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Hirst, William Mark. "Outcome measurement error in survival analysis." Thesis, University of Liverpool, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.366352.
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Clifford, Paul Ian. "An infometric approach to mental health outcome measurement." Thesis, University College London (University of London), 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.408295.
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Casteleijn, Jacoba Magdalena Francina. "Development of an outcome measure for occupational therapists in mental health care settings." Thesis, University of Pretoria, 2010. http://hdl.handle.net/2263/28019.
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It is the responsibility of professions to provide evidence of the demonstrable value and quality of service delivery. Occupational therapists in mental health care settings find it difficult to produce convincing evidence of the demonstrable value and their contribution to health care. Currently no effective outcome measure for occupational therapists in mental health practices exists for the South African context . The development of an outcomes measuring system is much needed in these crucial times of cost-cutting, rendering quality of care with the minimum resources and the quest for evidence of the effect of intervention. The purpose of this study was to fill the outcome measurement gap by developing a system that is clinically tested and user-friendly for occupational therapists in mental health care settings. Such a system had to represent the outcomes in the occupational therapy programmes, meet the needs of the therapist in terms of purpose of the tool, be easily administered and be standardised. It was also important that the outcome measure was grounded in the theoretical framework that guides intervention programmes, namely Vona du Toit’s Model of Creative Ability. This theoretical framework is widely used in South African mental health care settings and was found suitable to be transformed into a rating scale for the outcome measure. A participatory approach combined with a mixed method exploratory design, specifically the instrument development model, was selected to guide the study. The development of the outcome measure happened in three phases. Domains for the outcome measure emerged after participation from occupational therapy clinicians and mental health care users in Phase 1. The operationalisation of the domains and the development of the rating scale happened during Phase 2. The third phase was the piloting of the outcome measure to identify issues to be optimised for the final implementation of the outcome measure. Eight domains with 52 representative items emerged from Phase 1. The domains were Process skills, Communication and Interaction skills, Lifeskills, Role performance, Balanced lifestyle, Motivation, Self-esteem and Affect. Clinicians were satisfied that these domains represented the service that they deliver and compared well with the mental health care users’ need for occupational therapy. The involvement of mental health care users in confirming relevant domains for the outcome measure ensured a client-centred approach in the research process. The outcome measure, named as the Activity Participation Outcome Measure (APOM), has a unique feature of generating reports and spider graphs for every mental health care user. The APOM was piloted in three mental health care settings. In spite of good intentions from clinicians to apply the measure, it was clear that measuring outcomes is neither a priority, nor a routine task in clinical settings. The preliminary investigation into the psychometric properties yielded positive results. However, the sample sizes for the validity and reliability samples were not optimal and further data collection needs to continue for confirmation. It is recommended that investigations into the psychometric properties of the instrument continue to eventually market it as a valid and reliable outcome measure for occupational therapists in mental health care settings.Thesis (PhD)--University of Pretoria, 2011.
Occupational Therapy
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Ortega, Sandra. "The impact of outcome measurement on non-profit organizations a case study /." Columbus, Ohio : Ohio State University, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1141401440.
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O'Donoghue, M. F. "The measurement of outcome in the treatment of epilepsy." Thesis, University College London (University of London), 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391616.
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Martin, Kathryn S. "Measurement and prediction of mobility outcome pre and post stroke rehabilitation using Clinical Outcome Variables (COVS)." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0006/MQ42660.pdf.
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Majocha, Timothy Wayne. "Outcome-based measurement, its use in assessing organizational end statements." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape2/PQDD_0020/MQ49156.pdf.
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Hambly, Karen. "Outcome measurement in articular cartilage repair : exploring the patient perspective." Thesis, London Metropolitan University, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.540604.
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This critical appraisal provides an overview of five published research papers that collectively make an original and significant contribution to the patients' perspective of outcome measurement after articular cartilage repair (ACR) of the knee. The work represents the evolution and development of the author's coherent research programme in this field over a period of 8 years. In 2003 the author conducted a comparative analysis of rehabilitative guidelines of 11 international ACR centres that identified large variations in practice. This work was significant as it resulted in the publication of the first evaluation of the evidence base for postoperative care after autologous chondrocyte implantation. The evidence base for postoperative care that was elucidated in this work served to uphold the biomedical model as being the dominant paradigm. Concurrently, the concept of patient-centred medicine was being actively promoted within primary~re in the UK and patient-reported outcomes (PRO) were being adopted as primary endpoints in new ACR clinical trials across Europe and in the USA. This gap between PRO evidence and practice prompted this researcher to evaluate patient's and orthopaedic surgeon's perspectives of the rehabilitation process using a mixed methods approach incorporating grounded theory and content analysis. These inductive pilot works were noteworthy as they indicated that not only were ACR service users willing to allow their views to be captured for research purposes but they were prepared to do so using web-based tools. Two key research questions emerged: what are the symptoms and disabilities most important to ACR patients and are current PRO measures capturing this information? To explore these questions, two commonly used knee-specific PRO measures were evaluated for item importance to ACRpatients from an online health community (OHC) using a clinical impact methodology. The emergent pattern was one of function in sports and recreation activities being important for people who had undergone ACR, more than an anterior cruciate ligament reconstruction (ACLR) cohort from the same OHC knee population. This work led to the formulation of a further research question: what is the postoperative physical activity profile of this OHC ACR population? The Tegner activity scale (TAS) is frequently used to assess physical activity level within ACR studies but this use had not previously been evaluated. The first systematic review of the TAS for ACR raised important methodological issues relating to the use and reporting of the outcome. The key findings from this review were utilised by the researcher to inform the reporting of cross-sectional TAS data for the ACR and ACLR groups from this OHC. The postoperative physical activity profile of this ACR population was one where activity levels increased with postoperative time but remained lower than expected compared with then-current clinical and normative data. The main body of this critical appraisal reviews and evaluates the papers within this research programme and the conceptual links between them. The methodological approaches used in the studies are reflected upon and the significance of the work and future directions for research are discussed.
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Barker, Simon L. "Genetics, epidemiology and outcome measurement of Idiopathic Congenital Talipes Equinovarus." Thesis, University of Aberdeen, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.369563.
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The aetiology, pathogenesis and optimal management of Idiopathic Congenital Talipes Equinovarus (ICTEV) remain the subjects of ongoing debate. The aims of this thesis were to test the hypothesis that both heritable and environmental factors play a role in the aetiology of ICTEV, and to develop a valid technique for severity and outcome assessment of ICTEV. I therefore investigated genetic inheritance through family pedigrees, the role of environmental factors by means of parental questionnaires, and evaluated outcome using both digital images and parental multiple-response questions. Families were recruited from 15 Scottish and 2 English centres generating189 participants. The children had a mean birth weight of 3.5kg, and 94.9% were singleton pregnancies. Breech and forceps deliveries were significantly higher in ICTEV compared with the general population. One in five mothers had been taking the oral contraceptive pill at the time of conception, 2.5% of mothers had experienced a stillbirth, compared to a population rate of 0.61 per 100 live births. Paternal (90%) and maternal (28%) tobacco use at time of conception together generated pre-natal exposure to 93.4% of ICTEV infants. This represents convincing evidence of an aetiological link between parental tobacco exposure and ICTEV, and has not been shown in previous studies. Males were twice as commonly affected as females. Risks to relatives of ICTEV infants have been calculated from pedigrees. Male cases were more likely to have a family history. A seasonal trend with a peak in Spring was observed. Subjective assessment of outcome did not significantly favour any one method. For the first time, a clinically validated digital photographic technique has been described to reliably measure calf muscle volume, demonstrating a 12-15% difference between sides in unilateral cases. Given the evidence for heterogeneity in aetiology (environmental and genetic factors) and in outcome, doubt is cast upon the unified diagnosis of ICTEV.
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Nicholl, Laura. "Outcome measurement in multiple sclerosis : psychometric analysis and clinical applications." Thesis, University of Ulster, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.428781.
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Jayakumar, Prakash. "Patient reported outcome (PRO) measurement of disability in orthopaedic trauma to the upper extremity." Thesis, University of Oxford, 2017. https://ora.ox.ac.uk/objects/uuid:4f39d510-c902-4112-8806-4eefb9bf25d3.
