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Validation of the short-form Generalized Self-Efficacy scale (GSE-6) in rehabilitation
European Congress of Epidemiology / Revue d’Épidémiologie et de Santé Publique 66S (2018) S277–S437 P9-39
P9-41
Validation of the short-form Generalized Self-Efficacy scale (GSE-6) in rehabilitation
Mortality in a Tunisian intensive care unit
M. Brünger ∗ , K. Spyra Institute of Medical Sociology and Rehabilitation Science, Charite Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany ∗ Corresponding author. E-mail address: [email protected] (M. Brünger) Introduction Self-efficacy (Bandura, 1997) plays a key role in psychological models explaining and predicting health behaviors (Schwarzer et al., 2011). This includes physical activity, nutritional behavior and substance consumption, which are addressed, for example, in interdisciplinary multimodal rehabilitation. The General Self-Efficacy Scale (GSE) is the most widely used instrument to assess this construct and is available in over 30 language versions (Schwarzer and Jerusalem, 1995). However, for economic reasons, it is not always possible to use the GSE in studies or clinical routine. Therefore, the short form GSE6 was proposed, which consists of six out of the original ten items (Romppel et al., 2013). However, there is no validation except for the cited study, which was applied to a sample of the general population and patients with heart failure, only. Hence, the aim of this work is to determine psychometric properties and the validity of GSE-6 among rehabilitation patients. Methods The basis of the reported analysis is a nationwide study in Germany with 2530 insured persons of the Federal German Pension Insurance (Brünger et al., 2016; Brünger and Spyra, 2017). Patients were asked to fill in a questionnaire prior to their rehabilitation. In addition, mental impairment (PHQ-4), depression and anxiety (HADS), impairment due to pain (PDI), health behavior (IRES), social support (IRES), and subjective work ability (WAS) were assessed. The sampling was stratified according to the nine disease groups most common. Psychometric properties were calculated by comparing the short and the original version (GSE-6/GSE). By analogy with the original version, the value range of GSE-6 was transformed to 10 to 40 points. The concurrent validity is reported with Spearman correlations to the other impairments and resources mentioned. Multigroup confirmatory factor analyses (CFA) including gender, age and diagnosis groups demonstrate the factorial validity of both scales. Results Mean sum scores of the short and the original version were quite similar: GSE-6 28.1 (SD: 6.0) points; GSE 27.8 (SD: 6.0) points. In 92.9% of the rehabilitees, the GSE-6 sum score diverged by the GSE sum score with a maximum of ±2 points. Soil effects existed for 2.6% of the rehabilitant patients in GSE-6 (GSE: 2.2%), ceiling effects for 0.5% (GSE: 0.4%). The mean discriminatory power of the items ranged from rix = 0.70 in GSE-6 to rix = 0.74 in GSE. The internal consistency according to Cronbach’s alpha was 0.89 for GSE-6 and 0.93 for GSE. GSE-6 and GSE were correlated with rs = 0.98. The correlations of GSE-6 and GSE to other impairments and resources were in a comparable range: depression (rs = 0.61, rs = 0.62), anxiety (rs = 0.56, rs = 0.57), mental impairment (rs = 0.56, rs = 0.58); social support (rs = 0.41, rs = 0.42); impairment due to pain (rs = −0.40, rs = 0.40); subjective ability to work (rs = 0.37, rs = 0.37) and health behavior (rs = 0.30, rs = 0.31). Stratified analyzes by gender and diagnosis groups provided comparable results. Multigroup CFA confirmed the one-dimensional structure of both scales independently of gender, age and diagnosis group. Conclusions There were only minor differences when using the GSE-6 compared to the original version. The psychometric properties are slightly less favorable on the short scale - as expected due to the lower number of items - but are also at a high level. Thus, an application of the short version in rehabilitation across all major diagnosis groups seems possible without relevant losses compared to the original version. In the future, it allows for a 40% reduction in time compared to the original GSE version and may facilitate the assessment of self-efficacy in studies and for screening purposes in clinical routine. Disclosure of interest est.
