI: 10.19082/7287

Manal Alammari, El-Sayed Nawar

Background Direct clinical assessment is the mainstay of evaluation in dentistry education. An effective evaluation method in prosthodontics should be equally valid and consistent; however, this is not attained frequently. A limited number of studies have applied an analytic evaluation in prosthodontics. Objective To compare the intra- and inter-raters’ variability in two evaluation methods: glance and grade (global), and checklist and criteria (analytical). Moreover, to identify the components of the analytical evaluation system and its applicability. Methods This cross-sectional study was carried out on outpatients attending removable prosthodontics clinics affiliated with King Abdulaziz University (Jeddah, Saudi Arabia) from December 2017 to April 2018. Two prosthodontist examiners evaluated a sample of 35 complete denture cases (20 male, 15 female) twice over a period of five months. Inter-rater and intra-rater agreement were computed using reliability test (interclass correlation coefficient ICC). Data were analyzed in IBM SPSS version 23, using paired-samples t-test, weighted kappa, and Wilcoxon signed-rank test. The level of significance was set at p≤0.05. Results The intra-rater agreement for the first and second exposures under global and analytical evaluation methods with Examiner A was outstanding with 90.7% and 99.8% agreement respectively. While with Examiner B, global was lower but still in the acceptable range with about 78.1%, and 96.1% for the analytical evaluation. Inter-rater reliability analysis showed high agreement between the two raters in the first exposure of the analytical evaluation with 97.3%, while it was 87.5% in the global evaluation. This trend goes the same with analytical in the second exposure with 93.2%; however, the second exposure under global evaluation failed the cut off, which is only 56.6% agreement. In evaluation of inter-raters agreement, the second exposure of the global method demonstrated inconsistency between the two examiners (p=0.002), while the analytical second exposure demonstrated more homogeneity (p=0.050). Intra-rater variability between first and second exposure in analytical evaluation was (0.711 for the first rater and 0.677 for the second rater). Intra-rater variability between first and second exposure in global evaluation was (<0.001 for the first rater and 0.075 for the second rater). Conclusion A simple objective and detailed method to evaluate complete denture insertion procedure was developed, and it showed that both intra-rater and inter-rater agreement were excellent for the analytical method that might overcome errors and subjectivity in evaluation that result from the limitations of global method. Results recommend suitability of using the analytical evaluation to improve reliability between raters.

背景:临床直接评估是牙科教育评估的主体。一种有效的修复学评价方法应具有同等有效性和一致性;然而，这并不经常实现。有限数量的研究将分析评估应用于修复学。目的:比较两种评估方法:glance和grade(全局)和checklist和criteria(分析)的内部和内部变异性。此外，确定了分析评价体系的组成部分及其适用性。方法:对2017年12月至2018年4月在沙特阿拉伯吉达的阿卜杜勒阿齐兹国王大学(King Abdulaziz University, Jeddah, Saudi Arabia)附属活动义齿诊所就诊的患者进行横断面研究。两位义齿医师在五个月的时间里对35例全口义齿病例(20例男性，15例女性)进行了两次评估。采用信度检验(类间相关系数ICC)计算评鉴者间和评鉴者内的一致性。数据分析采用IBM SPSS version 23，采用配对样本t检验、加权kappa检验和Wilcoxon sign -rank检验。p≤0.05为显著性水平。结果:审查员A采用整体评价法和分析评价法对第一次和第二次暴露的评分一致性非常好，分别为90.7%和99.8%。而对于审查员B, global的比例较低，但仍在可接受的范围内，约为78.1%，分析评价为96.1%。评估者间信度分析显示，两名评估者在分析评价的第一次曝光时的信度一致性为97.3%，而在整体评价中，信度一致性为87.5%。这一趋势与第二次曝光的分析相同，为93.2%;然而，全球评估下的第二次曝光未能通过切断，只有56.6%的一致性。在评估评分者之间的一致性时，全局方法的第二次曝光显示了两个审查员之间的不一致(p=0.002)，而分析性的第二次曝光显示了更多的同质性(p=0.050)。在分析评价中，第一次和第二次暴露的评分者内部变异性为(第一评分者0.711，第二评分者0.677)。结论:建立了一种简单、客观、详细的全口义齿插入过程评价方法，结果表明，该分析方法的内部和内部一致性都很好，可以克服由于全局方法的局限性而导致的评价误差和主观性。结果表明，采用分析性评价可以提高评价者之间的信度。

