Background: The government in Taiwan has promoted breastfeeding in recent years yet, exclusive initiation rates and continuation of breastfeeding remain low. Maternal attitudes have been found to be better predictors of infant feeding method during the postpartum period than socio-demographic factors. Understanding maternal attitudes related to infant feeding in Taiwan will support the development of better targeted, more effective health promotion programs aimed at increasing breastfeeding rates. Objectives: To examine maternal attitudes toward breastfeeding and the relationship of these factors to breastfeeding duration at six weeks postpartum. The Iowa Infant Feeding Attitude Scale (IIFAS) was translated into Chinese for this study; a secondary aim of the study was to assess the psychometric properties of the translated tool. Design: A prospective longitudinal study. Setting: A public hospital in Taichung City, Taiwan. Participants: Using convenience sample. 140 in-hospital breastfeeding mothers were recruited in the hospital setting to complete the IIFAS. A total of 120 (86%) completed 3 week follow-up interview and of those who continued to breastfeed 102 women (100%) were contacted at 6 weeks and completed the study protocol. Methods: Following a systematic translation procedure, mothers completed IIFAS questionnaire in the hospital. Then, participating women were contacted by telephone at three weeks and six weeks postpartum to obtain information regarding infant feeding status and duration. Results: Maternal breastfeeding attitudes were the only predictive factor of the breastfeeding duration (p=0.05). The Cronbach’s alpha for internal consistency was 0.73. In-hospital IIFAS scores significantly predicted infant feeding methods at six weeks postpartum. 72.9% (n=102) of the mothers were breastfeeding their infants, of which 37 mothers (26.4%) were exclusively breastfeeding, 65 mothers (46.4%) were partially breastfeeding at three weeks postpartum. These102 breastfeeding mothers were continued to be followed through six weeks postpartum. 62.1% (n=87) were still breastfeeding their infants, of which 34 mothers (24.3%) were exclusively breastfeeding and 53 mothers (37.9%) were partially breastfeeding at six weeks postpartum. Insufficient milk supply was the reason most often given for discontinuing breastfeeding. Conclusions: Maternal attitudes were related to breastfeeding duration. This study provides evidence that the translated version of the IIFAS is a valid and reliable tool to assess breastfeeding attitudes among Taiwanese mothers in the population tested. Breastfeeding rates showed that the low rates of exclusive breastfeeding. Health professionals might use this tool to identify mothers at increase risk for not continuing with exclusive breastfeeding and intervention strategies need to be developed to improve rates of successful exclusive breastfeeding.

The thesis deals with the development of identity in adolescence, especially the differentiation between the disharmonic and harmonious development. The main focus was the translation and cultural adaptation as well as the testing of the foreign self-report questionnaire AIDA (Assessment of Identity Development in Adolescence), which was accompanied by another research method - an open question asking the respondents for self- description. The AIDA questionnaire is aimed at detecting and recognition of the dangers of identity development in adolescence. One of the chief goals of the thesis is also checking the psychometric properties of these methods and their comparison. Among other determinants, age groups (11-18 years) and sex, or, gender of the respondents were taken into account. In 2012 Goth, Foelsch, Schlüter-Müller and Schmeck introduced the reliable and valid self-report questionnaire AIDA (Assessment of Identity Development in Adolescence), to assess pathology-related identity development in healthy and disturbed adolescents. The culture-adequate formulations for every original item were developed in a series of beta-tests, pilot tests, and a main testing to establish the Czech version of AIDA. Specific cultural idioms and culture-specific aspects were considered. During the main testing,...

Title: Interrater reliability of assessment set of clinical features of patients with multiple sclerosis Objectives: The aim of this thesis is to verify interrater reliability of the assessment set of clinical features of patients with multiple sclerosis which purpose is to evaluate sensitivly and comprehensivly the stage of the patients' clinical condition. Methods: According to the inclusion criteria, the patients with MS were selected by an independent neurologist who determined the EDSS score and duration of the disease. After, patients were evaluated by the assessment set by two independent physiotherapists. The assessment set of clinical features incluedes Low-Contrast Letter Acuity Test which tests contrast vision, Nine Hole Peg Test investiges fine motor skills, Timed 25 - Foot Walk evaluates walking speed over a distance of 7,5 m, Paced Auditory Serial Addition assesses cognitive function, Motricity Index tests muscle strength, Modified Ashworth Scale spasticity, Berg balance Scale equilibrium. Furthemore, the tests for evaluation of righting, equilibrium and protective reactions, the test evaluating knee hyperextension, the examination of dysdiadochokinesia and ataxia. Results: High interrater reliability was confirmed in all tests in the examinig set (ICC: 0,80 - 1), except for MAS...

