Content Validation of Clinical Evidence Related to Self-Care Deficits of Patients With Stroke

Oliveira‐Kumakura, Ana Railka de Souza; Silva, Kelly Cristina Rodrigues da; Sousa, Cássia Milena Freitas Machado; Biscaro, Jessica Aparecida; Spagnol, Gabriela Salim; Morais, Sheila Coelho Ramalho Vasconcelos

doi:10.1097/rnj.0000000000000225

Cited by 3 publications

(4 citation statements)

References 24 publications

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“…Part of this finding may be attributed to the limited use of the mRS in these categories, as it is primarily the responsibility of physicians to conduct this assessment in Brazil. Furthermore, culturally in Brazil, physical therapists more commonly adopt other scales, like the Barthel index, 22 to evaluate post-stroke functionality. 22 Even with the adoption of iRankin, physical therapists showed "weak" congruence.…”

Section: Discussionmentioning

confidence: 99%

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An automated flowchart for the Modified Rankin Scale assessment: A multicenter inter-rater agreement analysis

C de Andrade,

Quinn,

Carbonera

et al. 2024

International Journal of Stroke

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Background and objective The Modified Rankin Scale (mRS) is a widely adopted scale for assessing stroke recovery. Despite limitations, the mRS has been adopted as primary outcome in most recent clinical acute stroke trials. Designed to be used by multidisciplinary clinical staff, the congruency of this scale is not consistent, which may lead to mistakes in clinical or research application. We aimed to develop and validate an interactive and automated digital tool for assessing the mRS – the iRankin. Methods A panel of five board-certified and mRS-trained vascular neurologists developed an automated flowchart based on current mRS literature. Two international, experts were consulted on content and provided feedback on the prototype platform. The platform contained five vignettes, and five real video cases, representing mRS grades 0-5. For validation, we invited neurological staff from six comprehensive stroke centers to complete an online assessment. Participants were randomized into two equal groups usual practice versus iRankin. The participants were randomly allocated in pairs for the congruency analysis. Weighted kappa (kw) and proportions were used to describe agreement. Results A total of 59 professionals completed the assessment. The weight-Kappa was dramatically improved among Nurses 0.76 (95% CI 0.55-0.97) x 0.30 (0.07-0.67), and among Vascular Neurologists 0.87 (0.72-1) x 0.82 (0.66-0.98). In the accuracy analysis, after the standard mRS values for the vignettes and videos were determined by a panel of experts, and considering each correct answer as equivalent to 1 point on a scale of 0-15, it revealed a higher mean of 10.6 (±2.2) in the iRankin group and 8.2 (±2.3) points in the control group (p=0.02). In an adjusted analysis, the iRankin adoption was independently associated with the score of congruencies between reported and standard scores (Beta-coefficient 2.22, 95% CI 0.64-3.81, p-value= 0.007). Conclusion The iRankin adoption led to a substantial or near-perfect agreement in all analyzed professional categories. More trials are needed to generalize our findings. Our user-friendly and free platform is available at www.irankinscale.com

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Section: Discussionmentioning

confidence: 99%

“…Furthermore, culturally in Brazil, physical therapists more commonly adopt other scales, like the Barthel index, 22 to evaluate post-stroke functionality. 22 Even with the adoption of iRankin, physical therapists showed "weak" congruence. This finding may also be attributed to their aforementioned lower familiarity with the mRS.…”

Section: Discussionmentioning

confidence: 99%

An automated flowchart for the Modified Rankin Scale assessment: A multicenter inter-rater agreement analysis

C de Andrade,

Quinn,

Carbonera

et al. 2024

International Journal of Stroke

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“…It can also be seen that nursing students reflected not only the physical problems of rehabilitation patients, but also psy- chosocial problems in the nursing process. According to the preceding literature, the occurrence of self-care deficit after stroke is usually aftereffects of cerebral hypoperfusion (Everard et al, 2021;Oliveira-Kumakura et al, 2020;Oliveira-Kumakura et al, 2021), and nursing diagnosis associated with self-care deficits also show an association with motor and sensorial aftereffects. Third, it is necessary to examine the diagnostic indicators that includes defining characteristics, related/risk factors of each nursing diagnosis that nursing students select for rehabilitation patients.…”

Section: Discussionmentioning

confidence: 99%

The analysis of nursing diagnoses determined by students for patients in rehabilitation units

Park¹,

Jeong²

2022

J Exerc Rehabil

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This study aimed to analyze nursing diagnoses determined by the nursing students for pa-tients in rehabilitation unit. Data were collected from 190 case reports submitted by the nursing students who practiced in the rehabilitation unit, and analyzed on the basis of North American Nursing Diagnosis Association (NANDA) International, Inc. nursing diagnoses. Thirty different diagnoses were documented in rehabilitation unit. The most frequent nursing diagnosis was im-paired physical mobility (n= 68, 14.6%). The 30 diagnoses were grouped into 10 domains and 20 classes of the NANDA International, Inc. human response patterns. The average quality of nursing statements corresponded to a score of 8.63, indicating relatively good quality. The re-sults of this study will help to improve the quality of nursing process education and provide guidelines to improve the quality of nursing care for the rehabilitation nursing situation in Korea.

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“…All involved were previously trained (12 hr), and data collection was initiated only after agreement among raters was obtained. Moreover, to reduce the risk of bias assessment, the data collectors used a previously validated instrument with operational definitions to assess each defining characteristic (Oliveira-Kumakura et al, 2019).…”

Section: Methodsmentioning

confidence: 99%

Clinical Validation of Nursing Diagnoses Related to Self-Care Deficits in Patients with Stroke

et al. 2019

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To clinically validate the defining characteristics of nursing diagnoses related to self-care deficits in feeding, bathing, toileting, and dressing in patients with stroke. A diagnostic accuracy study was conducted with a sample of 135 patients with stroke. Sensitivity and specificity were calculated based on the latent class analysis method using the random effects model. The prevalence of diagnoses was 23.5% for Bathing self-care deficit, 18.5% for Dressing self-care deficit, 13.3% for Toileting self-care deficit, and 7.5% for Feeding self-care deficit. Fourteen defining characteristics were sensitive, and 17 were specific. Hemorrhagic stroke and note 4 on the Rankin scale was associated with self-care deficits. Of the 37 defining characteristics of the four diagnoses studied, 19 were clinically validated according to the latent class analysis model. These most accurate clinical indicators contribute to the development of the care plan for patients with stroke.

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Content Validation of Clinical Evidence Related to Self-Care Deficits of Patients With Stroke

Cited by 3 publications

References 24 publications

An automated flowchart for the Modified Rankin Scale assessment: A multicenter inter-rater agreement analysis

An automated flowchart for the Modified Rankin Scale assessment: A multicenter inter-rater agreement analysis

The analysis of nursing diagnoses determined by students for patients in rehabilitation units

Clinical Validation of Nursing Diagnoses Related to Self-Care Deficits in Patients with Stroke

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