A comparison of the revised Delirium Rating Scale (DRS–R98) and the Memorial Delirium Assessment Scale (MDAS) in a palliative care cohort with DSM–IV delirium

Objective: Assessment of delirium is performed with a variety of instruments, making comparisons between studies difficult. A conversion rule between commonly used instruments would aid such comparisons. The present study aimed to compare the revised Delirium Rating Scale (DRS–R98) and Memorial Delirium Assessment Scale (MDAS) in a palliative care population and derive conversion rules between the two scales. Method: Both instruments were employed to assess 77 consecutive patients with DSM–IV delirium, and the measures were repeated at three-day intervals. Conversion rules were derived from the data at initial assessment and tested on subsequent data. Results: There was substantial overall agreement between the two scales [concordance correlation coefficient (CCC) = 0.70 (CI95 = 0.60–0.78)] and between most common items (weighted κ ranging from 0.63 to 0.86). Although the two scales overlap considerably, there were some subtle differences with only modest agreement between the attention (weighted κ = 0.42) and thought process (weighted κ = 0.61) items. The conversion rule from total MDAS score to DRS–R98 severity scores demonstrated an almost perfect level of agreement (r = 0.86, CCC = 0.86; CI95 = 0.79–0.91), similar to the conversion rule from DRS–R98 to MDAS. Significance of results: Overall, the derived conversion rules demonstrated promising accuracy in this palliative care population, but further testing in other populations is certainly needed

Psychometric analysis of the Greek version of the Sibling Relationship Questionnaire

Οι αδελφικές σχέσεις συνιστούν σημαντικό παράγοντα δόμησης της συναισθηματικής αλλά και της όλης ανάπτυξης του ατόμου. παρά το ότι η Ελλάδα είναι μια χώρα όπου οι οικογενειακοί δεσμοί είναι ισχυροί, η έρευνα στο πεδίο της αδελφικής σχέσης είναι ελάχιστη. η έλλειψη αυτή οφείλεται, εν μέρει, στην απουσία έγκυρων δοκιμασιών. το SRQ, συνιστά μια ευρέως χρησιμοποιούμενη δοκιμασία στην έρευνα της αδελφικής σχέσης. στόχος της έρευνας είναι να μεταφράσει και να αναλύσει της ψυχομετρικές ιδιότητες του SRQ. το δείγμα της έρευνας αποτέλεσαν 185 παιδιά και έφηβοι. διερευνήθηκαν τα εξής: συγκλίνουσα εγκυρότητα, εσωτερική συνέπεια, επανέλεγχος αξιοπιστίας, συμφωνία ανάμεσα στις δοκιμασίες των παιδιών και των γονιών. η συγκλίνουσα εγκυρότητα κυμαινόταν από 0.29-0.68, η εσωτερική συνέπεια ήταν 0.86 και οεπανέλεγχος αξιοπιστίας κυμαινόταν από 0.58-0.78. η συμφωνία ανάμεσα στις δοκιμασίες των παιδιών και των γονιών ήταν σημαντική μόνο ως προς της μητέρες. η παραγοντική ανάλυση των δυο σημαντικό-τερων διαστάσεων της αδελφικής σχέσης (ζεστασιά/εγγύτητα και σύγκρουση) όπως εντοπίστηκαν στην πρωτότυπη έκδοση της δοκιμασίας, έδειξε ότι είναι εξίσου σημαντικές στην Ελληνική εκδοχή του SRQ.συνεπώς, η Ελληνική εκδοχή του SRQ συνιστά μια έγκυρη και αξιόπιστη δοκιμασία που μπορεί να χρησιμοποιηθεί στον Ελληνικό πληθυσμό και σε συγκριτικές έρευνες με πληθυσμούς άλλων χωρών.Siblings’ relationships are determinants of emotional and personal development. Although Greece is assumed a country with strong family bonds, no empirical research in this area exists; one of the reasons being the lack of reliable instruments. The SRQ is a widely used scale to measure this relationship. The aim of the present study was to translateand examine the psychometric properties of SRQ. One hundred and eighty five children and adolescents were recruited. Concurrent validity, internal consistency, test-retest reliability and agreement between parents-children versions of the translated scale were investigated. Concurrent validity ranged from 0.29 to 0.68, the overall internal consistency was 0.86 and the test-retest reliability ranged from 0.58 to 0.78. Agreement between children-parents versions was significant only when mothers do the rating. Confirmatory factor analysis for the two important dimensions Warmth/Closeness and Conflict, which have been identified in the original study it shows that they are also present also in the Greek version. Thus, the Greek version of SRQ is a valid and reliable instrument to be used within the Greek population, for multinational clinical research and for comparison with findings from other countries