Existem evidências de que as manifestações psicóticas não são vivenciadas apenas por pessoas diagnosticadas com transtornos mentais, mas também por pessoas saudáveis da população geral, as denominadas experiências tipo-psicóticas. A Escala de Avaliação das Experiências Psíquicas na Comunidade (CAPE) é um instrumento usado em pesquisas epidemiológicas e foi desenvolvido especificamente para a detecção e avaliação da frequência de experiências tipo-psicóticas na população geral. A CAPE, em sua apresentação original é composta por 42 itens, distribuídos em três dimensões: positiva, negativa e depressiva. O objetivo deste estudo foi verificar as evidências de fidedignidade e validade da CAPE em uma amostra brasileira e investigar a associação de traumas na infância e uso de cannabis com a ocorrência de experiências tipo-psicóticas em indivíduos da população geral. A amostra foi composta por 217 pacientes em primeiro episódio psicótico, 104 irmãos de pacientes psicóticos e 319 controles de base populacional, todos residentes na área de cobertura do Departamento Regional de Saúde do Estado de São Paulo (DRS XIII). Os participantes responderam a instrumentos de avaliação e diagnósticos, incluindo a Entrevista Clínica Estruturada para o DSM IV (SCID), o Questionário sobre Traumas na Infância (CTQ), Questionário de Experiências com Maconha (CEQ), além da CAPE. Os dados clínicos foram analisados por meio do pacote estatístico SPSS e as evidências psicométricas por meio do software AMOS. Após a retirada de nove itens, a CAPE, com 33 itens, mostrou bons índices de ajustamento [CFI = 0,895; GFI = 0,822; PGFI = 0,761; RMSEA = 0,055 p (rmsea <= 0,05) = 0,04] e boa consistência interna (> 0,70) em todos as suas dimensões. Nas análises realizadas apenas com a amostra de base populacional, não foram encontradas diferenças significativas entre as pontuações totais da CAPE-33 e das suas três dimensões quanto a intervalos de idade, estado civil e escolaridade. Mulheres apresentaram pontuações significativamente mais elevadas do que os homens no escore total (p<0,001) e nas dimensões negativa (p < 0,001) e depressiva (p < 0,001). A vivência de traumas na infância (abuso emocional, abuso físico, abuso sexual, negligência emocional, negligência física) associou-se com pontuações mais elevadas no escore total da CAPE (p <0,001) e nas suas três dimensões (positiva p = 0.001, negativa p = 0,004, depressiva p < 0,001). Indivíduos que relataram uso de cannabis alguma vez na vida apresentaram maiores pontuações na dimensão positiva da CAPE-33, em comparação às pessoas que nunca usaram a substância (p = 0,016). A CAPE adaptada para o Brasil (CAPE-33) mostrou bons índices de ajustamento e consistência interna, como encontrado em outras culturas. Presença de trauma precoce e uso de cannabis associaram-se à ocorrência de experiências tipo-psicóticas, à semelhança do que os estudos epidemiológicos mostram para a esquizofrenia. Nossos dados corroboram a abordagem dimensional das psicoses, com frequência e gravidade das manifestações se distribuindo num continnum na população geral. / There is evidence that psychotic manifestation is not experienced only by people diagnosed with mental disorders but also by healthy people in the general population, known as psychotic-like experiences. The Community Assessment Psychic Experiences (CAPE) is an instrument used in epidemiological research and was developed specifically for the detection and evaluation of the frequency of psychotic-like experiences in the general population. The CAPE, in its original submission, is composed of 42 items, distributed in three dimensions: positive, negative and depressive. The objective of this study was to verify the evidence of reliability and validity the CAPE in a brazilian sample and to investigate the association of childhood traumas and cannabis use with the occurrence of psychotic-like experiences in individuals of the general population. The sample consisted of 217 patients in the first psychotic episode, 104 siblings of psychotic patients and 319 population-based controls, all residents