Objective: This study investigated the inter- and intra-rater reliability of the Australian Spasticity Assessment Scale (ASAS) in adults with unilateral hypertonia following acquired brain injury. The ASAS has been sh...Objective: This study investigated the inter- and intra-rater reliability of the Australian Spasticity Assessment Scale (ASAS) in adults with unilateral hypertonia following acquired brain injury. The ASAS has been shown to be superior to other clinical tools for the assessment of spasticity in children with cerebral palsy but reliability has not been previously examined in adults. Method: Four muscle groups were rated on one occasion by four assessors using the ASAS in sixteen adults with unilateral hypertonia following acquired brain injury. Twelve participants returned one week later for reassessment by the same assessors. Results: Overall inter-rater reliability of the ASAS using a quadratic weighted Kappa was moderate (Kqw 0.58) with ranges from moderate to good (Kqw 0.42 - 0.70). Agreement between raters was greatest for soleus muscle and least for wrist flexors. Overall intra-rater reliability of each of the four raters was moderate to good (Kqw 0.48 - 0.79). Agreement within raters was greatest for soleus muscle and least for biceps muscle. Conclusions: The ASAS may represent an appropriate alternative to the clinical scales currently used to assess spasticity;however inter and intra-rater reliability data from this investigation are lower than those which have previously been reported by experienced users of the ASAS in children with cerebral palsy. Further investigation with a larger sample size is warranted before any firm conclusions may be drawn about the reliability and validity of this tool to assess spasticity in adults with acquired brain injury.展开更多
目的探讨品管圈(quality control circle,QCC)活动在降低老年患者静脉采血穿刺失败率中的应用效果。方法便利抽样法选取2015年9月至2016年8月在解放军总医院就诊的老年患者306例为研究对象,将QCC活动实施前(2015年9月至2016年2月)的153...目的探讨品管圈(quality control circle,QCC)活动在降低老年患者静脉采血穿刺失败率中的应用效果。方法便利抽样法选取2015年9月至2016年8月在解放军总医院就诊的老年患者306例为研究对象,将QCC活动实施前(2015年9月至2016年2月)的153例患者为对照组,活动实施后(2016年3-8月)的153例患者为观察组,成立以"降低老年静脉采血穿刺失败率"为主题的QCC活动小组,分析老年患者静脉采血失败原因,根据相关因素制订针对性措施并在活动中落实,达到降低采血失败率的目的。结果 QCC活动展开后,观察组患者的静脉穿刺失败率低于对照组患者,护理满意度高于对照组患者,差异均有统计学意义(均P<0.05)。结论 QCC活动的实施可以有效降低老年静脉采血穿刺失败率,有利于提升患者采血过程中的舒适度。展开更多
文摘Objective: This study investigated the inter- and intra-rater reliability of the Australian Spasticity Assessment Scale (ASAS) in adults with unilateral hypertonia following acquired brain injury. The ASAS has been shown to be superior to other clinical tools for the assessment of spasticity in children with cerebral palsy but reliability has not been previously examined in adults. Method: Four muscle groups were rated on one occasion by four assessors using the ASAS in sixteen adults with unilateral hypertonia following acquired brain injury. Twelve participants returned one week later for reassessment by the same assessors. Results: Overall inter-rater reliability of the ASAS using a quadratic weighted Kappa was moderate (Kqw 0.58) with ranges from moderate to good (Kqw 0.42 - 0.70). Agreement between raters was greatest for soleus muscle and least for wrist flexors. Overall intra-rater reliability of each of the four raters was moderate to good (Kqw 0.48 - 0.79). Agreement within raters was greatest for soleus muscle and least for biceps muscle. Conclusions: The ASAS may represent an appropriate alternative to the clinical scales currently used to assess spasticity;however inter and intra-rater reliability data from this investigation are lower than those which have previously been reported by experienced users of the ASAS in children with cerebral palsy. Further investigation with a larger sample size is warranted before any firm conclusions may be drawn about the reliability and validity of this tool to assess spasticity in adults with acquired brain injury.
文摘目的探讨品管圈(quality control circle,QCC)活动在降低老年患者静脉采血穿刺失败率中的应用效果。方法便利抽样法选取2015年9月至2016年8月在解放军总医院就诊的老年患者306例为研究对象,将QCC活动实施前(2015年9月至2016年2月)的153例患者为对照组,活动实施后(2016年3-8月)的153例患者为观察组,成立以"降低老年静脉采血穿刺失败率"为主题的QCC活动小组,分析老年患者静脉采血失败原因,根据相关因素制订针对性措施并在活动中落实,达到降低采血失败率的目的。结果 QCC活动展开后,观察组患者的静脉穿刺失败率低于对照组患者,护理满意度高于对照组患者,差异均有统计学意义(均P<0.05)。结论 QCC活动的实施可以有效降低老年静脉采血穿刺失败率,有利于提升患者采血过程中的舒适度。