The authors declare that they have no competing inter-
https://doi.org/10.1016/j.respe.2018.05.492
S417
A. Ben Cheikh , H. Ghali , M. Ben Rejeb ∗ , S. Chelly , S. Khefacha , H. Said Latiri Prevention and Care Safety, Sahloul University Hospital, Sousse, Tunisia ∗ Corresponding author. E-mail address: mohamed [email protected] (M. Ben Rejeb) Introduction Nosocomial infection (NI) constitute a major public health problem. It was extremely frequent and serious, especially in the intensive care unit (ICU). Thus, ICU-NIs increased patient mortality. The objective of this study was to determine rates and predictive factors of ICU of mortality in a Tunisian University Hospital. Methods We conducted a nested case-control study in a 630-beds public University Hospital in Eastern Tunisia. Cases and controls enrollment was based on data collected prospectively by an ICU-wide active surveillance of NI conducted over 12 months: from July first, 2010, through June 30, 2011. Patients admitted to the ICU were included in the study if they stayed in the ICU for more than 48 hours. All analyses were performed with SPSS for Windows, version 19.0. Results Overall, 301 patients were enrolled from ICU. The mean age was 44.8 ± 21.3 years. The mean of length of stay in ICU was 12.7 ± 4. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR = 0.9, 95% CI: 1.6 to 5.3). Overall, 62 case patients were compared to 239 control patients (total) for the final analysis. Logistic regression model demonstrated 5 independents predictive factors of ICU: age older than 65 years (OR: 5.78 [95% CI: 2.03–16.05] P = 0.001), duration of intubation 1–10 days (OR: 6.82 [95% CI: 1.90–24.45] P = 0.003), duration of intubation > 10 days (OR, 11.11 [95% CI: 2.85–43.28] P = 0.001), duration of central venous catherization (CVC) 1–7 days (OR: 6.85 [95% CI: 1.71–27.45] P = 0.007) and duration of CVC > 7 days (OR: 5.55 [95% CI: 1.70–18.04] P = 0.004). Conclusion In this series of ICU patients, duration of intubation and CVC had higher ICU mortality. It could be explained by the frequency of infectious complications that have been generated and the fragility of the clinical condition. So, the implementation of infection control programs could be result in significant reductions in mortality rates in the ICU. Disclosure of interest est.
The authors declare that they have no competing inter-
https://doi.org/10.1016/j.respe.2018.05.494 P9-42
High eating self regulatory skills predicts lower weight gain and healthy dietary intake among first year undergraduate students N. Kliemann a,∗ , H. Croker b , F. Johnson b , R. Beeken c Nutritional Epidemiology, International Agency for Research on Cancer, Lyon, France b Behavioural Science and Health, University College London, London, United Kingdom c Leeds Institute of Health Science, University of Leeds, Leeds, United Kingdom ∗ Corresponding author. E-mail address: [email protected] (N. Kliemann)
a
Introduction There is consistent evidence that suggests first year students are at risk of weight gain, but the reasons for this vulnerability are still unclear. Given the dramatic changes in routine, environment and social life experienced by first year undergraduate students, some level of self-regulatory skills may be required to keep healthy habits and/or build new ones due to disruptions of old habitual behaviours. The new environment may also increase demands on self-regulation to inhibit impulses towards food temptations, since students may be exposed to a high level of unhealthy food options at university. Therefore, this study aimed to examine relationships between eating self-regulatory skills, weight and dietary behaviours over 6 months in a UK cohort of undergraduate students.
P9-41
Validation of the short-form Generalized Self-Efficacy scale (GSE-6) in rehabilitation
Mortality in a Tunisian intensive care unit
M. Brünger ∗ , K. Spyra Institute of Medical Sociology and Rehabilitation Science, Charite Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany ∗ Corresponding author. E-mail address: [email protected] (M. Brünger) Introduction Self-efficacy (Bandura, 1997) plays a key role in psychological models explaining and predicting health behaviors (Schwarzer et al., 2011). This includes physical activity, nutritional behavior and substance consumption, which are addressed, for example, in interdisciplinary multimodal rehabilitation. The General Self-Efficacy Scale (GSE) is the most widely used instrument to assess this construct and is available in over 30 language versions (Schwarzer and Jerusalem, 1995). However, for economic reasons, it is not always possible to use the GSE in studies or clinical routine. Therefore, the short form GSE6 was proposed, which consists of six out of the original ten items (Romppel et al., 2013). However, there is no validation except for the cited study, which was applied to a sample of the general population and patients with heart failure, only. Hence, the aim of this work is to determine psychometric properties and the validity of GSE-6 among rehabilitation patients. Methods The basis of the reported analysis is a nationwide study in Germany with 2530 insured persons of the Federal German Pension Insurance (Brünger et al., 2016; Brünger and Spyra, 2017). Patients were asked to fill in a questionnaire prior to their rehabilitation. In addition, mental impairment (PHQ-4), depression and anxiety (HADS), impairment due to pain (PDI), health behavior (IRES), social support (IRES), and subjective work ability (WAS) were assessed. The sampling was stratified according to the nine disease groups most common. Psychometric properties were calculated by comparing the short and the original version (GSE-6/GSE). By analogy with the original version, the value range of GSE-6 was transformed to 10 to 40 points. The concurrent validity is reported with Spearman correlations to the other impairments and resources mentioned. Multigroup confirmatory factor analyses (CFA) including gender, age and diagnosis groups demonstrate the factorial validity of both scales. Results Mean sum scores of the short and the original version were quite similar: GSE-6 28.1 (SD: 6.0) points; GSE 27.8 (SD: 6.0) points. In 92.9% of the rehabilitees, the GSE-6 sum score diverged by the GSE sum score with a maximum of ±2 points. Soil effects existed for 2.6% of the rehabilitant patients in GSE-6 (GSE: 2.2%), ceiling effects for 0.5% (GSE: 0.4%). The mean discriminatory power of the items ranged from rix = 0.70 in GSE-6 to rix = 0.74 in GSE. The internal consistency according to Cronbach’s alpha was 0.89 for GSE-6 and 0.93 for GSE. GSE-6 and GSE were correlated with rs = 0.98. The correlations of GSE-6 and GSE to other impairments and resources were in a comparable range: depression (rs = 0.61, rs = 0.62), anxiety (rs = 0.56, rs = 0.57), mental impairment (rs = 0.56, rs = 0.58); social support (rs = 0.41, rs = 0.42); impairment due to pain (rs = −0.40, rs = 0.40); subjective ability to work (rs = 0.37, rs = 0.37) and health behavior (rs = 0.30, rs = 0.31). Stratified analyzes by gender and diagnosis groups provided comparable results. Multigroup CFA confirmed the one-dimensional structure of both scales independently of gender, age and diagnosis group. Conclusions There were only minor differences when using the GSE-6 compared to the original version. The psychometric properties are slightly less favorable on the short scale - as expected due to the lower number of items - but are also at a high level. Thus, an application of the short version in rehabilitation across all major diagnosis groups seems possible without relevant losses compared to the original version. In the future, it allows for a 40% reduction in time compared to the original GSE version and may facilitate the assessment of self-efficacy in studies and for screening purposes in clinical routine. Disclosure of interest est.