in the coverage area of the São Paulo Regional Health Department (DRS XIII). Participants responded to assessment and diagnostic tools, including the Structured Clinical Interview for DSM IV (SCID), the Childhood Trauma Questionnaire (CTQ), the Cannabis Experience Questionnaire (CEQ), and CAPE. Clinical data were analyzed using SPSS statistical package and the psychometric evidence using AMOS software. After the removal of nine items, CAPE, with 33 items, showed good adjustment indices [CFI = 0.895; GFI = 0.822; PGFI = 0.761; RMSEA = 0.055 p (rmsea <= 0.05) = 0.04] and good internal consistency (> 0.70) in all its dimensions. In the analyzes performed only with the population-based sample, no significant differences were found between the CAPE-33 total scores and its three dimensions regarding age, marital status and schooling intervals. Women presented scores significantly higher than men in the total score (p <0.001) and in the negative (p <0.001) and depressive (p <0.001) dimensions. The experience of childhood traumas (emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect) was associated with higher scores in the CAPE total score (p <0.001) and its three dimensions (positive p = 0.001, negative p = 0.004, depressive p <0.001). Individuals who reported cannabis use in their lifetime had higher scores in the positive dimension of the CAPE-33 compared to people who had never used the substance (p = 0.016). The CAPE adapted to Brazil (CAPE-33) showed good adjustment indices and internal consistency, as found in other cultures. Presence of early trauma and use of cannabis were associated with the occurrence of psychotic-like experiences, in accordance with what epidemiological studies show for schizophrenia. Our data corroborate the dimensional approach of the psychoses, with frequency and severity of the manifestations being distributed in a continnum in the general population.

A crescente importância da QV enquanto desfecho em saúde fez o grupo WHOQOL, da OMS, elaborar medidas de avaliação de QV para utilização internacional. Com a necessidade de instrumentos menores que demandassem pouco tempo para o preenchimento, foi desenvolvido o EUROHIS-QOL 8-ITEM, originado dos itens do WHOQOL- BREF. Objetivos: Testar as propriedades psicométricas do EUROHIS-QOL 8-ITEM em uma amostra brasileira. Métodos: A amostra foi constituída de 325 indivíduos. Eles foram divididos em dois grupos, 151 indivíduos constituiram o grupo dos doentes do Hospital de Clínicas de Porto Alegre, RS, e 174 o grupo dos saudáveis. Para a avaliação das propriedades psicométricas do índice EUROHIS-QOL 8-ITEM, foram realizadas algumas análises. A Consistência Interna, foi avaliada usando o Alpha de Cronbach. A validade discriminante foi avaliada comparando o grupo de doentes e saudáveis e também o de deprimidos e não-deprimidos. A análise da validade convergente ocorreu através da correlação do EUROHIS-QOL 8-ITEM com diferentes medidas de QV já validadas e reconhecidas, o SF-36 e o WHOQOL-BREF. A análise fatorial foi avaliada usando o modelo de equação estrutural (SEM). Avaliou-se a unidimensionalidade usando as propriedades do modelo de Rasch. Resultados: A consistência interna avaliada pelo Alpha de Cronbach (com valor de 0,81) monstrou-se boa. O índice EURO-HIS–QOL 8-ITEM também mostrou boa capacidade discriminativa entre os grupos de doentes e saudáveis (média1=3,32; DP1=0,70; média2=3,77; DP2=0,63 t =6,12, p < 0,001) e também entre os grupos de deprimidos e não deprimidos (média3=3,14; DP3=0,69; média4=3,72; DP4=0,61 t = 7,25 p <0,001). O instrumento demonstrou boa validade convergente, através de correlações significativas (p < 0,001) entre o EUROHIS-QOL 8-ITEM e todos os domínidos do WHOQOL- BREF (QV Geral r = 0,47; Saúde Geral r= 0,54; Físico r = 0,69; Psicológico r = 0,62; Relações Sociais r = 0,55; Meio Ambiente r = 0,55) e entre o EUROHIS-QOL 8-ITEM e os domínios do SF-36 (QV Geral r = 0,36; Capacidade Funcional r =0,49; Limitação Física r = 0,45; Dor r = 0,43; Saúde Geral r = 0,52; Vitalidade r = 0,21; Aspectos Sociais r = 0,45; Aspectos Emocionais