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Patient reported outcome (PRO) measurement of disability is integral to a patient-centered approach to health care and gauging the biopsychosocial impact of health conditions from the patient's perspective. This thesis investigates disability after proximal humerus, elbow and distal radius fractures; conditions that constitute a major burden in musculoskeletal health care and a substantial impact on health-related quality of life (HrQoL). Disability is defined by the World Health Organisation (WHO) International Classification of Disability, Functioning and Health (ICF) as âa multi-dimensional construct involving a dynamic interaction between impairment, activity limitations and participation restrictions, that are influenced by contextual factors'. This international, consensus-based framework acts as a guide for the application of outcome measures in performing scientific research. The WHO ICF also considers other patient perspectives on health and health care systems, including patient experience and patient activation within the contextual factors component. Patient experience encompasses aspects such as satisfaction, expectation management and confidence with care, and is measured using a variety of scales and questionnaires. Patient activation relates to 'the knowledge, skills and confidence a person has in managing their own health and health care'. This concept is quantified using patient activation measures (PAMs). The overarching goal of this thesis is to identify the most influential factors predicting disability after proximal humerus, elbow and distal radius fractures. This work also aimed to define the relationship between disability, experience and activation to inform the development of a patient-centred approach to managing these challenging injuries. The first systematic review highlights the dominance of psychosocial factors in influencing disability associated with a range of upper extremity conditions. Few studies have assessed this relationship in specific trauma populations. The second review underlines the paucity of upper extremity PRO measures incorporating fracture populations in their original development. It also reports the highly variable quality of initial studies introducing these measures. The final review demonstrates the superior measurement properties of computer adaptive tests (CATs), a contemporary form of PRO measurement, over fixed-scale instruments. Few studies apply CATs in trauma and few have been performed outside the U.S. These reviews collectively informed the selection of PRO measures for the experimental studies in this thesis. Firstly, a pilot study establishes a methodology for addressing the key objectives and the feasibility of using a web-based platform for measuring patient outcomes. Strong correlation between PROMIS Physical function CAT, a computer adaptive measure of physical function, and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), a region-specific, fixed scale is observed. The core experiment (n=734) expands upon this work and demonstrates correlations between a range of generic and region-specific measures in an upper extremity trauma population. Disability is shown to correlate with satisfaction, and the strength of this correlation increases over time. Applying PRO measures of disability in populations with shoulder, elbow and wrist fractures show that self-efficacy (i.e. coping ability) within 6 weeks of injury was the strongest predictor of medium-term disability at 6-9 months. In proximal humerus and elbow fractures, kinesiophobia (i.e. fear of movement) within a week of injury was also a strong predictor of disability. The final study concludes that greater patient activation is associated with greater health-related and experiential outcomes. However, psychosocial factors including self-efficacy, superseded activation in predicting disability and satisfaction. This thesis contributes evidence for musculoskeletal health care professionals (HCPs) to consider specific psychosocial factors, such as coping abilities, and patient activation early in the recovery process to improve disability following these injuries.
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Hamesse, Charles. "Simultaneous Measurement Imputation and Rehabilitation Outcome Prediction for Achilles Tendon Rupture." Thesis, KTH, Robotik, perception och lärande, RPL, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-231485.
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Achilles tendonbrott (Achilles Tendon Rupture, ATR) är en av de typiska mjukvävnadsskadorna. Rehabilitering efter sådana muskuloskeletala skador förblir en långvarig process med ett mycket variet resultat. Att kunna förutsäga rehabiliteringsresultat exakt är avgörande för beslutsfattande stöduppdrag. I detta arbete designar vi en probabilistisk modell för att förutse rehabiliteringsresultat för ATR med hjälp av en klinisk kohort med många saknade poster. Vår modell är tränad från början till slutet för att samtidigt förutsäga de saknade inmatningarna och rehabiliteringsresultat. Vi utvärderar vår modell och jämför med flera baslinjer, inklusive flerstegsmetoder. Experimentella resultat visar överlägsenheten hos vår modell över dessa flerstadiga tillvägagångssätt med olika dataimuleringsmetoder för ATR rehabiliterings utfalls prognos.Achilles Tendon Rupture (ATR) is one of the typical soft tissue injuries. Rehabilitation after such musculoskeletal injuries remains a prolonged process with a very variable outcome. Being able to predict the rehabilitation outcome accurately is crucial for treatment decision support. In this work, we design a probabilistic model to predict the rehabilitation outcome for ATR using a clinical cohort with numerous missing entries. Our model is trained end-to-end in order to simultaneously predict the missing entries and the rehabilitation outcome. We evaluate our model and compare with multiple baselines, including multi-stage methods. Experimental results demonstrate the superiority of our model over these baseline multi-stage approaches with various data imputation methods for ATR rehabilitation outcome prediction.
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de, Man Lapidoth Joakim. "Binge eating and obesity treatment : prevalence, measurement and long-term outcome." Doctoral thesis, Örebro universitet, Hälsoakademin, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-6627.
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Eating disorders and binge eating has repeatedly been shown to be common in surgical and behavioural weight loss treatments. Due to methodological variations and shortcomings in previous research, there is insufficient information about how eating disorders and binge eating are associated with outcome in weight loss treatments. There is therefore no consensus on how eating pathology should be adressed in weight loss treatments, which has led to large differences in the clinical practice. The main aim of this thesis was to address the issues of eating disorders and binge eating in weight loss treatments, and to investigate how binge eating is associated with long-term treatment outcome.
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Collett, Tess Janeen. "Measurement Implementation in Youth Psychotherapy: An Examination of Barriers and Facilitators of Y-OQ and TSM Implementation." BYU ScholarsArchive, 2019. https://scholarsarchive.byu.edu/etd/8588.
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Studies have shown a concerning and disproportionate amount of treatment failure and premature termination in youth populations. Routine measurement feedback has been proposed as a means to prevent treatment failure and premature termination for adults and may also improve youth mental health services. However, studies examining helpfulness of measurement feedback systems in youth populations have demonstrated a lack of effects more likely due to poor measurement implementation than to the measurement feedback system itself. Because contexts within the service settings are such crucial factors in whether an innovation is successfully implemented, examining barriers and facilitators in said contexts is a necessary step towards improving implementation for the ultimate purpose of improving youth mental health services. The present study explored barriers and facilitators to the implementation of the Youth Outcome Questionnaire (Y-OQ) and Treatment Support Measure (TSM) in youth routine clinical care. Thirteen staff of varying job titles, experiences, education and opinions towards measures were interviewed using consensual qualitative research (CQR) methods. Results were similar to previous studies, indicating multilevel barriers and facilitators to measurement implementation such as at the organization, staff, client and measure level. Using CQR data analysis, domains, categories and subcategories along with level of frequency are displayed and discussed in further detail. In addition to barriers and facilitators, interviewees provided recommendations for how to improve implementation of measures within their organization. Researchers provide recommendations of continued communication, re-assessment of barriers and facilitators over time and shared responsibility between stakeholders and professionals invested in improving youth mental health services.
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Sanders, Peter William. "The Development of a Short Form of the Clinically Adaptive Multidimensional Outcome Survey." BYU ScholarsArchive, 2017. https://scholarsarchive.byu.edu/etd/6462.
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The Evidence-Based Practice (EBP) movement has gained considerable influence in the healthcare industry, including psychotherapy. The American Psychological Association's (APA) official stance on EBP encouraged clinicians to used standardized outcome measures in routine practice in order to establish the efficacy of their interventions. Routine Outcome Measurement (ROM) systems were designed specifically to accomplish this purpose, and have been shown to improve client outcomes and provide valuable aggregate data that contributes to empirical literature. Despite this research and the endorsement of the APA's official EBP stance, these measures have not been widely adopted by clinicians. Several studies have found that clinicians find the measures impractical and lacking in clinical relevance. In order to accommodate these clinician concerns, while still maintaining the major features of ROM, the Clinically Adaptive Multidimensional Outcome Survey (CAMOS) was developed. The CAMOS employs a unique system that allows clinicians to be able to tailor the measure to the needs of their client, while still maintaining a core of standardized items. The present study attempted to identify a short form of McBride's measurement model, in order to determine which items would form this standardized core. The study found evidence for the validity and reliability of the CAMOS short form. With this evidence, the short form can serve as the basis for the CAMOS's unique tailoring system. It is hoped that the novel features of the CAMOS can help accomplish the APA's goals in relation to EBP.
