BackgroundUnderstanding the factors that make it more or less likely that healthcare practitioners (HCPs) will perform certain patient safety behaviors is important in developing effective intervention strategies. A questionnaire to identify determinants of HCP patient safety behaviors does not currently exist. This study reports the development and initial validation of the Influences on Patient Safety Behaviors Questionnaire (IPSBQ) based on the Theoretical Domains Framework.MethodsTwo hundred and thirty-three HCPs from three acute National Health Service Hospital Trusts in the United Kingdom completed the 34-item measure focusing on one specific patient safety behavior (using pH as the first line method for checking the position of a nasogastric tube). Confirmatory factor analysis (CFA) was undertaken to generate the model of best fit.ResultsThe final questionnaire consisted of 11 factors and 23 items, and CFA produced a reasonable fit: χ2 (175) = 345.7, p < 0.001; CMIN/DF = 1.98; GFI = 0.90 and RMSEA = 0.06, as well as adequate levels of discriminant validity, and internal consistency (r = 0.21 to 0.64).ConclusionsA reliable and valid theoretically underpinned measure of determinants of HCP patient safety behavior has been developed. The criterion validity of the measure is still unknown and further work is necessary to confirm the reliability and validity of this measure for other patient safety behaviors.
Introduction
Autosomal dominant tubulo-interstitial kidney disease due to
UMOD
mutations (ADTKD-
UMOD
) is a rare condition associated with high variability in the age of end-stage kidney disease (ESKD). The minor allele of rs4293393, located in the promoter of the
UMOD
gene, is present in 19% of the population and downregulates uromodulin production by approximately 50% and might affect the age of ESKD. The goal of this study was to better understand the genetic and clinical characteristics of ADTKD-
UMOD
and to perform a Mendelian randomization study to determine if the minor allele of rs4293393 was associated with better kidney survival.
Methods
An international group of collaborators collected clinical and genetic data on 722 affected individuals from 249 families with 125 mutations, including 28 new mutations. The median age of ESKD was 47 years. Men were at a much higher risk of progression to ESKD (hazard ratio 1.78,
P
< 0.001).
Results
The allele frequency of the minor rs4293393 allele was only 11.6% versus the 19% expected (
P
< 0.01), resulting in Hardy-Weinberg disequilibrium and precluding a Mendelian randomization experiment. An
in vitro
score reflecting the severity of the trafficking defect of uromodulin mutants was found to be a promising predictor of the age of ESKD.
Conclusion
We report the clinical characteristics associated with 125
UMOD
mutations. Male gender and a new
in vitro
score predict age of ESKD.
We developed a noninvasive immunohistochemical method to detect MUC1fs that, after further validation, may be useful in the future for diagnostic testing. Production of the MUC1fs protein may be central to the pathogenesis of ADTKD-.
Purpose-To evaluate self-referral from the Internet for genetic diagnosis of several rare inherited kidney diseases. Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:
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