r = 0,38 e Saúde Mental r = 0,17), com exceção do domínio social (p = 0,38). Na análise de Rasch, as medidas de ajuste geral do modelo apresentaram adequado desempenho estatístico e foi considerado um bom ajuste logo na primeira avaliação (Ajuste de resíduo Interação Item pessoa: M= 0,01 e DP= 1,51; ajuste de resíduo de pessoa: M = -0,38 e DP= 1,19 e Item traço: Item total X²=69,60 p=0,00. Personal Separation Index = 0,82), ou seja, os resíduos foram aceitáveis, não foi preciso excluir itens. O EUROHIS-QOL 8-ITEM, apresentou bom ajuste aos dados na análise fatorial confirmatória (X²= 18,46; DF= 15; CFI= 0,99; RMSEA= 0,03; GFI = 0,99; RMR=0,03; P = p,24). Conclusão: O EURHIS-QOL 8-ITEM, validado em amostras europeias apresentou adequadas propriedades psicométricas neste estudo, mostrando-se uma medida confiável de QV para ser usada em amostras brasileiras. / In the 70s, quality of life began to be considered a health outcome. With the growing importance of this assessment in different areas of medicine, there were no instruments developed in the cross-cultural perspective for international use. In this context, quality of life assessement outcome measures were developed by the WHOQOL group from WHO. With the need of shorter instruments which demanded less time to be filled in, the EUROHIS-QOL 8 ITEM was developed, originated from WHOQOL-BREF items. Objectives: Test the psychometric properties of EUROHIS-QOL 8-ITEM in a Brazilian sample. Methods: The sample consisted of 325 individuals. They were divided in to two groups, 151 subjects constituted the group of patients from the Hospital de Clinicas de Porto Alegre, RS, and 174 subjects the group of healthy controls. Some analyses were performed for the assessment of the psychometric properties of EUROHIS-QOL 8-ITEM index. Internal consistency was measured by using Cronbach’s alpha. Discriminant validity was assessed by comparing the group of patients and healthy controls and also the depressed and nondepressed. Analysis of convergent validity was through the correlation of EUROHIS-QOL 8-ITEM with different quality of life measures already validated and recognized as the SF-36 and WHOQO-BREF. Factor analysis was assessed using structural equation model (SEM). Unidimensionality was assessed using the properties of the Rasch model. Results: The Cronbach's alpha showed good internal consistency (with a value of 0.81). The measure also showed good discriminative ability between the groups of patients and healthy controls (mean1=3.32; SD1=0.70; mean2=3.77; SD2=0.63 t =6.12, p = 0,00) and between the depressed and nondepressed groups (mean3=3.14; SD3=0.69; mean4=3.72; SD4=0.61 t = 7.25 p =0.00). The instrument showed good convergent validity through significant correlations ( p < 0.001 ) between the EUROHIS–QOL 8-ITEM and all domains of WHOQOL-BREF (QV Overall r = 0.47; General Health r= 0.54; Physical Health r = 0.69; Psychological Health r = 0.62; Social Relationship r = 0.55; Meio Environment r = 0.55) and between EUROHIS-QOL 8-ITEM and the domains of the SF-36 (QV Overall r = 0.36; Functioning Physical r =0.49; Role Physical r = 0.45; Bodily Pain r = 0.43; General Health r = 0.52; Vitality r = 0.21; Social Functioning r = 0.45; Role Emotional r = 0.38 and Mental Health r = 0.17) , except for the social domain ( p = 0.38). In the Rasch analysis, general fit measures of the model had adequate statistical performance and were considered a good fit at the first assessment (residual fit Item-person Interaction: M = 0.01, SD = 1.51; person residual fit: M = -0.38, SD = 1.19 and Item-trait: Total Item X² = 69.60 p = 0.00. Personal Separation Index = 0.82), that is, the residuals were acceptable, it was not necessary to exclude items. The EUROHIS-QOL 8-ITEM showed a good fit to the data in the confirmatory factor analysis (X² = 18.46, DF = 15; CFI = 0.99; RMSEA = 0.03; GFI = 0.99; RMR = 0.03; P = 24). Conclusion: EUROHIS-QOL 8-ITEM, validated in European samples, showed adequate psychometric properties in this study showing to be a reliable quality of life measure to be used in Brazilian samples.