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Al, Hashmi Khamis Mohammed. "Aldosterone/Renin ratio : methods of measurement, physiological correlates and prediction of therapeutic outcome." Thesis, University of Glasgow, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.433058.
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Clarke, Penny E. "Maternal daily activity in low risk pregnancy : a longitudinal study." Thesis, Loughborough University, 2001. https://dspace.lboro.ac.uk/2134/7556.
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A review of the scientific literature revealed a lack of information regarding the integrated daily activity levels of low-risk pregnant women in contemporary Western society. A prospective, longitudinal study was therefore undertaken to (i) assess the impact of low-risk pregnancy on the daily activity levels of healthy, British primigravid women and (ii) examine the relationship between total maternal daily activity level and pregnancy outcome. The best combination of methods to measure daily activity levels during pregnancy was considered to be a subjective self-report measure used in conjunction with an objective ambulatory activity monitor. These methods were developed and were demonstrated to be both reliable and valid in non-pregnant women. However, the study identified some unique problems in using activity monitors in pregnant women. These problems emanated both from women's reluctance to wear an activity monitor when pregnant and from a need to measure extremely low levels of activity in late gestation. Both data from the ambulatory monitor and the new activity questionnaire demonstrated a overall decrease in mean maternal daily activity levels between 25 & 38 weeks gestation (n=51; p<0.01). This decline masked different maternal responses in different activity domains. The mean occupational activity ratios of women working full-time declined steadily between 16 & 34 weeks gestation (n=25, p<0.01). Women's working hours and the more flexible elements of their work were reduced whilst the frequency of work breaks increased. Between 25 & 38 weeks gestation, mean recreational activity ratios also declined (n=50, p<0.05). Participation in structured sports and exercise ceased and increasing amounts of time were spent within the home. In contrast, mean overall domestic activity ratios were maintained. Between 16 & 38 weeks gestation mean nocturnal activity ratios increased steadily (n=47; p=0.01) To maintain waking activity during pregnancy, women actively engaged in a number of different balancing strategies. These strategies comprised monitoring, prioritising, pacing and forward planning. Despite the changes that occurred in maternal activity behaviour, one of the strongest and most consistent predictors of maternal activity behaviour during pregnancy was that of maternal activity behaviour prior to pregnancy. Occupational activity levels pre-pregnancy were independently associated with maternal daily activity levels at 12,16 & 25 weeks gestation (p=0.004-0.020). Self-efficacy was the only significant predictor of the change in maternal daily activity levels between 25 & 38 weeks gestation (p=0.013). The women who reduced their activity the most were likely to be those individuals who had more difficulty in overcoming perceived barriers to physical activity participation. Five main barriers to physical activity were identified: (i) the physical symptoms of pregnancy (ii) the effect of outside influences (iii) a lack of motivation (iv) a low maternal body image and (v) a lack of time and/or appropriate facilities. Findings suggested that maternal daily activity may impact significantly on pregnancy outcome. Higher maternal daily activity at 16 weeks gestation was independently associated with a lower incidence of emergency caesarean section (p<0.05). Higher maternal daily activity at 38 weeks gestation was independently associated with a higher incidence of an induction of labour (p<0.05). Total daily activity at 25 & 34 weeks gestation was independently and negatively associated with infant birthweight (p<0.05).
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Krick, Stephanie. "IMPACT OF ETHICAL PRACTICES ON PERFORMANCE OUTCOME MEASURES IN A SELECT GROUP OF NONPROFIT ORGANIZATIONS IN FLORIDA." Doctoral diss., University of Central Florida, 2007. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/3250.
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Nonprofit programs deliver key social services to millions of people across the country everyday, however, little is known about the ethical practices of these programs. This research examines the relationship between a nonprofit program's ethical practices and the programs' measurable outcomes, such as changes in knowledge, attitudes, values, skills, behavior, condition, or status of the participant as a result of their involvement with nonprofit programs. An assumption of the study is that the achievement of the measurable outcomes found in a nonprofit program is directly related to the extent that ethical practices are utilized within that program. Ethical practices include role modeling, ethics development, ethics enforcement and review, stewardship, transparency, and empowerment. This study demonstrates that the ethical strategy Transparency influences the achievement of program performance outcomes. Through a combination of quantitative and qualitative analysis, this study attempts to illustrate the impact of transparency as well as determine how it is incorporated in nonprofit programs based on interviews with nonprofit program managers/directors. Additionally, this study demonstrates that the capacity of a program's processes is negatively associated with the achievement of program performance outcomes. This finding suggests the need for a greater level of transparency in program planning and performance outcome measure development in order to ensure the program is mission driven and its performance outcomes are meeting the needs of the community it serves.Ph.D.
Department of Public Administration
Health and Public Affairs
Public Affairs PhD
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Kyte, Derek Glenn. "The methodological and ethical issues associated with patient-reported outcome measurement in clinical trials." Thesis, University of Birmingham, 2015. http://etheses.bham.ac.uk//id/eprint/5698/.
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The doctoral research forming this thesis used mixed-methods to explore methodological and ethical issues associated with patient-reported outcome (PRO) measurement in clinical trials. A qualitative study of trial staff suggested there are perceived inconsistencies in the administration and management of PROs in some UK trials which could undermine PRO trial results and introduce bias. In addition, the study found that staff reported intermittently encountering ‘concerning’ PRO data in trials, but were unsure how it should be managed. A large-scale survey of UK-based trial staff and management demonstrated the genralisiability of these findings. A systematic review of PRO literature for front-line data collection staff found guidance was lacking. A large-scale review of PRO-specific literature for trial protocol developers suggested guidelines were inconsistent and difficult to access. Finally, using a novel PRO protocol checklist, a systematic review of trial protocols found that PRO information was commonly absent, even where a PRO was the primary outcome. In conclusion, the thesis highlights a need for the development of comprehensive consensus-based PRO guidelines addressing protocol development, training and the management of ‘concerning’ PRO data in trials; aiming to facilitate improvements in PRO protocol content and PRO assessment, whilst protecting the interests of trial participants.
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Young, Nancy, and J. G. Wright. "Measuring Pediatric Physical Function." Lippincott, Williams & Wilkins, 1995. https://zone.biblio.laurentian.ca/dspace/handle/10219/111.
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Most pediatric orthopaedic interventions are intended to improve or preserve physical function, yet their outcomes have been assessed using primarily surrogate measures (e.g., radiographic indices) that may not accurately represent patients'function. Physical function may be more appropriately measured with activity-based scales, but these have been infrequently applied in surgical studies. The purpose of this study was to identify existing activity-based physical-function scales appropriate for pediatric orthopaedics, to present criteria useful for scale selection, and to discuss the special problems of measuring physical function in children. Twenty-one scales relevant to pediatric orthopaedics are described according to their target population, purpose, method of administration, content, and quality of standardization. These scales have been further classified according to a new taxonomy. The unique aspects of measuring physical function in children are discussed and include the effect of age and development, method of reporting, and question formats. Standardized measures of physical function based on physical-activity ability exist and should be used more frequently to assess pediatric orthopaedic interventions
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Klundt, Jared S. "Are Therapists Using Outcome Measures and Does It Matter?A Naturalistic Usage Study." BYU ScholarsArchive, 2014. https://scholarsarchive.byu.edu/etd/4028.
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Outcome measurement has been demonstrated to be beneficial when used as a routine part of psychological practice (Lambert et al., 2002), improving both treatment time and outcome of patients, and helping therapists determine which of their patients are not responding to their current treatments (Hannan et al., 2005; Whipple et al., 2003). Despite these proven benefits, many therapists are reluctant to implement and use outcome measures in their routine practice (Hatfield & Ogles, 2007). In addition, the research demonstrating the benefits of these outcome measures has used randomized experimental design to examine the effects of outcome feedback to therapists. The current study focused on examining the benefits of naturalistic usage of outcome measurement feedback in a setting where such measures are a part of routine practice. Therapists' regular use of the feedback from the Outcome Questionnaire-45 was found to have statistical but not clinical significance in the prediction of a patient's symptom change. Additionally, the regularity with which a therapist views a patient's outcome measure feedback was not significantly correlated with that patient's treatment length, overall change in symptoms, or symptom level at termination. Implications regarding these findings are discussed and recommendations regarding the future study of outcome measures are provided.