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引用次数: 1

Is echocardiographic epicardial fat thickness increased in patients with coronary artery disease? A systematic review and meta-analysis. 超声心动图显示冠心病患者心外膜脂肪厚度增加吗?系统回顾和荟萃分析。

Electronic Physician

Pub Date : 2018-09-09 eCollection Date: 2018-09-01 DOI: 10.19082/7249

Mohammad Ali Ansari, Mohsen Mohebati, Farid Poursadegh, Mahdi Foroughian, Alireza Sepehri Shamloo

Background: The relation of epicardial fat thickness (EFT) to coronary artery disease (CAD) has recently been reported in multiple studies. Echocardiography is a safe and relatively inexpensive and accessible approach to assess regional EFT, which can be performed easily in many centers.

Objective: To determine the association between echocardiographic EFT and the presence or the absence of CAD.

Methods: This was a systematic review and meta-analysis conducted on literature available in electronic databases up to March 2018. The articles measuring EFT by echocardiography in the right ventricular (RV) free wall were included in the study. The quality of the enrolled items was assessed using the Methodological Index for Non-Randomized Studies (MINORS) checklist. The analyses were performed using the Comprehensive Meta-Analysis version 2 software. Cochran's Q test and I² index were used to evaluate heterogeneity.

Results: This meta-analysis was performed on 13 studies involving 2,436 patients (1,622 with CAD, and 814 without CAD). The maximum EFT reported by echocardiography was 12.9±2.7 mm in the CAD group and 8.4±2.5 mm in the non-CAD group. The minimum EFT reported by echocardiography was 2.2±1.8 mm in the CAD group and 1.8±1.4 mm in the non-CAD group. The heterogeneity was found among the researched studies (I²=91.8%, p=0.000, Q-value=146.43, df [Q] =12) using the random effect model. The patients with CAD had a significantly higher echocardiographic EFT than those without CAD (SMD=1.03, 95% CI= 0.70-1.37, p=0.000).

Conclusion: According to the findings of this meta-analysis, the echocardiographic EFT in the subjects with CAD was significantly higher than that of those without CAD. The measurement of echocardiographic EFT seems to be an acceptable strategy for risk stratification of heart diseases considering ease of use, cost-effectiveness and non-exposure characteristics, compared to other imaging interventions.

背景:最近有多项研究报道了心外膜脂肪厚度(EFT)与冠状动脉疾病(CAD)的关系。超声心动图是一种安全且相对便宜的评估局部EFT的方法，在许多中心都可以很容易地进行。目的:探讨超声心动图EFT与冠心病存在与否的关系。方法:对电子数据库中截至2018年3月的文献进行系统综述和荟萃分析。本研究纳入了超声心动图测量右心室游离壁EFT的文章。采用非随机研究方法学指标(未成年人)检查表对入选项目的质量进行评估。使用综合meta分析软件2进行分析。采用Cochran’s Q检验和I2指数评价异质性。结果:本荟萃分析纳入了13项研究，涉及2,436例患者(1,622例CAD, 814例非CAD)。超声心动图显示，冠心病组EFT最大值为12.9±2.7 mm，非冠心病组EFT最大值为8.4±2.5 mm。超声心动图显示冠心病组最小EFT为2.2±1.8 mm，非冠心病组最小EFT为1.8±1.4 mm。采用随机效应模型分析各研究间存在异质性(I2=91.8%， p=0.000, Q值=146.43,df [Q] =12)。冠心病患者超声心动图EFT明显高于非冠心病患者(SMD=1.03, 95% CI= 0.70 ~ 1.37, p=0.000)。结论:本荟萃分析结果显示，冠心病患者的超声心动图EFT明显高于非冠心病患者。与其他成像干预相比，考虑到易用性、成本效益和非暴露特性，超声心动图EFT测量似乎是心脏病风险分层的一种可接受的策略。

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引用次数: 13

Effectiveness of neurofeedback training on verbal memory, visual memory and self-efficacy in students. 神经反馈训练对学生言语记忆、视觉记忆和自我效能感的影响。

Electronic Physician

Pub Date : 2018-09-09 eCollection Date: 2018-09-01 DOI: 10.19082/7259

Mohammad Nazer, Hanifeh Mirzaei, Mohammadreza Mokhtaree

Background: Memory is the basis for the development of language skills and learning processes, and self-efficacy is one of the most important predictors of academic achievement.

Objective: This study aimed to determine the effects of neurofeedback training (NFB) on verbal and visual memory and self-efficacy in students of Rafsanjan University of Medical Sciences.

