Thesis (MMed)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Numerous tests exist for the assessment of general cognitive functioning. Most of these tests
were developed within the discipline of psychology. Neuropsychological tests are very useful,
but have some limitations. Administration of the tests is limited to a psychologist, is very timeconsuming
in that it can take 3-8 hours to administer and often need specialized equipment.
At the other end of the continuum are very brief screening tests. General practitioners,
psychiatrists and occupational therapists, in addition to psychologists, also use these tests.
Although useful, the short tests only provide limited information. An intermediate level test
streamlining the assessment process between the very short and longer neuropsychological
tests is therefore introduced by this study.
The Bedside Cognitive Assessment Battery (BCAB) was developed in 1995 and are since
used, at Tygerberg Hospital's Memory Clinic, to assess patients and teach students. The test
comprehensively assesses the six main classes of cognitive functioning, namely attention
and concentration, speech, memory, motor functioning, perceptual functioning and executive
functioning. Approximately 35-45 minutes is required for administration and training is
needed to administer the BCAB. No specialized equipment is needed for administration. The
battery can therefore be used at the bedside, in the office or at old age homes.
The aims of this study were to validate the BCAB for use with people aged eighteen years
and older, and provide normative values for use in clinical settings. The test was revised in
1997 and 2001, and extensively so in 2002, but was never formally evaluated for validity.
Well-known single tests were used to compile the BCAB. Most of these tests have proven
validity and reliability, but only for foreign populations. In addition, some items were
reformulated and others created by the researchers. The introduction of normative values
would also be useful to assist in the delineation of cognitively intact and impaired individuals.
This study succeeded in providing a table of normative values.
One-hundred-and-sixty Afrikaans and English participants, and fourteen Xhosa participants
were assessed in their mother tongue language. This project thus also introduced a Xhosa
version of the BCAB. The purpose of the Xhosa version was to address the lack of culturally
relevant cognitive assessment instruments. Results were evaluated for the effects of the
variables' language, gender, age and education. The effect of language was most noticeable
in the Xhosa group. Gender did not affect results as dramatically as age and especially,
education. These significant effects on the aforementioned variables have been described in previous reports. The BCAB is thus relevant and useful as a detector of mild to moderate
impairment. It can also be used to identify specific impairment. This can narrow down the
investigation of psychologists, thus saving time and money. In addition, medical and nonmedical
staff can use the BCAB.
Some limitations were also identified. The sample used may limit the generalization of
results. Some test items also need revision, along with further validation studies. Clinicians
are therefore advised to use the BCAB only in addition to complete clinical examinations
when making decisions regarding a patient's cognitive status. The BCAB appears to be a
valid tool for bedside assessment. However, this study could only set the stage for further
research, especially studies concerned with establishing normative values. / AFRIKAANSE OPSOMMING: Verskeie toetse bestaan vir die evaluering van algemene kognitiewe funksionering, waarvan
die meeste ontwikkel is binne die sielkunde. Neuro-sielkundige toetse is baie bruikbaar, maar
het sekere beperkings. Administrasie van die toetse is beperk tot sielkundiges, maar
tydrowend weens 'n tydsduur van drie tot agt uur, en verg dikwels gespesialiseerde
toerusting. Aan die ander kant is heelwat kart siftings-toetse beskikbaar. Aigemene
praktisyns, sielkundiges en arbeidsterapeute, asook sielkundiges, gebruik dit. Hoewel
bruikbaar, bied die kart toetse beperkte inligting. 'n lntermediere vlak toets om die
evaluerings-proses tussen kart en langer neuro-sielkundige toetse te integreer word met
hierdie studie beoog.
Die Bedkant Kognitiewe Evaluasie Battery (BKEB) is in 1995 ontwikkel en gebruik in die
Geheue-kliniek van die Tygerberg Hospitaal om pasiente te evalueer en studente op te lei.
Die toets is gerig op die omvattende evaluering van die ses hoof-klasse van kognitiewe
funksionering. Hierdie klasse omvat aandag en konsentrasie, spraak, geheue, motoriese
funksionering, perseptuele funksionering en uitvoerende funksionering. Sowat 35 tot 45
minute word benodig vir administrasie terwyl opleiding vereis word vir die neem van die
toets. Geen gespesialiseerde toerusting is nodig nie. Die battery kan dus by die bedkant, in
die kantoor of in ouetehuise gebruik word.
Die doelwitte van hierdie studie is om die BKEB te evalueer in gebruik by 18-jariges en ouer,
en normatiewe waardes te bepaal vir gebruik in kliniese omgewings. Die toets is in 1997 en
2001 hersien. In 2002 is dit uitvoerig hersien, maar nooit ge-evalueer vir geldigheid nie.
Bekende enkel-toetse is gebruik am die BKEB saam te stel. Dit is as geldig en betroubaar
bewys, hoewel slegs onder buitelandse bevolkingsgroepe. Hierbenewens is sekere items
herformuleer en ander bygewerk deur die navorsers. Normatiewe waardes sal oak handig
wees in die afbakening van kognitief normaal-funksionerende en kognitief-ingekorte
individue. Hierdie studie het daarin geslaag am 'n tabel van normatiewe waardes daar te stel.
Een-honderd-en-sestig Afrikaans- en Engels-sprekendes, en 14 Xhosa-sprekendes is tydens
hierdie studie in hulle moedertaal ge-evalueer. Hierdie projek het dus oak 'n Xhosaweergawe
van die BKEB geskep. Die doel van die Xhosa-weergawe was am die gebrek aan
'n kultureel toepaslike kognitiewe instrument te beklemtoon. Resultate is ge-evalueer
gedagtig aan veranderlikes soos taal, geslag, ouderdom en opleidingsvlak. Taal het die
grootste invloed gehad op uitslae van Xhosa-deelnemers. Geslag het nie die uitslae so dramaties bernvloed soos ouderdom, en veral opleidingsvlak nie. Literatuur het meestal die
groot uitwerking van hierdie veranderlikes bevestig. Die BKEB is dus relevant en handig in
die naspeuring van ligte tot matige kognitiewe ingekortheid. Dit kan ook gebruik word om
spesifieke kognitiewe ingekortheid te identifiseer. Die kan die omvang van ondersoek deur
sielkundiges vernou, wat kan lei tot In groot besparing in tyd en geld. Hierbenewens kan
mediese en nie-mediese personeel aangewend word in die gebruik van die BKEB.
Sekere tekortkominge is ge·,dentifiseer. Die steekproef mag egter die veralgemening van die
uitslae beperk. Sekere toets-items mag ook hersiening vereis, tesame met verdere
geldigheid-studies. Kliniese praktisyns word daarom aangeraai om die BKEB slegs in
aanvulling tot omvattende kliniese ondersoeke te gebruik vir besluite m.b.t. In pasient se
kognitiewe status. Die BKEB kom voor as In geldige instrument vir bedkant evaluering.
Hierdie studie kon egter slegs die tafel dek vir verdere ondersoek, veral t.o.v. studies wat
poog om normatiewe waardes daar te stel.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/50219 |
| Date | 04 1900 |
| Creators | Roos, Annerine |
| Contributors | Hugo, Frans J., Daniels, Willem M. U., Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Psychiatry. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 125, [75] p. : ill. |
| Rights | Stellenbosch University |
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