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Huber, Manuel [Verfasser], and Reiner [Akademischer Betreuer] Leidl. "From outcome measurement to outcome prediction in patient management : the case for individually valued health-related quality of life / Manuel Huber ; Betreuer: Reiner Leidl." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2020. http://d-nb.info/1204827761/34.
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Bouchard, Vanessa. "Illness intrusiveness in Multiple Sclerosis: an exploration from the perspective of modern outcome measurement theory." Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=114388.
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Illness intrusiveness is a construct that emerged in the 1980's to describe disease impact or how much disease symptoms and treatments interfere with valued life activities. This thesis presents two manuscripts applying modern outcome measurement theories and models to examine the construct of illness intrusiveness in people with Multiple Sclerosis (MS). The first manuscript presents the result of a codification exercise on the International Classification of Functioning Disability and Health (ICF). Mapping of the 13 items of the original Illness Intrusiveness Rating Scale (IIRS) and 5 new items added by our team to reflect constructs felt to be missing from the original measure was done by a group of nine rehabilitation experts. It also illustrates the composition of the IIRS as a latent construct using Rasch Analysis. The results showed that, using the ICF framework, this construct could be regarded as measuring participation and 14 of the 18 (13 original + 5 new) items formed a unidimensional hierarchical construct. Manuscript 2, which is a secondary analysis of a sample of 189 subjects with Multiple Sclerosis (MS), presents the steps and results of a path analysis aimed at contributing evidence for the impact of MS related physical and mental impairments on the latent construct of illness intrusiveness. Path analysis showed a complete mediation of the effects of physical symptoms on illness intrusiveness through mainly fatigue and self perceived physical function. Understanding what impacts the life of people living with MS is important for target interventions and to focus the direction of future research.L'impact de la maladie est un concept qui a émergé au cours des années 80 afin de décrire et comprendre à quel point les symptômes et les traitements d'une maladie chronique créent de l'interférence avec les activités de la vie quotidienne jugées importantes par les patients. Cette dissertation présente deux manuscrits appliquant les théories modernes sur les outils de mesure et la modélisation afin d'examiner le concept de l'impact de la maladie chez les gens atteints de sclérose en plaque (SP). Le premier manuscrit présente les résultats d'un exercice de codification sur le modèle conceptuel de l'Organisation Mondiale de la Santé (OMS) nommé la Classification International du Fonctionnement, du Handicap et de la Santé (CIF). Les 13 items de la mesure originale de l'impact de la maladie (Illness Intrusiveness Rating Scale, IIRS) ainsi que 5 items ajoutés par notre groupe afin de combler les concepts apparaissant comme absents de la mesure originale furent codifiés par un groupe de neuf experts dans le domaine de la réadaptation. En utilisant une analyse de Rasch, il fut également démontré que la composition du IIRS est un construit latent. Les résultats ont démontré, que par rapport au modèle conceptuel du CIF, l'impact de la maladie est un concept du domaine de la participation et que 14 des 18 items testés forment un construit unidimensionnel et hiérarchique. Le deuxième manuscrit, qui est une analyse secondaire d'un échantillon de 189 patients atteints de la SP, présente les étapes suivies et les résultats d'une analyse des pistes causales qui vise à contribuer des indices par rapport à l'effet des symptômes physiques et mentaux de la SP sur le construit latent de l'impact de la maladie. L'analyse des pistes causales a démontré une médiation complète de l'effet des symptômes physiques sur l'impact de la maladie principalement par la fatigue et la capacité physique telle que perçue par le patient. Comprendre les facteurs qui ont un impact sur la vie des gens atteints de SP tient un rôle important pour cibler des interventions et focaliser la direction des futures recherches dans ce domaine.
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Beckles, Gina. "PREFERENCES FOR PERFORMANCE MEASURES: A STUDY OF A FEDERAL AGENCY." Doctoral diss., University of Central Florida, 2006. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/4238.
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The purpose of this dissertation was to determine the preferences of clients of programs administered by selected federal agencies and the preferences of the federal managers who administer the programs in assessing performance measurement systems. Using the general progression of previous budgetary models used in the public sector, the researcher developed the Modified Balance Scorecard (MBSC), a performance measurement model designed specifically for use within the public sector. Surveys based on the MBSC were administered to public managers and to clients of those managers in order to determine their preferences. The results showed that managers preferred public good measures and clients preferred financial measures. Both groups' second preferred index of measures was internal management process measures. This research is important in policy formulation and provides many implications regarding the effective presentation of policies. These results can be used to help craft policies for maximum effectiveness, based on the preferences of the respective groups.Ph.D.
Department of Public Administration
Health and Public Affairs
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Kitching, Jolanda. "The measurement outcome equivalence of the career path appreciation (CPA) for employees from diverse cultural backgrounds." Pretoria : [s.n.], 2004. http://upetd.up.ac.za/thesis/available/etd-03162005-151333.
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Thesis (M. Comm. (Economic and business science))-University of Pretoria, 2004.Summaries in English and Afrikaans. Includes bibliographical references. Available on the Internet via the World Wide Web.
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Berkeljon, Arjan. "Multidimensional Item Response Theory in Clinical Measurement: A Bifactor Graded-Response Model Analysis of the Outcome-Questionnaire-45.2." BYU ScholarsArchive, 2012. https://scholarsarchive.byu.edu/etd/3568.
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Bifactor Item Response Theory (IRT) models are presented as a plausible structure for psychological measures with a primary scale and two or more subscales. A bifactor graded response model, appropriate for polytomous categorical data, was fit to two university counseling center datasets (N=4,679 and N=4,500) of Outcome-Questionnaire-45.2 (OQ) psychotherapy intake data. The bifactor model showed superior fit compared to a unidimensional IRT model. IRT item parameters derived from the bifactor model show that items discriminate well on the primary scale. Items on the OQ's subscales maintain some discrimination ability over and above the primary scale. However, reliability estimates for the subscales, controlling for the primary scale, suggest that clinical use should likely proceed with caution. Item difficulty or severity parameters reflected item content well, in that increased probability of endorsement was found at high levels of distress for items tapping severe symptomatology. Increased probability of endorsement was found at lower levels of distress for items tapping milder symptomatology. Analysis of measurement invariance showed that item parameters hold equally across gender for most OQ items. A subset of items was found to have item parameters non-invariant across gender. Implications for research and practice are discussed, and directions for future work given.
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Allred, Aaron M. "Does Social Role Functioning Predict Work Productivity? Further Validation of the Social Role Scale of the Outcome Questionnaire." BYU ScholarsArchive, 2012. https://scholarsarchive.byu.edu/etd/3666.
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Mental health problems are associated with significant losses in work productivity and, consequently, have significant ramifications for business entities and the general economy. Several instruments have been developed to measure productivity-related constructs such as absenteeism and presenteeism. The current study examines the utility of the Outcome Questionnaire-45 (OQ), a commonly used mental health questionnaire, in predicting work productivity. This relationship is explored as a preliminary step in assessing the degree to which changes in mental health brought about by psychotherapy will improve work productivity. Forty-nine participants were recruited from a call center in a small market research firm based in the Western United States. Work productivity was measured using four subscales of the Work Productivity and Activity Impairment (WPAI) questionnaire as well as an objective measure. The OQ and WPAI were administered on a weekly basis over the course of five weeks. Participant characteristic variables and work-time variables were also measured. A mixed models analysis of covariance (ANCOVA) with repeated measures showed that the Social Role (SR) Scale, a subscale of the OQ, was a significant predictor of Presenteeism, Overall Work Impairment, and Activity Impairment subscales. Latent growth modeling (LGM) was used to examine the relationship between the variables while accounting for individual trajectory differences. Although the results suggested that an unconditional model of Overall Work Impairment with SR as a time-varying covariate provided a good fit for the data, standardized regression weights between the variables were not significant. Implications of findings, limitations, and recommendations for future research are discussed.
