Exploring associations between self-reported executive functions,impulsive personality traits,driving self-efficacy,and functional abilities in driver behaviour after brain injury

ObjectiveThe assessment of self-awareness and self-efficacy as they relate to driving after stroke and TBI is lacking in the literature where the focus has tended to be on neuropsychological testing of underlying component of cognition in predicting driving outcome. Therefore, this study aims to investigate the associations between self-rating of higher-level functions and post-injury driving behaviour.MethodsThe present one-year follow-up study included twenty-four adults with stroke and ten adults with traumatic brain injury (TBI) deemed suitable for driving after a comprehensive driving evaluation according to Norwegian regulations. In addition, but not part of the decision making, baseline measurements included self-rating of executive functions (Behaviour Rating of Executive Function (BRIEF-A)), impulsive personality traits (UPPS Impulsive Behaviour Scale), driving self-efficacy (Adelaide Driving Self-Efficacy Scale (ADSES)), and functional abilities (Awareness Questionnaire (AQ)). Follow-up measurements twelve months after baseline were collected, the ADSES, AQ, and Swedish Driver Behaviour Questionnaire (Swedish DBQ).ResultsPerceived driving self-efficacy and functional abilities did not change from baseline to follow-up. Baseline perceived executive functions and impulsive personality traits were significantly associated with driving self-efficacy at follow-up. Lower self-efficacy and functional abilities were associated with lower driving mileage and increased use of compensatory driving strategies, whereas lower self-efficacy beliefs were associated with driver mistakes and inattention. Driver violations and inattention were associated with minor accidents.ConclusionThe present study demonstrates that higher-level functions such as executive functions, impulsive personality traits, driving self-efficacy and functional abilities, influence post-injury accident involvement mediated through proximal driving factors such as driver inattention. Further evidence is warranted to explore self-rating measures compared to performance-based methods as predictors of risky driver behaviour, crashes, and near misses.     

An evaluation of video-prompting procedures via telehealth to teach first aid skills to children with intellectual and developmental disabilities

Unintentional injuries are one of the leading causes of morbidity and mortality among children with intellectual and developmental disabilities (IDD). First aid training involves teaching critical first aid skills, some of which are designed to treat unintentional injuries. To date, no study has (a) evaluated the effects of a video-prompting procedure to teach first aid skills to children with IDD or (b) attempted to teach these skills to children by using a telehealth delivery format. We used a concurrent multiple-baseline-across-skills design to evaluate the efficacy of a video-prompting procedure via telehealth to teach five children with IDD to perform first aid on themselves for insect stings, minor cuts, and minor burns under simulated conditions. For all participants, our procedure produced large improvements that maintained for a minimum of 4 weeks. Furthermore, the effects of the training generalized to novel confederates for all participants, and these effects maintained for a minimum of 4 weeks.     

医生、护士对PICC告知态度的调查研究

了解医生护士对PICC告知态度。自设问卷调查北京市两所医院执行PICC操作科室医生护士。医生护士认为操作前应向患者告知并签署同意书,部分原因有统计学差异;临床主要采取“医生告知、护士实施”模式;双方均倾向于降低自身法律风险的告知模式,赞成国家出台护士进行特殊告知的法律文件。建议现阶段采取医护共同告知模式。     

Predictive validity of the Westmead Post-Traumatic Amnesia Scale for functional outcomes in school-aged children who sustained traumatic brain injury

The Westmead Post-Traumatic Amnesia Scale (WPTAS) is routinely used for the assessment of post-traumatic amnesia (PTA) in children who sustained traumatic brain injury (TBI). Yet, the WPTAS' predictive validity for functional outcomes is largely unknown. We aimed to determine whether PTA duration measured by the WPTAS (i) differentially predicts functional outcomes and (ii) contributes to predictions of outcomes beyond the Glasgow Coma Scale (GCS) in children who sustained TBI. Participants were children and adolescents with moderate-to-severe TBI (n = 55) aged 8–15 years. PTA duration was assessed with the WPTAS. Outcomes at the first outpatient follow-up were scored on the Kings Outcome Scale for Childhood Head Injury (KOSCHI) and the TBI Outcome Domain Scale-Extended (ODS-E). Longer PTA and lower GCS were both significantly correlated with worse (i) global outcomes: presence of disability on the KOSCHI and lower score on the ODS-E and (ii) select specific outcomes on the ODS-E: mobility, mood and cognition. PTA duration predicted cognitive outcome on the ODS-E independently, beyond GCS. Together, PTA duration and GCS, predicted the global KOSCHI outcome, as well as the ODS-E mobility and mood outcomes. Neither GCS nor PTA duration correlated with the ODS-E communication, impulsivity/disinhibition, headache, fatigue, sensory impairments or somatic complaints outcomes. PTA duration measured by the WPTAS is a significant unique predictor of functional cognitive outcomes in children who sustained moderate-to-severe TBI, and in combination with the GCS, a significant predictor of global, and several specific functional outcomes.     

Development of a Career Stress Scale for Hospital Nurses: Implications for Workplace Counseling

The author performed 3 studies to investigate the construct validation and applicability of a Career Stress Scale for hospital nurses. After conducting an exploratory factor analysis on a sample of 141 nurses in the 1st study, the author examined divergent and convergent validity in the 2nd study, and performed a confirmatory factor analysis to test the hypothesized model on a sample of 284 teaching hospital nurses. The final study aimed to expand the findings, and the author used multigroup structural equation modeling to examine the measurement invariance of the Career Stress Scale for a district hospital, in a sample of 166 nurses. Recommendations for future studies and workplace counseling are discussed.