Methods: This quasi-experimental study was conducted on students of Rafsanjan University of Medical Sciences (Rafsanjan, Iran). Twenty-six students without severe neuropsychological disorder, history of epilepsy and drug abuse were selected randomly and divided into two groups. First, the participants completed the Morgan-Jinks Student Efficacy Scale (MJSES) and then were assessed by Kim Karad Visual Memory Test (KKVMT) and Wechsler Memory Scale for verbal memory (WMSVM). The experimental group underwent 15 sessions of neurofeedback training (NFB) for increase in sensorimotor response (SMR) in central zero (Cz) and fronto-central zero (FCz) location at the psychology clinic Rafsanjan University of Medical Sciences. Visual and verbal memory and self-efficacy were assessed by KKVMT, WMSVM and MJSES after completion of sessions and one month later. Posttest and follow-up of the control group were also carried out simultaneously with the experimental group. Data were analyzed in SPSS version 16, using descriptive statistical and repeated measures ANCOVA. The significance level of examining the hypotheses was set at p≤0.05.

Results: The Mean±SD of verbal memory in the experimental group in pretest, posttest and follow-up was 20±1.9, 22.58±2.1, 22.41±2.06 respectively (p<0.001, Effect size= 0.53).There were significant changes in short-term (p=0.001, Effect size =0.41) and long-term (p=0.001, Effect size =0.42) visual memory. The changes of mid-term visual memory and self-efficacy in the experimental group were not significant (p=0.135, p=0.062).

Conclusion: NFB is effective in improving verbal memory and some dimensions of visual memory. Further studies are needed to achieve better results.

背景:记忆是语言技能和学习过程发展的基础，而自我效能感是学业成就最重要的预测因素之一。目的:探讨神经反馈训练(NFB)对拉夫桑詹医科大学学生语言、视觉记忆和自我效能的影响。方法:以伊朗拉夫桑詹医科大学学生为研究对象进行准实验研究。随机选取无严重神经心理障碍、无癫痫史、无药物滥用史的学生26例，分为两组。被试首先完成Morgan-Jinks学生效能量表(MJSES)，然后采用Kim Karad视觉记忆测验(KKVMT)和Wechsler言语记忆量表(WMSVM)进行评估。实验组在拉夫桑詹医科大学心理诊所接受了15次神经反馈训练(NFB)，以提高中央零点(Cz)和前中央零点(FCz)位置的感觉运动反应(SMR)。在疗程结束后和1个月后分别用KKVMT、WMSVM和MJSES评估视觉、言语记忆和自我效能感。对照组与实验组同时进行后测和随访。数据分析采用SPSS version 16，采用描述性统计和重复测量ANCOVA。检验假设的显著性水平设为p≤0.05。结果:实验组言语记忆前测、后测和随访的均数±SD分别为20±1.9、22.58±2.1、22.41±2.06 (p)结论:NFB对言语记忆和部分视觉记忆维度有改善作用。需要进一步的研究来取得更好的结果。

{"title":"Effectiveness of neurofeedback training on verbal memory, visual memory and self-efficacy in students.","authors":"Mohammad Nazer, Hanifeh Mirzaei, Mohammadreza Mokhtaree","doi":"10.19082/7259","DOIUrl":"https://doi.org/10.19082/7259","url":null,"abstract":"Background: Memory is the basis for the development of language skills and learning processes, and self-efficacy is one of the most important predictors of academic achievement.Objective: This study aimed to determine the effects of neurofeedback training (NFB) on verbal and visual memory and self-efficacy in students of Rafsanjan University of Medical Sciences.Methods: This quasi-experimental study was conducted on students of Rafsanjan University of Medical Sciences (Rafsanjan, Iran). Twenty-six students without severe neuropsychological disorder, history of epilepsy and drug abuse were selected randomly and divided into two groups. First, the participants completed the Morgan-Jinks Student Efficacy Scale (MJSES) and then were assessed by Kim Karad Visual Memory Test (KKVMT) and Wechsler Memory Scale for verbal memory (WMSVM). The experimental group underwent 15 sessions of neurofeedback training (NFB) for increase in sensorimotor response (SMR) in central zero (Cz) and fronto-central zero (FCz) location at the psychology clinic Rafsanjan University of Medical Sciences. Visual and verbal memory and self-efficacy were assessed by KKVMT, WMSVM and MJSES after completion of sessions and one month later. Posttest and follow-up of the control group were also carried out simultaneously with the experimental group. Data were analyzed in SPSS version 16, using descriptive statistical and repeated measures ANCOVA. The significance level of examining the hypotheses was set at p≤0.05.Results: The Mean±SD of verbal memory in the experimental group in pretest, posttest and follow-up was 20±1.9, 22.58±2.1, 22.41±2.06 respectively (p<0.001, Effect size= 0.53).There were significant changes in short-term (p=0.001, Effect size =0.41) and long-term (p=0.001, Effect size =0.42) visual memory. The changes of mid-term visual memory and self-efficacy in the experimental group were not significant (p=0.135, p=0.062).Conclusion: NFB is effective in improving verbal memory and some dimensions of visual memory. Further studies are needed to achieve better results.","PeriodicalId":11603,"journal":{"name":"Electronic Physician","volume":"10 9","pages":"7259-7265"},"PeriodicalIF":0.0,"publicationDate":"2018-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.19082/7259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36528769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

