Elsie E. Gulick

Correlates of quality of life among persons with multiple sclerosis.

The purpose of this study was to investigate the extent to which objective (demographic) and subjective (self-reported health and role) domains predicted quality of life among 153 persons with multiple sclerosis (MS). Subjects completed the Life Situation Survey, a measure of quality of life, a demographic from (sex, education, age, MS duration, employment status, marital status), the MS-Related Symptoms Scale (motor, brain stem, sensory, mental/emotions, elimination subscales), and the 15-Item Activities of Daily Living (ADL) Self-Care Scale for MS Persons (fine/gross motor, communicating, recreation/socializing, intimacy subscales). Hierarchical multiple regression was used to enter three blocks of variables (demographic, symptom, and ADL domains), and stepwise was used to enter variables within each block. The final model resulted in two health domains (mental/emotions and sensory symptoms) and two role domains (intimacy and recreation/socializing) that predicted 61% of the variance in quality of life of persons with MS.

Parsimony and model confirmation of the ADL Self-Care Scale for multiple sclerosis persons.

Data from a 52-item self-administered Activities of Daily Living (ADL) Self-Care Scale designed for persons diagnosed with multiple sclerosis (MS) were refactored for the purpose of achieving scale parsimony and clarifying interrelationships among ADL self-care behaviors. Analyses were based on 629 MS subjects. Principal component analysis and Varimax rotated factor analysis were used to achieve scale parsimony. The resultant 15-item scale was subjected to confirmatory factor analysis to determine relationships among factors, observed variables, and residual variances within the factor model. Modification of the initial factor model due to a less than satisfactory goodness-of-fit index (GFI) (0.848) resulted in the inclusion of four additional relationships between observed variables and a second factor and six paired relations among the residual variances. The modified factor model had a satisfactory GFI of 0.95. These findings support the development of a 15-item self-administered ADL Self-Care Scale. The scale can be used to screen ADL functional levels in MS persons or to monitor changes in their ADL over time.

Psychometric properties of the alcohol use disorders identification test: a Korean version.

OBJECTIVE The Alcohol Use Disorders Identification Test (AUDIT) is an important screening tool but has never been administered to Korean Americans. This study was conducted to examine the psychometric properties of a Korean version of the AUDIT referred to as AUDIT-K and to determine which cutoff score of the scale would perform better in Korean Americans. METHOD Translation and backtranslation of the AUDIT-K were conducted to obtain a measure consistent with the Korean cultural understanding of alcohol use. Following satisfactory interrater agreements on each item about its Korean translation, the AUDIT-K was administered to 118 Korean American men (Time 1) and to 93 of the men approximately 1 month later (Time 2). Data were analyzed for internal consistency reliability, test-retest reliability, and construct validity. RESULTS Approximately 47.5% of Korean American men who participated in the study were identified as having drinking problems when using the World Health Organizations recommended cutoff score of 8, whereas approximately 20.3% were found to have problems with alcohol when using the cutoff score of 12, the one recommended for Koreans. Cronbachs alpha was .82 at Time 1 and was .80 at Time 2. Test-Retest reliability assessed via the intraclass correlation coefficient for the total AUDIT scale was .85. Principal components factor analysis with varimax orthogonal rotation revealed a two-factor solution, alcohol consumption and drinking problems, resulting in 57% of the explained variance. CONCLUSIONS The AUDIT-K was found to be internally consistent and stable over time and should be used in primary health care settings to screen Korean American men for alcohol use disorders to facilitate early interventions.

Model for predicting work performance among persons with multiple sclerosis

A causal model was tested on a sample of 201 MS subjects for the purpose of examining the role of selected demographic factors, work impediments, and work enhancers as predictors of activities essential for performing outside employment, home making, and for personal care. The results showed a relatively good fit of the model to the data through a number of indicators. Explained variance included: 9.0% in work impediments from the direct effect of age; 32.3% in work enhancers--A (job and environmental adjustment, social support, healthful practices) through direct effects from MS duration and work impediments; 9.8% in work enhancers--B (personal attributes) through direct effects from MS duration and work impediments; 61.1% in work performance through direct effects from the antecedent variables (age, education), stress-appraisal variable (work impediments), and coping variables (work enhancers-A, work enhancers-B).

Emotional distress and activities of daily living functioning in persons with multiple sclerosis.