Existem evidências de que as manifestações psicóticas não são vivenciadas apenas por pessoas diagnosticadas com transtornos mentais, mas também por pessoas saudáveis da população geral, as denominadas experiências tipo-psicóticas. A Escala de Avaliação das Experiências Psíquicas na Comunidade (CAPE) é um instrumento usado em pesquisas epidemiológicas e foi desenvolvido especificamente para a detecção e avaliação da frequência de experiências tipo-psicóticas na população geral. A CAPE, em sua apresentação original é composta por 42 itens, distribuídos em três dimensões: positiva, negativa e depressiva. O objetivo deste estudo foi verificar as evidências de fidedignidade e validade da CAPE em uma amostra brasileira e investigar a associação de traumas na infância e uso de cannabis com a ocorrência de experiências tipo-psicóticas em indivíduos da população geral. A amostra foi composta por 217 pacientes em primeiro episódio psicótico, 104 irmãos de pacientes psicóticos e 319 controles de base populacional, todos residentes na área de cobertura do Departamento Regional de Saúde do Estado de São Paulo (DRS XIII). Os participantes responderam a instrumentos de avaliação e diagnósticos, incluindo a Entrevista Clínica Estruturada para o DSM IV (SCID), o Questionário sobre Traumas na Infância (CTQ), Questionário de Experiências com Maconha (CEQ), além da CAPE. Os dados clínicos foram analisados por meio do pacote estatístico SPSS e as evidências psicométricas por meio do software AMOS. Após a retirada de nove itens, a CAPE, com 33 itens, mostrou bons índices de ajustamento [CFI = 0,895; GFI = 0,822; PGFI = 0,761; RMSEA = 0,055 p (rmsea <= 0,05) = 0,04] e boa consistência interna (> 0,70) em todos as suas dimensões. Nas análises realizadas apenas com a amostra de base populacional, não foram encontradas diferenças significativas entre as pontuações totais da CAPE-33 e das suas três dimensões quanto a intervalos de idade, estado civil e escolaridade. Mulheres apresentaram pontuações significativamente mais elevadas do que os homens no escore total (p<0,001) e nas dimensões negativa (p < 0,001) e depressiva (p < 0,001). A vivência de traumas na infância (abuso emocional, abuso físico, abuso sexual, negligência emocional, negligência física) associou-se com pontuações mais elevadas no escore total da CAPE (p <0,001) e nas suas três dimensões (positiva p = 0.001, negativa p = 0,004, depressiva p < 0,001). Indivíduos que relataram uso de cannabis alguma vez na vida apresentaram maiores pontuações na dimensão positiva da CAPE-33, em comparação às pessoas que nunca usaram a substância (p = 0,016). A CAPE adaptada para o Brasil (CAPE-33) mostrou bons índices de ajustamento e consistência interna, como encontrado em outras culturas. Presença de trauma precoce e uso de cannabis associaram-se à ocorrência de experiências tipo-psicóticas, à semelhança do que os estudos epidemiológicos mostram para a esquizofrenia. Nossos dados corroboram a abordagem dimensional das psicoses, com frequência e gravidade das manifestações se distribuindo num continnum na população geral. / There is evidence that psychotic manifestation is not experienced only by people diagnosed with mental disorders but also by healthy people in the general population, known as psychotic-like experiences. The Community Assessment Psychic Experiences (CAPE) is an instrument used in epidemiological research and was developed specifically for the detection and evaluation of the frequency of psychotic-like experiences in the general population. The CAPE, in its original submission, is composed of 42 items, distributed in three dimensions: positive, negative and depressive. The objective of this study was to verify the evidence of reliability and validity the CAPE in a brazilian sample and to investigate the association of childhood traumas and cannabis use with the occurrence of psychotic-like experiences in individuals of the general population. The sample consisted of 217 patients in the first psychotic episode, 104 siblings of psychotic patients and 319 population-based controls, all residents in the coverage area of the São Paulo Regional Health Department (DRS XIII). Participants responded to assessment and diagnostic tools, including the Structured Clinical Interview for DSM IV (SCID), the Childhood Trauma Questionnaire (CTQ), the Cannabis Experience Questionnaire (CEQ), and CAPE. Clinical data were analyzed using SPSS statistical package and the psychometric evidence using AMOS software. After the removal of nine items, CAPE, with 33 items, showed good adjustment indices [CFI = 0.895; GFI = 0.822; PGFI = 0.761; RMSEA = 0.055 p (rmsea <= 0.05) = 0.04] and good internal consistency (> 0.70) in all its dimensions. In the analyzes performed only with the population-based sample, no significant