Reliability of televisits for patients with mild relapsing–remitting multiple sclerosis in the COVID-19 era

Background Evidence of the cost-effectiveness of telemedicine (TM) for the management of Multiple Sclerosis (MS) has been provided recently. However, some doubts persist about the accuracy of neurological examinations performed remotely. Objectives This study investigated the reliability of neurological evaluations performed through TM in mild MS patients as compared with standard in-person visits. Methods In total, 76 patients with relapsing–remitting MS and Expanded Disability Status Scale (EDSS) ≤ 3.5 were consecutively recruited. Of them, 40 patients (52.6%) accepted to undergo both in-person and TM evaluations with independent examiners within 48 h. We alternatively asked patients to assure or not the presence of a caregiver during TM visits. A satisfaction questionnaire was administered to all participants. Results The inter-rater agreement attributed by two independent neurologists during TM visit was high (κ > 0.80) for EDSS and Functional Systems (FS) scores. Moderate agreement between TM and in-person evaluations emerged for pyramidal (κ = 0.57; p < 0.001), brainstem (κ = 0.57; p < 0.001), bowel and bladder (κ = 0.54; p < 0.001) and sensory (κ = 0.51; p < 0.001) FS scores, higher in patients providing the support of a caregiver. A good reliability was reported for EDSS scores computed during remote and in-person visits (ICC = 0.83; 95% CI 0.70–0.91; p < 0.001). Conclusions Despite the complexity of neurological examination, TM could be useful in monitoring MS patients with low disability.

Validation Study of the Spanish Version of the Marital Satisfaction Questionnaire for Older Persons

Interpersonal relationship quality is relevant for older adults′ well-being and mental health. Studies focused on methods to evaluate marital satisfaction in older adults and the relationship of this variable with psychological correlates are scarce. This study examined the psychometric properties of the Spanish version (Castro-Díaz et al., 2012) of the Marital Satisfaction Questionnaire For Older Persons (MSQFOP; Haynes et al., 1992) in a sample of middle-aged and older adults from Spain. Participants were 130 individuals (60.8% women) 40 years or older (M= 60.31, SD=11) involved in a marital/partner relationship. The assessed variables were marital satisfaction (MSQFOP), marital warmth, positive emotions, frequency of arguments, perceived stress associated with the COVID-19 pandemic, and anxiety and depressive symptoms. The results from the exploratory factor analysis yielded a three factor structure (compatibility, communication, and sex) explaining 77.8% of the variance. Even though the factor structure was the same as that of the original version, some items loaded on other factors. The internal consistency (Cronbach’s alpha) was 0.97. The results revealed significant (p &lt; .001) positive associations between marital satisfaction, marital warmth, and positive emotions. In addition, significant negative associations were found between marital satisfaction and frequency of arguments, stress associated with the COVID-19 pandemic, and anxious and depressive symptomatology (p &lt; .05). The findings suggest that Spanish version MSQFOP has good psychometric properties that recommend its use with middle-aged and older adults. Marital satisfaction seems to be a relevant construct for understanding stress, well-being, and mental health in middle-aged and older adults.

Body Image, Sexual Function, and Sexual Satisfaction Among Couples Before and After Gynecologic Cosmetic Surgery

Objective: This study aimed to compare women’s body image, sexual function and satisfaction before and after gynecologic cosmetic surgery. The study also aimed to assess women husband’s sexual satisfaction. Materials and methods: This was a pretest-posttest study. A sample of 50 women attending the pelvic floor clinic of Tehran University of Medical Sciences for gynecologic cosmetic surgery was entered into the study. Surgeries included labiaplasty, clitoral hoodectomy, vaginoplasty, vaginal rejuvenation, anterior and posterior colporrhaphy, perineoplasty, and perineorrhaphy. Women were assessed for the Body Image Quality of Life Inventory (BIQLI), the Larson Sexual Satisfaction Questionnaire (LSSQ-F), and Female Sexual Function Inventory (FSFI-6) at two points in time: baseline (one week before surgery) and 3 months after surgery. Similarly, the male partners were assed for sexual satisfaction using the Larson Sexual Satisfaction Questionnaire (LSSQ-M). To analyze the data paired samples t-test was applied. Results: The mean (SD) age of women was 43.36 (8.6) years and the mean (SD) duration of marriage was 22.18 (9.7) years. Ninety-four percent had history of vaginal delivery and 58.7 percent attend surgery due to husband’s sexual dissatisfaction. The results showed that women’s body image, sexual function and couples’ sexual satisfaction improved significantly after gynecologic cosmetic surgery (p ≤ 0.001). Conclusion: The findings suggest that female genital cosmetic surgery improved the body image and sexual function of women and sexual satisfaction in couples that might lead to a more pleasurable and healthier marital relationship.