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Findlay, Elizabeth. "An Exploration of Aggregated Patterns of Student Curriculum-Based-Measurement Outcome Data Within a Response to Intervention Program." DigitalCommons@USU, 2012. https://digitalcommons.usu.edu/etd/1433.
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One major concern when developing a response to intervention (RTI) program is to select effective practices that will be successfully implemented and sustained with adequate organizational guidance and support. The purpose of this study was to explore patterns of student tier placement data as a school-based case example of the nature and utility of RTI in an applied setting. Specifically, this study aimed to explore the extent that the percentages of students placed in a three-tier program based on student oral reading fluency (ORF) level and growth trajectories reflect the standard RTI tier placement (80%, 15%, and 5%) at fall, winter, and spring in a school setting. Percentages of the total student population tier placement were explored with ORF data from third- and fourth-grade students (N = 429) at two schools in fall, winter, and spring. Results showed that school and ORF data reflected the standard percentages of student populations within each tier in fall, winter, and spring. However, slope data showed greater percentages of students in the more intensive tiers. Moreover, flexible grouping, or movement between tiers occurred for few students when movement occurred based on school or ORF level data. No significant differences were found between the school and ORF student tier placements in fall, winter, and spring. A significant difference was found in spring between placement methods with a larger proportion of students in Tier 1 based on the school assignments and a larger proportion of students in Tier 2 and Tier 3 based on ORF slope assignments.
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Slade, Michael Dominic. "The development and evaluation of an evidence-based approach to implementing outcome measurement in routine mental health services." Thesis, King's College London (University of London), 2004. https://kclpure.kcl.ac.uk/portal/en/theses/the-development-and-evaluation-of-an-evidencebased-approach-to-implementing-outcome-measurement-in-routine-mental-health-services(e35d47a2-800b-4ca6-b759-eb7c6c6e0804).html.
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Tillett, William. "Work disability in psoriatic arthritis." Thesis, University of Bath, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.629672.
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Psoriatic arthritis is an inflammatory arthritis affecting a fifth of patients with skin psoriasis. Inflammation of the joints and tendons causes pain, stiffness, reduced function and disability. Work disability is increasingly recognised as an important, patient centred, functional measure of disease yet little is known about work disability in psoriatic arthritis. The overall aim of my thesis is to examine patient reported work disability in psoriatic arthritis by undertaking the following; • A systematic review of the relevant literature • Classification of a cohort of patients to study • Validation of a commonly used work outcome measure used in other rheumatic diseases • Selection of a suitable measure of structural damage to inflamed joints for investigating the associations of work disability in longitudinal observational studies. The results of the systematic review identified limited data reporting high levels of work disability associated with a wide variety of disease and non-disease related factors. The review also identified the lack of a validated outcome measure for use in psoriatic arthritis. I report the classification of a large single centre longitudinal cohort of patients with psoriatic arthritis and evidence supporting the retrospective application of a psoriatic arthritis classification criterion. Subsequently I report a preliminary validation study of the work productivity and activity impairment questionnaire to measure work disability in psoriatic arthritis and a further study comparing the existing measures of structural damage in psoriatic arthritis. Finally I developed and supervised a multicentre observational study to examine the associations of work disability in psoriatic arthritis. The study identified reduced work effectiveness to be associated with measures of disease activity, whereas unemployment was associated with recent disease onset, greater age and worse physical function. The study will provide a valuable cohort for prospective study of work disability and the effect of medical treatment and will form part of my planned post-doctoral studies.
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Bouchard, Danielle. "Assessment of the Therapeutic Alliance Scales: A Reliability and Validity Meta-Analytic Evaluation." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37810.
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Abstract
Extensive research has been conducted out on the construct of therapeutic alliance. With the growing emphasis on evidence-based practice in psychology it is vital that measures used in both clinical and research settings are empirically well-suited for the population under investigation. However, many measurement issues related to the reliability and validity of the alliance construct remain unaddressed or unresolved. Two studies were designed to add to the scientific evidence on the therapeutic alliance by establishing empirical evidence of the psychometric properties of this construct’s most commonly used measures, with the intention of identifying the most psychometrically sound alliance measures. This was first done by systematically reviewing the literature to identify studies that used the most commonly used alliance measures. Next, key psychometric properties of each measure (internal reliability and predictive validity) were reviewed to determine if the alliance was assessed in the context of individual adult psychotherapy. In the first study, I conducted a reliability generalization analysis to (a) estimate the average reliability coefficient of each alliance measure identified in the systematic review and (b) examine the potential influence that study characteristics may have had on the reliability estimates. Six different alliance measures were included (Agnew Relationship Measure, California Psychotherapy Alliance Scales, Counselor Rating Form, Penn Alliance Scales, Therapeutic Bond Scale, Working Alliance Inventory), in various formats and rater versions, resulting in a total of 17 alliance measure variants for this first analysis. In the second study, I conducted a validity generalization analysis using only those studies from the first study that were identified as containing outcome data. The purpose of this study was to synthesize the alliance-outcome effect sizes that have been reported for the most commonly used therapeutic alliance measures and to assess the potential impact study characteristics may have on those effect sizes. Five different alliance measures (California Psychotherapy Alliance Scales, Counselor Rating Form, Penn Alliance Scales, Therapeutic Bond Scale, Working Alliance Inventory, Vanderbilt Therapeutic Alliance Scale) in various formats and rater versions, resulting in a total of 15 alliance measure variants were included in this analysis. This second study was different from previous alliance-outcome meta-analyses as I only included studies that (a) could be identified as providing psychotherapy, as opposed to other mental health services, (b) assessed the alliance from individual adult psychotherapy, (c) were identified as using the most commonly used alliance measures, and (d) measured the alliance at the midpoint of treatment, or earlier. This second study also differed from previous meta-analyses as I conducted separate analyses for correlational data and partial correlational data. The reliability generalization study found that majority of the alliance measures were good choices for assessing the alliance based on their mean reliability coefficients. The validity generalization study found relatively no difference in the early alliance’s ability to predict treatment outcomes in individual adult psychotherapy between full correlation data (r = .24) and partial correlation data (r = .23). There was also no difference found among the different alliance measures, or their variants, in their ability to predict treatment outcomes, suggesting that no one alliance measure is statistically better at predicting outcomes. The results from both studies suggest that, based on their overall level of reliability as well as their ability to predict treatment outcomes, both researcher and clinicians should consider these measures, with few exceptions, as comparably good choices for assessing the alliance in adult individual psychotherapy.
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Islam, A. K. M. Moinul, and Michael Unterkalmsteiner. "Software Process Improvement Measurement and Evaluation Framework (SPI-MEF)." Thesis, Blekinge Tekniska Högskola, Sektionen för datavetenskap och kommunikation, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-2493.
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During the last decades, the dependency on software has increased. Many of today’s modern devices embed software to control their functions. The increasing dependency has also taken part in shaping the software development process to produce better quality software. Many researchers and practitioners have spent large investments to improve the software development process. A research area within software engineering that addresses the assessment and improvement issues in development processes is called Software Process Improvement (SPI). One of the essential aspects in software process improvement is measuring the outcome of the implemented changes. The measurement and evaluation of software process improvement provides the means for the organization to articulate the achievement level of their goals. Although the importance of measuring and evaluating the outcome of software process improvement is paramount, there exist no common guidelines or systematic methods of measuring and evaluating the improvement. This condition evokes difficulties for practitioners to implement software process improvement measurement programs. This issue has raised the challenge to develop and implement an effective framework for measuring and evaluating the outcome of software process improvement initiatives. This thesis presents a measurement and evaluation framework for software process improvement. SPI-MEF provides guidelines in the form of systematic steps to evaluate the outcome of software process improvement. The framework is based on key concepts which were elaborated in previous work. In this thesis, a validation of SPI-MEF is also conducted by involving representatives from academia and industry. The validation is aimed to judge the frameworks’ usability, applicability and usefulness. Finally, a refinement of the framework is carried out based on the input from the validation.
