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Objectives: To determine the Minimal Clinically Important Difference (MCID) and Robust Clinically Important Difference (RCID) of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) as measures of response to intervention. Methods: Retrospective analysis of existing data. Both distribution- and anchor-based methods were used to triangulate on the MCID and to identify a moderate, that is, more robust, level of change (RCID) for the MPAI-4. These were further evaluated with respect to clinical provider ratings. Participants: Data for individuals with acquired brain injury in rehabilitation programs throughout the United States in the OutcomeInfo Database (n = 3087) with 2 MPAI-4 ratings. Main Measures: MPAI-4, Supervision Rating Scale, Clinician Rating of Global Clinical Improvement. Results: Initial analyses suggested 5 T-score points (5T) as the MCID and 9T as the RCID. Eighty-one percent to 87% of clinical raters considered a 5T change and 99% considered a 9T change to indicate meaningful improvement. Conclusions: 5T represents the MCID for the MPAI-4 and 9T, the RCID. Both values are notably less than the Reliable Change Index (RCI). While the RCI indicates change with a high level of statistical confidence, it may be insensitive to change that is considered meaningful by providers and participants as indicated by the MCID. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare 2 subjective and 1 objective method for assessing hot flush frequency: prospective pa- per hot flush diaries, prospective electronic event markers, and the Biolog ambulatory sternal skin conductance monitor. METHODS: Fifty-five breast cancer survivors provided two 24-hour periods of data, 1 week apart, at baseline before being randomized for an intervention study. Women completed a prospective paper hot flush diary and pressed an event marker to subjectively record each hot flush they experienced while wearing a sternal skin conductance monitor. RESULTS: Sensitivity was uniformly low (< 50%) for both subjective methods at each week. The estimated probability that a woman would record a true monitor-verified hot flush subjectively by diary or event marker was between 36% and 50% of the time if she was awake and between 22% and 42% of the time if she was asleep. Underreporting of diary hot flushes consequently resulted in more than 50% missing severity and bother ratings. Specificity was high (96-98%) for both the diary and event marker, for both weeks, and for both waking and sleeping times. The positive predictive value was low (34-52%), and negative predictive value was high (94-97%). This indicates that, rather than over-reporting hot flushes when they did not exist, women tended to underreport hot flushes when they did exist. CONCLUSION: Use of prospective paper hot flush diaries and electronic event markers may seriously underestimate hot flush frequency and result in missed intensity and bother ratings. [ABSTRACT FROM AUTHOR]

Objectives: To describe the performance of the Healthy Aging Brain Care Monitor Self Report (HABC-M SR) in assessment of post-intensive care syndrome (PICS) among Acute Respiratory Failure ICU survivors., Design: Secondary data analysis of a randomized controlled trial., Setting: Patients evaluated by a nurse care coordinator in an out-of-hospital setting., Patients: English-speaking adults 18 years old or older who were admitted to the ICU with acute respiratory failure requiring invasive or noninvasive mechanical ventilation for greater than or equal to 24 hours., Interventions: Patients randomized to the intervention arm of the mobile critical care recovery program, a negative trial testing multidisciplinary care to improve quality of life., Measurements and Main Results: HABC-M SR scale was used to assess PICS in the intervention group at ICU discharge, 3, and 6 months post-discharge. Hospital Anxiety and Depression Scale; Pain, Enjoyment of Life, and General Activity Scale; Timed Up and Go; and Patient-Reported Outcomes Measurement Information System sleep scores were obtained at the same time. Mini-Mental State Examination (MMSE) was administered at baseline and 6 months. ICU survivors reported mild PICS symptoms, which improved over 6 months (mean HABC-M SR scores: baseline [8.5, sd 7.6], 3 mo [5.3 mo, sd 6.6 mo], and 6 mo [5.2 mo, sd 6.9 mo; p < 0.001]). HABC-M SR total score had moderate internal consistency that improved over time (Cronbach's alpha = 0.78 at baseline and 0.84 at 6 mo). The psychological subscale of HABC-M SR was moderately correlated with standardized scales for mood, pain, and sleep. The cognitive subscale was not significantly correlated with MMSE., Conclusions: While HABC-M SR correlated with mood, physical, and sleep symptoms, the cognitive subscale was less sensitive compared with standardized scales., Competing Interests: Dr. S. Khan is supported by the National Institute on Aging (NIA; K76 AG074925). Dr. B. A. Khan is supported by the NIA (R01 AG055391, R01 AG06763) and the National Heart, Lung, and Blood Institute (NHLBI; R01 HL131730). Dr. Gao is supported by the NIA (K07 AG076659, P30 AG010133, and P30 AG072976). Dr. Wang is supported by the NIA (K23 AG062555, P30 AG010133, and P30 AG072976). Drs. Savsani, S. H. Khan, Perkins, Wang, Gao, and B. A. Khan received support for article research from the National Institutes of Health (NIH). Drs. Gao’s, S. H. Khan’s, and B. A. Khan’s institutions received funding from the NIH. Dr. Perkins’ received funding from the NHLBI and the NIA. Drs. Gao’s and B. A. Khan’s institutions received funding from the NIH. The remaining authors have disclosed that they do not have any potential conflicts of interest., (Copyright © 2024 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.)

Background: Resilience is a positive health outcome identified by the Committee on Future Direction for Behavioral and Social Sciences as a research priority for the National Institutes of Health. The Resilience in Illness Model (RIM) was developed from a series of qualitative and quantitative studies, to increase understanding of how positive health protective factors (ie, social integration, family environment, courageous coping, and derived meaning) may influence resilience outcomes. The RIM also includes 2 risk factors: illness-related distress and defensive coping., Objective: The purpose of this 2-part article was to report on evaluation of the RIM for adolescents/young adults (AYAs) with cancer. Here, in part 1, our purpose was to describe the exploratory RIM evaluation, and in part 2 we describe the confirmatory RIM evaluation., Methods: An exploratory evaluation of RIM was done using exploratory latent variable structural equation modeling with a combined sample from 2 studies of preadolescents and AYAs with cancer aged 10 to 26 years (n = 202)., Results: Results, including goodness-of-fit indices, support the RIM as a theory with a high level of explained variance for outcomes of resilience (67%) and self-transcendence (63%). Variance explained for proximal outcomes ranged from 18% to 76%., Conclusions: Findings indicate that, following confirmatory testing, the RIM may be a useful guide to developing targeted interventions that are grounded in the experiences of the AYAs., Implications for Practice: Understanding of the AYA cancer experience to improve holistic care is increased.