Purpose: Preference-based summary scores are used to quantify values, differences, and changes in health-related quality of life (HRQoL) that can be used for cost-effectiveness analyses. The PROMIS-Preference (PROPr) measure is a preference-based summary score comprised of 7 PROMIS domains. The PROMIS-16 is a new PROMIS profile instrument.
View Article and Find Full Text PDFQuality improvement (QI) in medicine is reliant on a team-based approach and an understanding of core QI principles. Part 2 of this continuing medical education series outlines the steps of performing a QI project, from identifying QI opportunities, to carrying out successive Plan-Do-Study-Act cycles, to hard-wiring improvements into the system. QI frameworks will be explored and readers will understand how to interpret basic QI data.
View Article and Find Full Text PDFPatient safety (PS) and quality improvement (QI) have gained momentum over the last decade and are becoming more integrated into medical training, physician reimbursement, maintenance of certification, and practice improvement initiatives. While PS and QI are often lumped together, they differ in that PS is focused on preventing adverse events while QI is focused on continuous improvements to improve outcomes. The pillars of health care as defined by the 1999 Institute of Medicine report "To Err is Human: Building a Safer Health System" are safety, timeliness, effectiveness, efficiency, equity, and patient-centered care.
View Article and Find Full Text PDFObjective: Veterans with spinal cord injuries and disorders (SCI/D) utilizing Veterans Affairs healthcare facilities are also Medicare eligible. Use of multiple health care systems potentially duplicates or fragments care in this population; yet little is known about those using multiple systems. This study describes dual use of services paid for by VA and Medicare among Veterans with SCI/D.
View Article and Find Full Text PDFBackground: Mixed-method studies can shed light on the mechanisms through which interventions effectively reduce caregiver depression.
Objective: The objective of this qualitative study was to understand factors contributing to reduced depressive symptoms in stroke caregiver treatment responders compared with nonresponders.
Methods: A mixed-methods explanatory sequential design was used to assess cognitive behavioral coping use and helpfulness in reducing depression among experimental study treatment responders and nonresponders.
Hundreds of standard measures have been developed to assess a diverse array of conditions, characteristics, and outcomes essential to the practice of medical rehabilitation. These measures provide a common metric needed to coordinate care, communicate with stakeholders, and assess treatment efficacy. Allied health professionals typically rely on functional measures that correspond to their discipline and scope of practice, yet functional outcomes may be dependent on psychological and social (psychosocial) factors that affect a client's capacity to engage and actively participate in their care.
View Article and Find Full Text PDFObjectives: To understand the factor structure of health-related quality of life specific to caregivers of people living with traumatic brain injury (TBI).
Design: Prospective, cross-sectional data collection.
Setting: Three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility.
Introduction: The U.S. Department of Veterans Affairs (VA), the single largest health care system in the United States, provides comprehensive medical and behavioral health services to more than 9 million Veterans.
View Article and Find Full Text PDFObjective: To examine the different sources of medications, the most common drug classes filled, and the characteristics associated with Medicare Part D pharmacy use in veterans with spinal cord injury/disorder (SCI/D).
Design: Retrospective, cross-sectional, observational study.
Setting: Outpatient clinics and pharmacies.
Background Context: Common data elements (CDE) represent an important tool for understanding and classifying health outcomes across settings. Although CDEs have been developed for a number of disorders, to date CDEs for lumbar spinal stenosis (LSS) have not been fully developed. To facilitate the identification of CDEs and measures to assess them, this technical study leverages the International Classification of Functioning, Disability and Health (ICF), peer-reviewed research, and a panel of experts to identify CDEs specific to LSS.
View Article and Find Full Text PDFThe purposes of this study were to develop and validate a measure of unmet resource needs of the caregivers of survivors of stroke and to describe the caregivers' unmet needs during 1 year. A longitudinal, descriptive design was used to test the reliability and validity of the Unmet Resource Needs (URN) measure. Item development was based on literature review and preliminary study findings.
View Article and Find Full Text PDFArch Phys Med Rehabil
January 2014
Clinical translation of research evidence is a challenge for rehabilitation clinicians. Publicly accessible and free, online educational resources that summarize research evidence can support implementation of research evidence into practice. Several online resources have been developed recently to overcome common knowledge translation barriers.
View Article and Find Full Text PDFPurpose: The study purposes were to assess the efficacy of a caregiver problem-solving intervention (CPSI) on stroke caregiver physical and psychosocial adaptation compared with a wait-list control (WLC) treatment, and to assess the mediation effects of coping on outcomes.
Methods: A stress and coping model guided the study design. Outcomes were depression, anxiety, preparedness, life changes, and family functioning.