The validation of the PRISMA-7 questionnaire in community-dwelling elderly people living in Antalya, Turkey. PRISMA-7问卷在土耳其安塔利亚社区居住老年人中的有效性分析。

Electronic Physician

Pub Date : 2018-09-09 eCollection Date: 2018-09-01 DOI: 10.19082/7266

Hakan Yaman, Zeynep Ünal

Background: The screening of frailty in older adults is an important issue in the preventive approach in medicine. Frailty is one of the leading causes of morbidity and premature mortality in older adults.

Objective: The aim of this study was to validate the PRISMA-7 questionnaire in community-dwelling elderly people living in Antalya, Turkey.

Methods: This study was cross-sectional and observational in nature and was conducted in Antalya (Turkey) from February 2016 to April 2017. One hundred fifty patients participated in this study. PRISMA-7 and the CSHA Clinical Frailty Scale were applied to these patients along with a questionnaire on socio-demographics. No translations were available for the PRISMA-7 or the CSHA in Turkish language. The PRISMA-7 and the CSHA Clinical Frailty Scale were translated by two translators to Turkish language; after compilation and agreeing to one Turkish translation, the text was translated back by two translators to English. The translation was then compiled to one text and compared with the original text. After agreement on the translation, both translations were piloted in 10 elderly people. The final form has been applied in this study. Data of the ten piloted patients have not been included into the dataset. Data were analyzed by IBM-SPSS version 22, using descriptive statistics, Pearson product-moment correlation, and receiver operator characteristic (ROC) analysis. The level of significance was set at 0.05.

Results: Our study showed that participants were in average vulnerability to frailty. The test-retest reliability score for the PRISMA-7 Scale and for the CSHA Clinical Frailty Scale were (r= 99.2; p<0.001) and (r=97.5; p<0.05), respectively. After using CSHA Clinical Frailty Scale as a reference standard, PRISMA-7 showed that the area under ROC curve (AUC) was 0.903; which is the best accuracy; and medium level for internal consistency (Cronbach's α =0.714) as a measure for reliability. A cut-off point of 4 or higher for PRISMA-7revealed high sensitivity (81.5%) and specificity (88.2%) for frailty.

Conclusion: We would recommend PRISMA-7 as a reliable and valid instrument, with high-level accuracy in the screening process of frailty.

背景:老年人虚弱的筛查是医学预防方法中的一个重要问题。虚弱是老年人发病和过早死亡的主要原因之一。目的:本研究的目的是在土耳其安塔利亚的社区居住老年人中验证PRISMA-7问卷。方法:本研究为横断面观察性研究，于2016年2月至2017年4月在土耳其安塔利亚进行。150名患者参与了这项研究。对这些患者应用PRISMA-7和CSHA临床虚弱量表以及社会人口统计问卷。没有PRISMA-7或CSHA的土耳其语译本。PRISMA-7和CSHA临床虚弱量表由两名翻译人员翻译成土耳其语;在编辑并同意一个土耳其语翻译后，文本由两名翻译人员翻译回英语。然后翻译成一个文本，并与原文进行比较。双方就翻译达成一致后，两种翻译都在10位老年人中进行了试点。最后一种形式已应用于本研究。10名试点患者的数据尚未纳入数据集。数据分析采用IBM-SPSS第22版，采用描述性统计、Pearson积差相关和receiver operator characteristic (ROC)分析。显著性水平设为0.05。结果:我们的研究表明，参与者处于平均脆弱状态。PRISMA-7量表和CSHA临床虚弱量表的重测信度得分为(r= 99.2;结论:PRISMA-7在衰弱筛查过程中具有较高的准确性，是一种可靠、有效的检测工具。

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引用次数: 12