BackgroundEmotional distress is higher in persons with multiple sclerosis (MS) than in other chronic illnesses. Not known is whether personal attributes of the person with MS and/or the presence of social support will function as mediating and/or moderating variables between emotional distress and adaptation to the illness. ObjectivesDetermine if personal attributes and social support function as mediating and/or moderating variables between emotional distress and ADL functioning in persons with MS. MethodsSecondary analyses of data obtained from 686 persons with MS through self-report measures of emotional distress, personal attributes, social support, and ADL functioning was conducted. Separate mediation and moderation models were tested using stepwise and hierarchical multiple regression. Demographic variables of education, age, and length of MS illness, were controlled in all analyses. ResultsPersonal attributes and social support functioned as mediator variables between emotional distress and ADL functioning. Additionally, personal attributes and not social support functioned as a moderator. Significant main effects were shown for social support and emotional distress in the moderator model. ConclusionPersonal attributes and social support mediated the effects of emotional distress by decreasing its impact on ADL functioning. Personal attributes, as a moderator variable, demonstrated that higher levels were associated with low levels of emotional stress and moderate or lower levels of personal attributes were associated with increased emotional distress suggesting that personal attributes may intervene between emotional distress and ADL functioning by attenuating or preventing a stress appraisal response.

Reliability and validity of the Sexual Pressure Scale for Women‐Revised

Sexual pressure among young urban women represents adherence to gender stereotypical expectations to engage in sex. Revision of the original five-factor Sexual Pressure Scale was undertaken in two studies to improve reliabilities in two of the five factors. In Study 1 the reliability of the Sexual Pressure Scale for Women-Revised (SPSW-R) was tested, and principal components analysis was performed in a sample of 325 young, urban women. A parsimonious 18-item, four-factor model explained 61% of the variance. In Study 2 the theory underlying sexual pressure was supported by confirmatory factor analysis using structural equation modeling in a sample of 181 women. Reliabilities of the SPSW-R total and subscales were very satisfactory, suggesting it may be used in intervention research.

Influence of Infant Feeding Method on Postpartum Relapse of Mothers With MS

In an effort to determine relapse rates in breast-feeding and non—breast-feeding mothers with multiple sclerosis (MS) as well as differences in symptom prevalence between relapsing and non-relapsing mothers, weekly diaries through the first six postpartum months were kept by mothers to record the frequency and percentages of infant feeding by breast or formula and health problems that the mothers experienced. Of 140 mothers who breast-fed their infants, 35 (25%) experienced at least one neurologist-confirmed MS relapse during the first six months and 47 (33.6%) during the 12-month period; for non—breast-feeding mothers, 18 (51.4%) experienced relapse by six months and 22 (61.1%) by 12 months. MS relapse during pregnancy predicted increased relapse during the first three postpartum months while an increased percentage of infant feedings by breast predicted decreased relapse. Relapse the year before pregnancy and during pregnancy predicted increased relapse during the four- to six-month postpartum period. L...

Physical Activity Among People With Multiple Sclerosis

Most studies reported in the literature regarding physical activity among people with multiple sclerosis (MS) focus on structured interventions. Physical activity can also be gained through many no...

Reliability and validity of the work assessment scale for persons with multiple sclerosis

Reliability and. validity of the Work Assessment Scale (WAS) was done on a sample of 551 subjects with multiple sclerosis. Work was defined as those activities performed in employment, homemaking and/or personal care. The WAS has two parts consisting of: Work-Impeding (WAS-I) and Work Enhancing (WAS-E) situations and conditions. Varimax rotated factor analysis of the WAS-I resulted in a seven-factor solution containing 33 of the 53 scale items. Theta reliability coefficients for the factors ranged between .73 and .90 and test-retest correlation coefficients (n = 51) ranged between .76 and .91. Varimax rotated factor analysis of the WAS-E resulted in a five-factor solution containing 19 of the 27 scale items. Theta reliability coefficients for the factors ranged between .66 and. .81 and test-retest correlation coefficients ranged between .68 and .82. Concurrent validity was shown between WAS and both ADL and Symptom subscales.

Cross-Cultural Validation of a Smoking Abstinence Self-Efficacy Scale in Korean American Men

The main purpose of the study was to examine the psychometric properties of a Smoking Abstinence Self-Efficacy Scale with Korean men in the US. The scale was modified to reflect the Korean cultural practice of smoking behavior and was cross-culturally validated with a panel of 10 professionals. An 11-item Korean version of the scale was administered twice over a one-month period. Data were analyzed for internal consistency reliability, stability, and construct validity. After the deletion of one item, an exploratory factor analysis yielded two factors, which explained 62% of the variance. Internal consistency was satisfactory for the total scale (.89), Factor I (.88), and Factor II (.80) but intraclass correlation coefficient for the total scale (.57) was low. Nicotine dependence and nicotine withdrawal showed modest but statistically significant correlations with the scale.