differences were found between the CAPE-33 total scores and its three dimensions regarding age, marital status and schooling intervals. Women presented scores significantly higher than men in the total score (p <0.001) and in the negative (p <0.001) and depressive (p <0.001) dimensions. The experience of childhood traumas (emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect) was associated with higher scores in the CAPE total score (p <0.001) and its three dimensions (positive p = 0.001, negative p = 0.004, depressive p <0.001). Individuals who reported cannabis use in their lifetime had higher scores in the positive dimension of the CAPE-33 compared to people who had never used the substance (p = 0.016). The CAPE adapted to Brazil (CAPE-33) showed good adjustment indices and internal consistency, as found in other cultures. Presence of early trauma and use of cannabis were associated with the occurrence of psychotic-like experiences, in accordance with what epidemiological studies show for schizophrenia. Our data corroborate the dimensional approach of the psychoses, with frequency and severity of the manifestations being distributed in a continnum in the general population.

Patient adherence to in-clinic rehabilitation is between 30-70% and even lower for home exercise programs (HEPs). Barriers to patient adherence have been identified and include but are not limited to anxiety, depression, lack of positive feedback, lack of social support, lack of time, low levels of physical activity at baseline, pain during exercise, and low self-efficacy. As clinicians prescribing rehabilitation may not be able to influence all of the identified barriers, they may positively influence others. Self-efficacy, or an individual’s belief in his/her ability to successfully complete a task, is a patient barrier that may be addressed by a clinician when aware of low self-efficacy and have tools to improve this barrier. Interventions to overcome this specific barrier have demonstrated an increase in not only self-efficacy but patient adherence as well. Although interventions have proven to be successful, patient adherence has yet to increase according to the literature. At this time, there is no evidence to suggest that clinicians are assessing an individual’s level of self-efficacy prior to prescribing HEPs. In addition, there is no known metric to measure self-efficacy for HEPs in patients rehabilitating musculoskeletal conditions. Assessment of patient barriers, specifically self-efficacy, needs to be a standard of care in order to increase adherence, in turn, improve patient outcomes and to reduce the cost to our healthcare system. The first purpose of this dissertation was to determine in patients with musculoskeletal conditions what scales have been developed and evaluated for assessing self-efficacy in conjunction with adherence. In addition, to determine if a tool exists specifically to assess self-efficacy for HEPs. Due to the task and situation-specific nature of self-efficacy, it is important that this construct is reflected in the assessments utilized by clinicians. The second purpose was to determine the importance and utilization of patients’ self-efficacy to physical therapists when addressing patient barriers. This included determining how physical therapists assess patient self-efficacy and barriers to assessment. The third purpose was to develop the Self-Efficacy for Home Exercise Programs Scale and determine the psychometric properties of the instrument. This also allowed for the examination of how self-efficacy relates to patient adherence in a musculoskeletal patient population. The results of the first study suggest that within the musculoskeletal literature, a number of scales are being used to assess patient self-efficacy. These scales are either task, situation, or condition specific. No scale was found to assess self-efficacy for HEPs. This finding indicates the need to develop a scale to assess self-efficacy for HEPs. In the second study, 71% (n = 329/464) of physical therapists, disclosed assessing self-efficacy prior to prescribing HEPs and rated self-efficacy as very to extremely important when it comes to their patients’ adherence. Verbal discussion is the most common method of self-efficacy assessment (50%), followed by observation of the patient (38%), then patient self-report questionnaires (10%). Commonly, physical therapists report using verbal discussion and observation in combination. Of the 29% of the physical therapists that do not assess self-efficacy, 40% report not knowing how to assess self-efficacy, 19% are not sure what to do with the information once self-efficacy is assessed, 16% claim there are other barriers to assessment, 15% claim that assessing self-efficacy will not change their practice, another 