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Ryu, Duchwan. "Regression analysis with longitudinal measurements." Texas A&M University, 2005. http://hdl.handle.net/1969.1/2398.
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Bayesian approaches to the regression analysis for longitudinal measurements are
considered. The history of measurements from a subject may convey characteristics
of the subject. Hence, in a regression analysis with longitudinal measurements, the
characteristics of each subject can be served as covariates, in addition to possible other
covariates. Also, the longitudinal measurements may lead to complicated covariance
structures within each subject and they should be modeled properly.
When covariates are some unobservable characteristics of each subject, Bayesian
parametric and nonparametric regressions have been considered. Although covariates
are not observable directly, by virtue of longitudinal measurements, the covariates
can be estimated. In this case, the measurement error problem is inevitable. Hence,
a classical measurement error model is established. In the Bayesian framework, the
regression function as well as all the unobservable covariates and nuisance parameters
are estimated. As multiple covariates are involved, a generalized additive model is
adopted, and the Bayesian backfitting algorithm is utilized for each component of the
additive model. For the binary response, the logistic regression has been proposed,
where the link function is estimated by the Bayesian parametric and nonparametric
regressions. For the link function, introduction of latent variables make the computing
fast.
In the next part, each subject is assumed to be observed not at the prespecifiedtime-points. Furthermore, the time of next measurement from a subject is supposed to
be dependent on the previous measurement history of the subject. For this outcome-
dependent follow-up times, various modeling options and the associated analyses
have been examined to investigate how outcome-dependent follow-up times affect
the estimation, within the frameworks of Bayesian parametric and nonparametric
regressions. Correlation structures of outcomes are based on different correlation
coefficients for different subjects. First, by assuming a Poisson process for the follow-
up times, regression models have been constructed. To interpret the subject-specific
random effects, more flexible models are considered by introducing a latent variable
for the subject-specific random effect and a survival distribution for the follow-up
times. The performance of each model has been evaluated by utilizing Bayesian
model assessments.
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Trotter, Vinessa Kaye. "The Relationship Between Psychological Well-Being and Work Productivity: Validation of the OQ Productivity Index." BYU ScholarsArchive, 2008. https://scholarsarchive.byu.edu/etd/1867.
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Managed Mental Health Care (MMHC) began blanketing the United States when cost of care rose exponentially. MMHC is one avenue many employers and insurance companies have chosen to provide employees with mental health treatment at controlled costs. However, not all employers view supplying their employees with mental health treatment beneficial, as they do not know mental health problems can significantly decrease work productivity. Brown and Jones (2005) used the Social Role Scale (SR) of the Severe Outcome Questionnaire (SOQ) to estimate work productivity in employees under the assumption that the scale measures work productivity. The purpose of this study was to move closer to an estimation of the relationship between improved mental health and improved workplace functioning by examining the relationships among a self-report measure of mental health (i.e., the SR), a self-report measure of work productivity (i.e., the Work Productivity and Activity Impairment Scale [WPAI]), and objective measures of work productivity (i.e., the quality and timeliness of institutional records, supervisor ratings, and sick hours used). It was thought that understanding the relationships among these measures might assist in estimating the cost/benefit of investing in psychotherapy. Participants in this study were employees and inpatients at the Utah State Hospital. Statistical analyses indicated the SR did predict two WPAI scales (i.e., Presenteeism and Activity Impairment) for employees. Specific relationships among measures, and suggestions for future research, are discussed.
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Gladwell, Peter William. "Focusing outcome measurement for Transcutaneous Electrical Nerve Stimulation evaluation: incorporating the experiences of TENS users with chronic musculoskeletal pain." Thesis, University of the West of England, Bristol, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.601206.
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This thesis has used qualitative interviews to generate knowledge about the use of Transcutaneous Electrical Nerve Stimulation (TENS) by patients with chronic musculoskeletal pain. This knowledge can inform the selection of appropriate outcome measures which are relevant to the patients' use of TENS, and can be used to focus the design of future TENS evaluations. Methods Semi-structured interviews were used to explore the perceived benefits of TENS reported by secondary ca re pain clinic patients with chronic musculoskeletal pain. The data were analysed using an ind uctive thematic analysis and a parallel, theo retical thematic analysis was undertaken to faci litate linking against other datasets and outcome measures. Two other forms of data generation were used to ens ure that a comprehensive understanding of the perceived benefits of TENS was developed. The analysis was compared with outcome measures used previously for TENS evaluations in chronic pain and chronic low back pain findings & impli ca tions The analysis indicated that TENS should be considered as a complex intervention, with benefits which extend beyond pain relief, including a red uction in muscle sensations (such as tension and spasm), and di straction from pain as separate benefits. Patients reported using TENS in a strategic manner, for example in order to manage pain fl are-ups, ach ieve functiona l goals, enhance rest periods and reduce medication. This indicates that outcomes need to be contextualised to the specific strategy of use. The benefits re ported by TENS users had a low degree of match against previously used outcome measures. This indicates that these previously used outcome measures have limi ted ca pacity to capture patient-reported benefits. An alte rna tive a pproach to outcome measurement is developed, which has the potential to test elements of the analysis developed in t hi s thesis, as well as enhancing the sensitivity of future TENS evaluations.
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Olsson, Jennie. "Jämförelse av ekonomiskt utfall vid klassning av massaved enligt dagens klassningssystem och det nya systemet Prima-Sekunda : – En fallstudie på Mellanskog." Thesis, Linnéuniversitetet, Institutionen för skog och träteknik (SOT), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-89540.
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In August 2019, Prima-Sekunda is about to be introduced, a new classification system for the classification of pulpwood during surveying to industry. This new classification system should be more time and cost effective and at the same time offer the industries commodity volume with better quality. The purpose of this study was to compare if there was any difference in the economic outcome with the new Prima-Sekunda compared to today's classification system when measuring pulpwood. Based on the 95 piles measured, it appeared that today's classification system gives somewhat better paid than Prima-Sekunda due to the prices for Prima-Sekunda which are initially set slightly lower than today's pulpwood price. The introduction of Prima-Sekunda should be price neutral, which means that the prices for Prima-Sekunda as shown in the current study must be reasonably equal to the current pulpwood price for this goal to be materialized.
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Rollison, Julia. "Methodological Decision-Making in Evaluation: An Examination of Implications of Using a Stage of Change Outcome Variable." Thesis, Boston College, 2014. http://hdl.handle.net/2345/bc-ir:103736.
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Thesis advisor: Lauren SaenzMethods for classifying and treating an outcome variable are critical to explore in health research and evaluation, given the potential impact the choice of method may have on the findings and subsequent recommendations (Merbitz, Morris, & Grip, 1989). Further, given the prominent application of the Transtheoretical Model in health research, the stages of change construct continues to be a critical outcome measure concept used in various applied evaluation studies (Bridle et al., 2005; Nigg, 2002; Prochaska, DiClemente, & Norcross, 1992). The purpose of this dissertation study was to determine if findings differ depending on the approach to categorizing and analyzing a stage of change outcome variable, and if so, to highlight how these may affect policy and programmatic decision-making. Using data from a study on evidence-based program adoption decisions, this dissertation examined five approaches to treating and analyzing a single Decision to Adopt outcome variable. These different approaches were compared from both a methodological and pragmatic perspective. Hypothetical stakeholder illustrations were used to highlight differences in decision-making priorities and use of findings based on role, background, and organizational priorities. In comparing methods for classifying and treating the stage of change outcome variable, findings revealed notable differences in effect size, estimation, implication of major findings, and limitations of approach. The hypothetical stakeholder illustrations stressed the significance of personal values and preferences as key influential factors in decision-making and use of evaluation results. This dissertation highlighted how decisions are inextricably linked to the logic model and underlying theory, particularly as it relates to defining evaluation questions, determining how to categorize constructs, and assigning value to codes. Further, it reinforces the significance of contextual considerations in evaluation and how these cannot be ignored in the decision-making process (e.g., budgetary limitations, practical constraints, political factors). The proposed directions for future research seek to continue advancing this understanding of the impact of methodological decisions in different contexts and help improve the utility of evaluations more broadly
Thesis (PhD) — Boston College, 2014
Submitted to: Boston College. Lynch School of Education
Discipline: Educational Research, Measurement and Evaluation
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Schäffler, Thorsten [Verfasser], Carl Marcus [Gutachter] Wallenburg, and Jürgen [Gutachter] Weber. "Role and outcome of performance measurement in horizontal alliances : an empirical examination / Thorsten Schäffler. Gutachter: Carl Marcus Wallenburg ; Jürgen Weber." Vallendar : WHU - Otto Beisheim School of Management, 2016. http://d-nb.info/1113538465/34.