The authors declare that they have no competing inter-
https://doi.org/10.1016/j.respe.2018.05.492
S417
A. Ben Cheikh , H. Ghali , M. Ben Rejeb ∗ , S. Chelly , S. Khefacha , H. Said Latiri Prevention and Care Safety, Sahloul University Hospital, Sousse, Tunisia ∗ Corresponding author. E-mail address: mohamed [email protected] (M. Ben Rejeb) Introduction Nosocomial infection (NI) constitute a major public health problem. It was extremely frequent and serious, especially in the intensive care unit (ICU). Thus, ICU-NIs increased patient mortality. The objective of this study was to determine rates and predictive factors of ICU of mortality in a Tunisian University Hospital. Methods We conducted a nested case-control study in a 630-beds public University Hospital in Eastern Tunisia. Cases and controls enrollment was based on data collected prospectively by an ICU-wide active surveillance of NI conducted over 12 months: from July first, 2010, through June 30, 2011. Patients admitted to the ICU were included in the study if they stayed in the ICU for more than 48 hours. All analyses were performed with SPSS for Windows, version 19.0. Results Overall, 301 patients were enrolled from ICU. The mean age was 44.8 ± 21.3 years. The mean of length of stay in ICU was 12.7 ± 4. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR = 0.9, 95% CI: 1.6 to 5.3). Overall, 62 case patients were compared to 239 control patients (total) for the final analysis. Logistic regression model demonstrated 5 independents predictive factors of ICU: age older than 65 years (OR: 5.78 [95% CI: 2.03–16.05] P = 0.001), duration of intubation 1–10 days (OR: 6.82 [95% CI: 1.90–24.45] P = 0.003), duration of intubation > 10 days (OR, 11.11 [95% CI: 2.85–43.28] P = 0.001), duration of central venous catherization (CVC) 1–7 days (OR: 6.85 [95% CI: 1.71–27.45] P = 0.007) and duration of CVC > 7 days (OR: 5.55 [95% CI: 1.70–18.04] P = 0.004). Conclusion In this series of ICU patients, duration of intubation and CVC had higher ICU mortality. It could be explained by the frequency of infectious complications that have been generated and the fragility of the clinical condition. So, the implementation of infection control programs could be result in significant reductions in mortality rates in the ICU. Disclosure of interest est.
The authors declare that they have no competing inter-
https://doi.org/10.1016/j.respe.2018.05.494 P9-42
High eating self regulatory skills predicts lower weight gain and healthy dietary intake among first year undergraduate students N. Kliemann a,∗ , H. Croker b , F. Johnson b , R. Beeken c Nutritional Epidemiology, International Agency for Research on Cancer, Lyon, France b Behavioural Science and Health, University College London, London, United Kingdom c Leeds Institute of Health Science, University of Leeds, Leeds, United Kingdom ∗ Corresponding author. E-mail address: [email protected] (N. Kliemann)
a
Introduction There is consistent evidence that suggests first year students are at risk of weight gain, but the reasons for this vulnerability are still unclear. Given the dramatic changes in routine, environment and social life experienced by first year undergraduate students, some level of self-regulatory skills may be required to keep healthy habits and/or build new ones due to disruptions of old habitual behaviours. The new environment may also increase demands on self-regulation to inhibit impulses towards food temptations, since students may be exposed to a high level of unhealthy food options at university. Therefore, this study aimed to examine relationships between eating self-regulatory skills, weight and dietary behaviours over 6 months in a UK cohort of undergraduate students.