The Efficacy, Safety and Satisfaction Associated with Switching from Brinzolamide 1% and Brimonidine 0.1% to a Fixed Combination of Brinzolamide 1% and Brimonidine 0.1% in Glaucoma Patients

We evaluated glaucoma patients for the efficacy, safety and satisfaction associated with switching from brinzolamide 1% and brimonidine 0.1% to a fixed combination of brinzolamide 1% and brimonidine 0.1%. A total of 22 glaucoma patients were enrolled and completed this prospective, nonrandomized study that evaluated patients who underwent treatment with at least brinzolamide 1% and brimonidine 0.1%. Patients on brinzolamide 1% and brimonidine 0.1% were switched to a brinzolamide/brimonidine fixed-combination ophthalmic suspension (BBFC). Evaluations of intraocular pressure (IOP), superficial punctate keratopathy (SPK) and conjunctival hyperemia were conducted at baseline and at 4 and 12 weeks. The Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9) was utilized to assess the change in treatment satisfaction. At baseline and at 4 and 12 weeks, the IOP was 15.0 ± 4.1, 14.8 ± 4.1 and 14.8 ± 4.1 mmHg, respectively. There were no significant differences observed at any of the time points. However, the SPK score significantly decreased at 12 weeks, even though no significant differences were observed for the conjunctival hyperemia incidence at any of the time points. After switching from brinzolamide 1% and brimonidine 0.1% to BBFC, there was a significant increase in the TSQM-9 score for convenience and global satisfaction. Both an improvement in the degree of SPK and an increase in treatment satisfaction occurred after switching from brinzolamide 1% and brimonidine 0.1% to BBFC, even though there were sustained IOP values throughout the 12-week evaluation period.

Psychometric properties of the Malay version Women’s Views of Birth Postnatal Satisfaction Questionnaire using the Rasch measurement model: a cross-sectional study

Background Maternal satisfaction must be assessed in order to reflect the quality of care, which is considered an outcome of healthcare services. It can also be used to contrast and compare satisfaction with various care models or service configuration or to assess overtime changes. The purpose of this study was to investigate the psychometric properties of the Malay version Women’s Views of Birth Postnatal Satisfaction Questionnaire (WOMBPNSQ) based on the Rasch scale model of labour satisfaction. Methods This is a cross-sectional study. Postpartum women were identified from a tertiary hospital and evaluated at 1-month postnatal period using WOMBLSQ. The Rasch model was used to investigate the reliability, unidimensionality, item and person misfits and distribution map. Results A total of 195 women were involved. The Rasch analysis revealed that the 30 items had a high level of reliability at 0.99 and item separation at 9.02. It has a low level of reliability at 0.45 and persons separation at 0.90. All the items are considered fit. Five people have most misfitting response strings based on item IPS_Q15, ‘I was given little advice on contraception following the birth of my baby’, but extremely trivial differences were found in the parameter estimates after refitting the model. The more difficult item to endorse satisfaction is item CA_Q17 ‘I was given little advice on contraception following the birth of my baby’. Conclusions The WOMBLSQ tested in postpartum women proved to have high item reliability index but with an adequate sample. The analysis shows that the 30 items target the right form of respondents, have similar latent characteristics of postpartum women and a shared sense of satisfaction. For future improvement, more difficult items endorsing satisfaction should be created, and the common items in which satisfaction is expected should be reduced.

Evidence-Based Optimization of the Mandarin Version of the Post Stroke Checklist: A Mixed Methods Study

Background: The Post Stroke Checklist has been proved to be feasible and useful in standardizing the process for long-term post-stroke care and we developed a Mandarin version of it (M-PSC). However, it is not capable of enforcing follow-up care after stroke and further optimization is needed.Methods: Participants were consecutively recruited from 13 departments in a specialized hospital on the discharge date. The trained clinicians contacted them by telephone calls at six months since the most recent diagnosis. A satisfaction questionnaire was sent to the participant whilst clinicians completed a satisfaction questionnaire and the Pragmatic Face and Content Validity Test (PRAC-Test). Then, a debriefing meeting was held to discuss potential problems of the M-PSC. Quantitative and qualitative data were both collected from April 2021 to May 2021.Results: A total of 167 individuals consented to take part in the study.113 participants completed the assessment at six months and three were excluded due to missing data. The M-PSC identified a wide range of unmet needs related to stroke and at least one need was reported in 76.4% of participants. The average time taken to administer the M-PSC was 8 mins. Satisfaction ratings were high for participants (8.5/10) and clinicians (9.6/10). Totally 31 further screenings were conducted and 33 appropriate referrals were accomplished. Several areas for improvement were identified and revised.Conclusions: The M-PSC is a feasible and useful measure in enforcing follow-up care and promising to be an approach in standardizing post-stroke follow-up practice in telehealth during the coronavirus disease 2019 pandemic.