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Hammer, Ann M. "Forced use on arm function after stroke : clinically rated and self-reported outcome and measurement during the sub-acute phase." Doctoral thesis, Örebro universitet, Hälsoakademin, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-9601.
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The overall aim was to evaluate the effectiveness of forced use on arm and hand recovery after stroke by applying a restraining sling on the non-affected arm and to investigate psychometric properties of selected upper limb measures. Papers I and II reported a randomised trial with 1- and 3-month follow-ups. Thirty patients 1 to 6 months after stroke were included and received regular training for 2 weeks of intervention. The forced-use group had in addition a restraining sling on the non-paretic arm. Outcome measures were the Fugl-Meyer Assessment, the Modified Ashworth scale, the 16-hole peg test, grip force, the Action Research Arm test, and the Motor Assessment Scale (Paper I), and the Motor Activity Log (MAL) (Paper II). Results in Papers I and II showed no statistical difference in change between groups. Both groups improved over time. Paper III assessed the responsiveness of the MAL and its cross-sectional and longitudinal validity. The MAL was responsive to change, with Standardised Response Means and Responsiveness Ratios larger than 1.0. Correlations between the MAL and the other measures were mostly close to 0.50. Paper IV investigated test–retest intra-rater reliability of measuring grip force with Grippit, and assessed relationships between grip forces of both hands, and between sustained and peak grip force. The paretic hand needs to score a change of 10% or 50 N to exceed the measurement error. The mean ratio between sides was 0.66, and between sustained and peak grip force, 0.80–0.84. In conclusion, this thesis provides preliminary evidence that forced use does not generate greater improvement on upper limb motor impairment, capacity, and performance of activity than regular rehabilitation. The findings indicate that the MAL is a responsive measure of daily hand use in patients with stroke. Correlations of construct validity indicated that daily hand use might need to be measured separately from body function and activity capacity. The coefficients calculated for repeatability and reproducibility were acceptable, and the Grippit instrument can be recommended.
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Galloway, Ann. "The measurement of a personal style : its influence and the influence of the sociality corollary upon the therapeutic process and outcome." Thesis, University of Newcastle Upon Tyne, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.340668.
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Singh, Jeshika. "Development of a descriptive system for patient experience." Thesis, Brunel University, 2018. http://bura.brunel.ac.uk/handle/2438/16385.
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Efficient allocation of public resources requires identification, measurement and quantification of costs and benefits of alternative programs. Patient reported outcomes (PROs) are routinely incorporated into economic evaluations of health technologies, but patient experience is often overlooked. This thesis aims to develop a descriptive system for patient experience that can be valued and used to inform economic evaluation. The generation and selection of items is key in the development of any PRO measure. The thesis provides a contemporary overview of recommended methods and those actually used by instrument developers. Frequently a staged approach is used to establish dimensions first, using exploratory factor analysis, followed by item selection using item response theory (IRT), Rasch or structural equation modelling (SEM). I demonstrate the use of different methods for item selection and its underlying mechanics, followed by comparison of the methods. An existing patient dataset, the Inpatient survey (2014) that collected information on nearly 70 aspects of healthcare delivery from NHS users was used. Logistic regression analyses were applied with respondents' rating of overall patient experience specified as dependent variable. Advanced statistical analyses focussed mostly on patients who had an operation or procedure. Latent construct or dimensions were derived and measurement model was confirmed using confirmatory factor analysis. IRT and factor analysis were employed in each one-factor model for item selection. Regression analyses identified many significant variables but most overlapped conceptually. An 11 and 8 factor model for patients with A&E and planned admissions respectively was determined. A generalised partial credit model and a factor analysis model identified different items to include in each dimension. Broadly the items identified by different methods related to respect, comfort and clear communication to patients. This thesis presents descriptive systems for patient experience that is amenable to valuation. It also demonstrates that different patient experience instruments are generated based on patient population used and item selection technique adopted.
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Harrison, Sarah M. "An Examination of Evaluation Plan Quality in Human Service Nonprofit Organizations." Bowling Green State University / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1237401086.
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Evans, James S. "A qualitative analysis of the performance measurement and outcome management procedures applied to the PLEBE Summer Program at the United States Naval Academy." Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 2002. http://library.nps.navy.mil/uhtbin/hyperion-image/02Jun%5FEvans%5FJames.pdf.
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Gioia, Christopher J. "Using the Timeline Followback to Identify Time Windows Representative of Annual Posttreatment Drinking." NSUWorks, 2011. http://nsuworks.nova.edu/cps_stuetd/34.
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Using 12-month post treatment Timeline Followback drinking reports, data extrapolated from shorter time windows (e.g., 1 month, 6 months) were used to estimate total annual drinking. The objective was to determine whether data from a shorter time window would provide an estimate of annual drinking sufficiently consistent with the full year report such that it can be used in place of the full report. Data for this study were obtained from problem drinkers who voluntarily participated in a randomized controlled trial of a mail-based intervention. Complete follow-up data were obtained for 467 of the 825 participants who completed a 12-month Timeline Followback of their post intervention drinking. The results of this study suggest that 3 months is the necessary minimum time window to best represent annual posttreatment drinking with alcohol abusers. The major implication of this finding is that alcohol treatment outcome studies can use a shorter posttreatment time window, which is more time and resource efficient, over which to obtain follow-up data with little to no loss in the representativeness of that data.
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Deffner, Veronika [Verfasser], and Helmut [Akademischer Betreuer] Küchenhoff. "Exposure modeling and exposure measurement error correction in health outcome models with longitudinal data structure : Exposure to particulate matter / Veronika Deffner. Betreuer: Helmut Küchenhoff." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2016. http://d-nb.info/1111505292/34.
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Árnadóttir, Guðrún. "Measuring the impact of body functions on occupational performance : validation of the ADL-focused occupation-based neurobehavioral evaluation (A-ONE)." Doctoral thesis, Umeå universitet, Arbetsterapi, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-32083.
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Background: Among the instruments commonly used by occupational therapists working in the area of rehabilitation of persons with neurological disorders are evaluations of both occupation, such as activities of daily living (ADL), and body functions. While persons with neurological diagnoses typically have symptoms that represent diminished neurobehavioral functions, the resulting pattern of neurobehavioral impairments affecting ADL performance often differs among diagnostic groups. Usually, neurobehavioral impairments are evaluated in a context that is separate from and not natural for ADL task performance. The A-ONE is a unique instrument that can be used to evaluate both ADL performance (ADL scale) and, in the natural context of the ADL task performance, the underlying neurobehaviors that cause diminished ADL task performance among persons with neurological disorders (Neurobehavioral scale). The scales of the instrument are of ordinal type, and in their existing form, do not have measurement properties. Measurement properties are a requirement of evidence-based and quality assured rehabilitation services. The overall aim of this doctoral study was to further develop and validate the A-ONE. This included (a) internal validation to explore the potential for converting the ordinal scales of the instrument to interval scales, (b) examination of which of the neurobehavioral items would be most beneficial and clinically useful for constructing a new Neurobehavioral Impact (NBI) scale for evaluating persons with different neurological diagnoses, and (c) exploration of whether persons with right and left cerebrovascular accidents (RCVA, LCVA) differ in mean NBI measures. Methods: This thesis is comprised of four studies which all contribute in different ways to the validation of the scales of the A-ONE. In the first three studies, Rasch analyses, a widely accepted modern test theory methodology, was used to examine internal validity of the scales and the reliability of the A-ONE measures. In the fourth study, ANCOVA was used to explore between group differences, and Pearson correlation coefficients were used to explore relations between person measures from the different A-ONE scales. Results: The first study of 209 persons diagnosed with CVA and dementia provided support for converting the ordinal ADL scale to an interval scale that has potential to be used to measure change in ADL performance over time. The second and third studies, including 206 and 422 persons respectively, indicated that it is possible to construct several unidimensional versions of a new NBI scale from the neurobehavioral items of the instrument, each with different item content and hierarchical item structure. Further, some of these NBI scales could be used across different diagnostic groups. When exploring differences between 215 persons with RCVA and LCVA on the NBI scale developed for CVA, results of the ANCOVA (with ADL ability as a covariate) indicated that there is no significant difference between groups in their mean NBI measures, despite known differences in patterns of neurobehavioral impairments. Conclusions: The results of this thesis indicate that the A-ONE, although developed by traditional psychometric methods for the purpose of providing useful information for intervention planning, now also has the potential to be used to measure change and compare diagnostic groups. This additional feature will likely enhance both clinical and research potential of the instrument. In order to make the results of the study accessible for clinicians, conversion tables need to be developed.