9% claim assessing self-efficacy takes too much time, and the last 1% do not know what self-efficacy is. These results further suggest the need for a scale to assess self-efficacy for HEPs. The purpose of the final study was to developed a Self-Efficacy for Home Exercise Programs Scale. The scale was found to have high internal consistency (α = 0.96), acceptable test-retest reliability (ICC = 0.8, SEM = 5, MDC = 7), and strong convergent validity with the Self-Efficacy for Exercise scale (rho(ρ) = 0.83, p < 0.01). Unique to this scale, a cutoff score was determined to be 59 points with a positive likelihood ratio of 2.0 (95% CI 1.1 – 2.5) indicating those who score below 59 points on the SEHEPS would be 2 times more likely to be non-adherent than adherent to their HEP. A weak to moderate, positive relationship was detected between the patients’ initial level of self-efficacy for their HEP and adherence (rho(ρ) = 0.38, p = 0.03). These results suggest that the Self-Efficacy for Home Exercise Programs Scale may be utilized by rehabilitation clinicians to assess self-efficacy for HEPs. Clinically, this scale may provide clinicians the ability to decipher patients who are not likely to adhere to their prescribed HEP, allowing clinicians to intervene immediately. Early intervention to improve self-efficacy may increase adherence to HEPs and eventually patient outcomes.

Depression is a mental illness that requires prompt identification and treatment due to grave consequences if untreated. Depression can affect a person's level of functioning, lead to worsening health conditions, comorbid substance abuse, and suicide. Despite these facts, the current state of nursing practice includes an inadequate diagnosis of patients with depression, lack of guidelines for the use of assessment tools and diagnostic tests to identify depression, and insufficient information concerning the accuracy of depression assessment tools. This systematic literature review examined 6 depression assessment tools in regard to their accuracy as identified by specificity, sensitivity, reliability, and validity. This project also examined the pros and cons, demographics, and healthcare settings that use these depression inventory tools. This project used the Orlando nursing process theory as a theoretical framework. Based on the review of 10 articles selected, evidence showed that the Hamilton depression rating scale has the highest sensitivity (93%) and specificity (97%) rates. The implications for positive social change include the opportunity for clinicians to use the findings of this project in their selection of depression assessment tools in healthcare settings. Other researchers can use this project as a valuable resource for management of major depressive disorders.

Thesis (M.A. (Industrial Psychology))--North-West University, Potchefstroom Campus, 2007.

The aim of this study was to determine the psychometric properties of a shortened version of the Zimbardo Time Perspective Inventory (ZTPI) in an African context. This self-report questionnaire, referred to as the Zimbardo Time Perspective Inventory -Revised Form (ZTPI-RF) consists of 20 items representing the five subscales of the original scale, namely: Past-Positive, Past-Negative, Present-Hedonistic, Present-Fatalistic and Future. The ZTPI-RF was completed by participants (N=1050) from urban (n=451) and rural (n=599) areas in the North-West Province of South Africa, together with a number of measures of psychological well-being. These scales, which were included for criterion-related validity purposes, were the Affectometer 2 (short version) (Kammann & Flett, 1983), the Satisfaction with Life Scale (Diener, Emmons, Larsen & Griffin, 1985), Sense of Coherence Scale (Antonovsky, 1987, 1993) and the General Health Questionnaire (Goldberg & Hillier, 1979). Results regarding the reliability and construct validity of the ZTPI-RF and its subscales were unsatisfactory. Qualitative data was also obtained, and analyzed by means of direct content analysis to help establish a picture of how time perspective prevails in an African context, and to determine whether time perspective is associated with psychological well-being. Qualitative results showed that participants from an African context were strongly oriented toward the present and that social support played the most prominent role regarding participants' attitude toward the present. It was concluded that the ZTPI-RF is, in its current form, not reliable for the determination of time perspective of individuals from an African context, and that a longitudinal qualitative approach might be best suited to obtain information about the nature and dynamics of time perspective in an African context. / Thesis (M.A. (Psychology))--North-West University, Potchefstroom Campus, 2008.