BackgroundMusculoskeletal disorders affect all racial and ethnic groups, including Hispanics. Because these disorders are not life-threatening, decision-making is generally preference-based. Little is known about whether Hispanics in the U.S. differ from non-Hispanic Whites with respect to key decision making preferences.MethodsWe assembled six focus groups of Hispanic and non-Hispanic White patients with chronic back or knee pain at an urban medical center to discuss management of their conditions and the roles they preferred in medical decision-making. Hispanic groups were further stratified by socioeconomic status, using neighborhood characteristics as proxy measures. Discussions were led by a moderator, taped, transcribed and analyzed using a grounded theory approach.ResultsThe analysis revealed ethnic differences in several areas pertinent to medical decision-making. Specifically, Hispanic participants were more likely to permit their physician to take the predominant role in making health decisions. Also, Hispanics of lower socioeconomic status generally preferred to use non-internet sources of health information to make medical decisions and to rely on advice obtained by word of mouth. Hispanics emphasized the role of faith and religion in coping with musculoskeletal disability. The analysis also revealed broad areas of concordance across ethnic strata including the primary role that pain and achieving pain relief play in patients' experiences and decisions.ConclusionsThese findings suggest differences between Hispanics and non-Hispanic Whites in preferred information sources and decision-making roles. These findings are hypothesis-generating. If confirmed in further research, they may inform the development of interventions to enhance preference-based decision-making among Hispanics.
SUMMARY
The reliability of the Functional Independence Measure for Children (WeeFIM) was examined in 37 non‐disabled children and 30 children with disabilities, from 12 to 76 months of age. The WeeFIM is derived from the Functional Independence Measure (FIM) and includes 18 items involving six functional subscalcs. Stability was assessed by administering the WeeFIM instrument to each child's caregiver on two occasions separated by 7 to 14 days. Intraclass correlation co‐efficients (ICCs) for individual items ranged from 0.90 to 0.99. The ICC for the six WeeFIM subscales ranged from 0.94 for social cognition to 0.99 for transfers and locomotion. The ICC value for total WeeFIM test‐retest reliability was 0.98 for children with disabilities and 0.99 for children without disabilities. Equivalence reliability was examined by comparing ratings obtained when using personal assessment with ratings collected during a telephone interview. No statistically significant differences were found for individual items, subscale scores or total WeeFIM values.
RÉSUMÉ
La fidélité et lafaibilité d' équivalence de la Mesure d'Indépendance Fonctionelle pour enfants (WeeFIM)
La fiabilité de la Mesure d'Indépendance Fonctionnelle pour enfants (WeeFlMSIM) a étéévaluée chez 30 enfants porteurs d'incapacité et 37 enfants indemnes, âgés de 12 à 76 mois. La WeeFIM est derivee de la Mesure d'lndependance Fonctionnelle et inclut 18 items rdpartis en six sous‐echelles fonctionnelles. La fidelite fut évaluée en administrant la WeeFIM sur chaque enfant pris en charge a deux occasions separees par un delai de sept a 14 jours. Les coefficients de correlation intraclasse (ICC) pour les items individuels s'echelonnaient entre 0.90 et 0.99. Les ICC pour les six sous‐echelles WeeFIM s'echelonnaient entrc 0.94 pour la connaissance sociale et 0.99 pour les deplacements et la locomotion. Les valeurs ICC de fidelite test‐retest sur la WeeFIM globale etaicnt de 0.98 pour les enfants avec incapacity, et 0.99 pour les enfants indemnes. La fiabilite d'equivalcnce fut etudide en comparant les resultats obtenus directement de personne a personne, et les resultats recueillis par communication téléphonique. Aucune différence significative ne fut trouvée, ni pour les items individuels, ni pour les sous‐echelles, ni pour les valeurs globales de la WeeFIM.
ZUSAMMENFASSUNG
Die Stahilitäts‐ und Gleichwertigkeits‐Reliabilitat des Functional Independence Measure for Children (WeeFIM)
Bei 30 Kindern mil Behinderungen und 37 nicht behinderten Kindern im Alter zwischen 12 und 76 Monaten wurde die Reliabilitat des Functional Independence Measure for Children (WeeFIM) untersucht. Das WeeFIM ist vom Functional Independence Measure (FIM) abgeleitet und enlhalt 18 Punkte, die sechs funktionelle Untergruppen beinhalten. Die Stabilitat wurde Uberpruft, indem der WeeFIM von jeder Pflegeperson des Kindes zweimal im Abstand von sieben bis 14 Tagen durchgefiihrt wurde. Die Korrelationskoeffizienten (ICC) für individuelle Punkte betrug zwischen 0.90 und 0.99. Die ICCs für die sechs WeeFI...
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