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Bråndal, Anna. "Rehabilitation after stroke with focus on early supported discharge and post-stroke fatigue." Doctoral thesis, Umeå universitet, Medicin, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-120127.
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Background Stroke is a major cause of disability worldwide. After treatment in a specialized stroke unit, early supported discharge (ESD) followed by home rehabilitation has shown to be an effective way to improve patient outcome and quality of care for persons with mild to moderate stroke. ESD service is recommended in the national and international guidelines for stroke care, but has only partially been implemented in Sweden. Following stroke, fatigue is a common consequence that often becomes more evident when the patient comes home. Currently, there is insufficient evidence about how to measure, treat and handle post-stroke fatigue. The overall aim of this thesis was to evaluate and implement early supported discharge (ESD) based on stroke patients experience after discharge from the stroke unit and local conditions. The aim was also to evaluate post-stroke fatigue with a potentially valid and reliable scale and finally to prepare for a study to evaluate cardiorespiratory training as a part of ESD service for patients with post-stroke fatigue. Methods In paper I, nine strategically chosen patients were interviewed of their experience of falling ill, the hospital stay, discharge, contact with health care after discharge and their request of support. Papers II-III describe and evaluate the development, content, implementation and effects of a locally adopted method for early supported discharge (Umeå Stroke Center ESD) in modern stroke care. Paper II included 153 consecutive patients and paper III, 30 232 patients with first-ever stroke registered in the Riksstroke registry in Sweden. Paper II evaluated number of patients/year, clinical and functional health status, satisfaction in relation to needs, accidental falls/other injuries and resources with the result summarized in a value compass. The implementation process was evaluated retrospectively by means of Consolidated Framework for Implementation (CFIR). Paper III evaluated patient reported outcome measurements (PROMs) at 3 months. The primary outcome in paper III was satisfaction with the rehabilitation after discharge. Secondary outcomes were information about stroke provided, tiredness/fatigue, pain, dysthymia/depression, general health status and dependence in activities of daily living (mobility, toilet hygiene and dressing). Multivariable logistic regression models for each PROM was used to analyze associations between PROMs and ESD/no ESD. In Paper IV, the Fatigue Assessment scale (FAS) was translated into Swedish and evaluated regarding psychometric properties when self-administered by persons with mild to moderate stroke. 72 consecutively patients selected from the stroke unit admission register received a letter including three questionnaires: the FAS, the Short Form Health Survey (SF-36) subscale for vitality and the Geriatric Depression Scale GDS-15. A second letter with FAS was sent within 2 weeks, for re-test evaluation. Paper V is a study protocol for a planned randomized controlled trial (RCT) of 50 consecutive stroke patients will who receive stroke unit care followed by ESD-service at Umeå Stroke Center, University Hospital, Umeå, Sweden. Paper V will investigate if a structured cardiorespiratory interval training program (CITP) added to the ESD-service may result in relieved post-stroke fatigue and increased oxygen uptake. Results The interviews in Paper I revealed three main categories with subcategories: “Responsible and implicated”, “Depersonalized object for caring measures” and “The striving for repersonalization and autonomy”. The findings indicate that coming home gave the informants’ important insights and understanding of the stroke, its consequences and was also an important factor for the recovery. Paper II-III showed that it is possible to develop and implement an adapted ESD service for stroke patients based on the patients’ experiences and requests, evidence-based recommendations and local conditions. The ESD service reduced dependence of activity, increased mobility with seemingly no increased risk of accidental falls or other injuries. The patient satisfaction in relation to needs regarding the ESD was high. Paper III showed that patients that received ESD were more satisfied with rehabilitation after discharge, had less need for assistance with ADL and less dysthymia/depression compared to patients that did not receive ESD. Study IV showed that the Swedish FAS used at home as a selfadministered questionnaire is a reliable and valid questionnaire for measuring fatigue in persons with mild to moderate stroke. The internal consistency was good, the agreement between the test and retest reliability for individual items (weighted kappa) was for the majority of items good or moderate. The relative reliability for total scores was good and the absolute reliability was 9 points. The Swedish FAS had no floor nor ceiling effects and correlated both with the SF-36, subscale for vitality and the GDS-15 indicating convergent construct validity, but not divergent construct validity. Conclusion It is possible to develop and implement ESD care for stroke patients based on patients’ experience and needs, evidence-based principles and local conditions. Early supported discharge (ESD) in the setting of modern stroke unit care appears to have positive effects on rehabilitation in the subacute phase. The Swedish FAS used at home as a self-administered questionnaire is reliable and valid for measuring fatigue in persons with mild to moderate stroke.
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Cheng, Chow Kian, and Rahadian Bayu Permadi. "Towards an Evaluation Framework for Software Process Improvement." Thesis, Blekinge Tekniska Högskola, Sektionen för datavetenskap och kommunikation, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-3625.
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Software has gained an essential role in our daily life in the last decades. This condition demands high quality software. To produce high quality software many practitioners and researchers put more attention on the software development process. Large investments are poured to improve the software development process. Software Process Improvement (SPI) is a research area which is aimed to address the assessment and improvement issues in the software development process. One of the most important aspects in software process improvement is to measure the results gained from the embarked process change. Without measuring the results, it is hard to tell whether the goals have been achieved or not. However, measurement for software process improvement is not a trivial task. Furthermore, there is no common systematic methodology that can be used to help measuring the performance of software process improvement initiatives. This thesis is intended to provide basic key concepts for the effective measurement and evaluation of the outcome of software process improvement. A major part of this thesis presents the systematic review in evaluating the outcome of software process improvement. The systematic review is aimed at the identification of the major issues in software process improvement evaluation and to gather the requirements for a software process improvement measurement and evaluation framework. Based on the results of the systematic review, a measurement and evaluation model is formulated. The objective of the model is to provide the groundwork for a software process improvement measurement and evaluation framework. The model is deemed to be applicable in a broad spectrum of scenarios by providing concepts that are independent from specific SPI initiatives.
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Pesudovs, Konrad, J. M. Burr, Clare Harley, and David B. Elliott. "The development, assessment, and selection of questionnaires." Lippincott Williams & Wilkins for the American Academy of Optometry, 2007. http://hdl.handle.net/10454/4513.
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NoPatient-reported outcome measurement has become accepted as an important component of comprehensive outcomes research. Researchers wishing to use a patient-reported measure must either develop their own questionnaire (called an instrument in the research literature) or choose from the myriad of instruments previously reported. This article summarizes how previously developed instruments are best assessed using a systematic process and we propose a system of quality assessment so that clinicians and researchers can determine whether there exists an appropriately developed and validated instrument that matches their particular needs. These quality assessment criteria may also be useful to guide new instrument development and refinement. We welcome debate over the appropriateness of these criteria as this will lead to the evolution of better quality assessment criteria and in turn better assessment of patient-reported outcomes.
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Heinl, Daniel [Verfasser], and Christian [Akademischer Betreuer] Apfelbacher. "What are the best quality of life measurement instruments for eczema? Perspectives on popularity and quality as a contribution to developing a core outcome set. / Daniel Heinl ; Betreuer: Christian Apfelbacher." Regensburg : Universitätsbibliothek Regensburg, 2018. http://d-nb.info/1169912400/34.
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