Burnout in mental health services in Ireland during the COVID-19 pandemic

Background Burnout is a consequence of chronic occupational stress. Specific work-related factors may contribute to burnout experienced by those working in mental health services (MHS), many of which have increased since the COVID-19 pandemic. Aims To examine personal, work- and patient-related burnout among MHS staff in Ireland during the COVID-19 pandemic, and explore the impact of work-related conditions on burnout. Method We conducted a cross-sectional survey of three MHS across Ireland utilising a study-specific questionnaire, the Copenhagen Burnout Inventory and the Effort–Reward Imbalance scale. Results Of 396 participants, 270 (70.6%) were female. Moderate and high personal burnout was experienced by 244 (64.1%) participants; work-related burnout by 231 (58.5%) participants and patient-related burnout by 83 (21.5%) participants. Risk factors for both personal and work-related burnout were female gender, urban service, time spent outside main responsibilities, overcommitment, high score on the Effort–Reward Imbalance scale and intention to change job. Being younger, with high workload and deterioration of personal mental health during the pandemic was associated with higher personal burnout, whereas a lack of opportunity to talk about work-related stress contributed to work-related burnout. Fewer factors were associated with patient-related burnout, namely overcommitment, working in urban services and poorer physical and mental health during the COVID-19 pandemic. Conclusions High levels of personal and work-related burnout were found among mental health workers. The weak association with COVID-19-related factors suggest levels of burnout predated the pandemic. This has implications for MHS given the recognised additional work burden created by COVID-19

A pilot study of performance among hospitalised elderly patients on a novel test of visuospatial cognition: the letter and shape drawing (LSD) test.

peer-reviewedObjectives. Conventional bedside tests of visuospatial function such as the clock drawing (CDT) and intersecting pentagons tests (IPT) are subject to considerable inconsistency in their delivery and interpretation. We compared performance on a novel test – the letter and shape drawing (LSD) test –with these conventional tests in hospitalised elderly patients. Methods. The LSD, IPT, CDT and the Montreal Cognitive Assessment (MoCA) were performed in 40 acute elderly medical inpatients at University Hospital Limerick The correlation between these tests was examined as well as the accuracy of the visuospatial tests to identify significant cognitive impairment on the MoCA. Results. The patients (mean age 81.0±7.71; 21 female) had a median MoCA score of 15.5 (range = 1–29). There was a strong, positive correlation between the LSD and both the CDT (r = 0.56) and IPT (r = 0.71). The correlation between the LSD and MoCA (r = 0.91) was greater than for the CDT and IPT (both 0.67). The LSD correlated highly with all MoCA domains (ranging from 0.54 to 0.86) and especially for the domains of orientation (r = 0.86), attention (0.81) and visuospatial function (r = 0.73). Two or more errors on the LSD identified 90% (26/29) of those patients with MoCA scores of ⩽20, which was substantially higher than for the CDT (59%) and IPT (55%). Conclusion. The LSD is a novel test of visuospatial function that is brief, readily administered and easily interpreted. Performance correlates strongly with other tests of visuospatial ability, with favourable ability to identify patients with significant impairment of general cognition.PUBLISHEDpeer-reviewe

Low peripheral levels of insulin growth factor-1 are associated with high incidence of delirium among elderly patients: A systematic review and meta-analysis

Introduction Delirium, a serious condition observed in critically ill patients, clinically presents with impaired cognition and consciousness. The relationship between delirium and peripheral levels of insulin growth factor-1 (IGF-1) is unclear. Thus we conducted a meta-analysis to address this issue. Methods Seven major electronic databases were searched from inception until October 2, 2017 to obtain relevant clinical variables to compare the difference in IGF-1 levels between delirious and non-delirious elderly in-patients. A random effects meta-analysis was conducted. Results We studies 10 articles involving 294 delirious patients (mean age 73.0 years) and 604 non-delirious patients (mean age 76.9 years). We found that peripheral levels of IGF-1 in patients with delirium were significantly lower than in those without delirium (Hedges‘ g = −0.209, 95% confidence interval [CI] = −0.393 to −0.026, p = 0.025). Meta-regression analyses found that no variables such as percentage of cognitive impairment, mean age, and female proportion contribute to heterogeneity in terms of the entire population. Conclusions Our data suggests that lower peripheral levels of IGF-1 could be associated with a higher incidence of delirium among elderly patients. Further prospective studies with larger sample sizes are needed to investigate the association between peripheral levels of IGF-1 and delirium