Background: Due to an ageing population, multimorbidity is becoming more common. Treatment burden (the effort required of patients to look after their health and the impact this has on their wellbeing) is prevalent in patients with multimorbidity. The Multimorbidity Treatment Burden Questionnaire (MTBQ) is a patient-reported outcome measure of treatment burden that has been validated amongst patients with multimorbidity in the UK. The aim of this study was to translate and culturally adapt the MTBQ into Chinese and to assess its reliability and validity in elderly patients with multimorbidity in hospital. Methods: The original English version of the MTBQ was translated into Chinese using Brislin's model of crossculture translation. The C-MTBQ was piloted on a sample of 30 elderly patients with multimorbidity prior to being completed by 156 Chinese elderly patients with multimorbidity recruited from a hospital in Zhengzhou, China. We examined the proportion of missing data, the distribution of responses and floor and ceiling effects for each question. Factor analysis, Cronbach's alpha, intraclass coefficient and Spearman's rank correlations assessed dimensional structure, internal consistency reliability, test-retest reliability and criterion validity, respectively. Results: The average age of the respondents was 73.5 years (range 60-99 years). The median C-MTBQ global score was 20.8 (interquartile range 12.5-29.2). Significant floor effects were seen for all items. Factor analysis supported a three-factor structure. The C-MTBQ had high internal consistency (Cronbach's alpha coefficient, 0.76) and test-retest reliability (the intraclass correlation coefficient, 0.944), the correlations between every item and global scores scored > 0.4. The scale content validity index(S-CVI) was 0.89, and the item level content validity index(I-CVI)was 0.83~1.00. The criterion validity was 0.875. Conclusion: The Chinese version of MTBQ showed satisfactory reliability and validity in elderly patients with multimorbidity, and could be used as a tool to measure treatment burden of elderly patients with multimorbidity in hospital.
The effects of an electrical double layer (EDL), boundary slip and their combined effects on the microchannel flow stability are investigated. Instead of applying the traditional streaming electrical current balance (ECB) mode, a newly introduced electrical current density balance (ECDB) mode is used to compute the conduction current when the effects of EDL is considered. The modified N-S equations and Poisson-Boltzmann equation together with the ECDB mode and Navier slip boundary are the theoretical basis for the present approach. The stability analysis considering the modifications of EDL and boundary slip is built up by the small perturbation method. It is found that the effect of EDL results in inflexions on the mean velocity profile near walls and destabilizes the stability of flow. On the contrary, the effect of boundary slip stabilizes the stability of flow. The effectiveness of boundary slip on the mean velocity and flow stability is influenced strongly by the effect of EDL. The effect of boundary slip can be disappeared when the Zeta potential is large enough.
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