The SASI model and score provide important tools to control for stroke severity at time of hospital discharge. It can be used as a risk-adjustment variable in administrative data analyses to measure postdischarge outcomes.
The Rasch equating method successfully created three crosswalks between the FIM motor items and K-MBI, with the equated test items demonstrating good psychometrics. The crosswalks would address the incomparable scoring systems between the FIM motor items and K-MBI. Implications for Rehabilitation The three crosswalk tables (scoring tables) would allow clinicians to compare or translate a patient's motor scores between the FIM and K-MBI. The crosswalk tables would allow health-care administrators to track patients' functional status across various rehabilitation facilities that exclusively use the FIM or K-MBI.
Objective
To investigate the impact of age and sex on 30-, 60- and 90-day hospital readmission after acute hospital discharge for individuals with traumatic brain injury (TBI).
Design
Retrospective cohort study.
Setting
Acute hospitals and post-acute discharge settings
Participants
From the 2013 Nationwide Readmissions Database, we retrieved information on 52,877 individuals with diagnosis-related group codes of TBI. We included only those alive at index acute discharge and excluded those discharged with same-day readmission. We divided our sample into four age groups: 18-40, 41-65, 66-75 and 76+ years old.
Interventions
NA.
Main Outcome Measure(s)
All-cause hospital readmission.
Results
Sex differences in 30-, 60- and 90-day hospital readmission were found for all age groups (all p<.05). The largest sex differences in hospital readmission were in the two oldest groups (66-75, 76+). For both sexes, the oldest group (76+) had the highest adjusted 90-day readmission risk [e.g., 90-day readmission: Odds Ratio (OR) = 2.32 (2.01-2.69) for males; OR=1.96 (1.59-2.43) for females]. Among those readmitted within 90 days, the youngest group (18-40 years) had the highest cumulative readmission percent (35% for both sexes) within the first week post-hospital discharge.
Conclusion
Age and sex were significantly associated with hospital readmission during the first 90 days post-discharge in our TBI sample. Specifically, those aged 66-75 or 76+ had the highest readmission risk over 90 days for both sexes. The findings suggest that clinicians should consider age and sex in discharge planning and for the entire episode of care for the TBI population.
Importance: Societal stigma gravely impedes occupational justice for transgender and gender-nonconforming (TGNC) people, producing vast health disparities for this population.
Objective: To test the feasibility of an intervention to reduce stigma and improve the well-being of TGNC people.
Design: A parallel, mixed-methods design was used to test feasibility in the areas of acceptability, demand, and limited efficacy.
Setting: Community.
Participants: Forty-two audience members and 5 TGNC interviewees.
Intervention: Virtual, narrative-informed play reading and moderated discussion about gender diversity and affirmative care.
Outcomes and Measures: The valid and reliable Acceptance and Action Questionnaire–Stigma was used to assess stigma beliefs. An open-ended, qualitative question assessed TGNC interviewees’ experiences.
Results: Recruitment and participant responses to the intervention indicated feasibility in the areas of acceptability, demand, and limited efficacy. However, future efforts at obtaining a diverse TGNC sample are needed.
Conclusions and Relevance: The intervention decreased stigma beliefs in audience members and offered a positive experience for TGNC participants. Feasibility outcomes warrant future efficacy testing.
What This Article Adds: This article adds an innovative intervention for promoting occupational justice to support the health and well-being of TGNC people. The community-based intervention facilitates change in societal attitudes and stigmatizing beliefs.
Purpose
The aim of this study is to investigate the psychometrics of the Patient-Reported Outcomes Measurement Information System self-efficacy for managing daily activities item bank.
Methods
The item pool was field tested on a sample of 1087 participants via internet (n = 250) and in-clinic (n = 837) surveys. All participants reported having at least one chronic health condition. The 35 item pool was investigated for dimensionality (confirmatory factor analyses, CFA and exploratory factor analysis, EFA), item-total correlations, local independence, precision, and differential item functioning (DIF) across gender, race, ethnicity, age groups, data collection modes, and neurological chronic conditions (McFadden Pseudo R2 less than 10 %).
Results
The item pool met two of the four CFA fit criteria (CFI = 0.952 and SRMR = 0.07). EFA analysis found a dominant first factor (eigenvalue = 24.34) and the ratio of first to second eigenvalue was 12.4. The item pool demonstrated good item-total correlations (0.59–0.85) and acceptable internal consistency (Cronbach’s alpha = 0.97). The item pool maintained its precision (reliability over 0.90) across a wide range of theta (3.70), and there was no significant DIF.
Conclusion
The findings indicated the item pool has sound psychometric properties and the test items are eligible for development of computerized adaptive testing and short forms.
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