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BackgroundWeb-based technology has recently become an important source for sharing health information with patients after an acute cardiac event. Therefore, consideration of patients’ perceived electronic health (eHealth) literacy skills is crucial for improving the delivery of patient-centered health information. ObjectiveThe aim of this study was to translate and adapt the eHealth Literacy Scale (eHEALS) to conditions in Norway, and to determine its psychometric properties. More specifically, we set out to determine the reliability (internal consistency, test-retest) and construct validity (structural validity, hypotheses testing, and cross-cultural validity) of the eHEALS in self-report format administered to patients after percutaneous coronary intervention. MethodsThe original English version of the eHEALS was translated into Norwegian following a widely used cross-cultural adaptation process. Internal consistency was calculated using Cronbach α. The intraclass correlation coefficient (ICC) was used to assess the test-retest reliability. Confirmatory factor analysis (CFA) was performed for a priori-specified 1-, 2-, and 3-factor models. Demographic, health-related internet use, health literacy, and health status information was collected to examine correlations with eHEALS scores. ResultsA total of 1695 patients after percutaneous coronary intervention were included in the validation analysis. The mean age was 66 years, and the majority of patients were men (1313, 77.46%). Cronbach α for the eHEALS was >.99. The corresponding Cronbach α for the 2-week retest was .94. The test-retest ICC for eHEALS was 0.605 (95% CI 0.419-0.743, P0.06). After modifications in the 3-factor model, all of the goodness-of-fit indices indicated a good fit. There was a weak correlation with age (r=–0.206). Between-groups analysis of variance showed a difference according to educational groups and the eHEALS score, with a mean difference ranging from 2.24 (P=.002) to 4.61 (P

Aims and Objectives: To (i) determine the prevalence of delirium and identify delirium subtypes in surgical and non‐surgical patients aged ≥65 years, (ii) determine whether certain precipitating factors affect the prevalence of delirium and (iii) review patients' medical records for description of delirium symptoms and the presence of International Classification of Diseases (ICD‐10) coding for delirium in discharge summaries. Methodological Design and Justifications: Despite being a robust predictor of morbidity and mortality in older adults, delirium might be inadequately recognised and under‐reported in patients' medical records and discharge summaries. A point prevalence study (24‐h) of patients ≥65 years from surgical and non‐surgical wards was therefore conducted in a tertiary university hospital. Ethical Issues and Approval: The study was approved by the Data Protection Officer at the university hospital (2018/3454). Research Methods, Instruments and/or Interventions: Patients were assessed for delirium with 4AT and delirium subtypes with the Delirium Motor Subtype Scale. Information about room transfers, need and use of sensory aids and medical equipment was collected onsite. Patients' medical records were reviewed for description of delirium symptoms and of ICD‐10 codes. Results: Overall, 123 patients were screened (52% female). Delirium was identified in 27% of them. Prevalence was associated with advanced age (≥85 years). The uncharacterised delirium subtype was most common (36%), followed by hypoactive (30%), hyperactive (24%) and mixed (9%). There were significant associations between positive screening tests and the need and use of sensory aids. Delirium symptoms were described in 58% of the patients who tested positive for delirium and the ICD‐10 code for delirium was registered in 12% of these patients' discharge summaries. Conclusions: The high prevalence of delirium and limited use of discharge codes highlight the need to improve the identification of delirium in hospital settings and at discharge. Increased awareness and detection of delirium in hospital settings are vital to improve patient care. [ABSTRACT FROM AUTHOR]

There is a pressing need for effective interventions targeting mental disorders for service-involved youth across child welfare, correctional and mental health residential settings. Identifying effective common practice elements (CPEs) is a promising direction toward developing effective, flexible, and feasible therapeutic interventions. The aims of this study were: 1) to identify CPEs in treatment programs for adolescents with internalizing and/or externalizing disorders across residential settings, 2) to identify which CPEs are present in effective versus all trials, and 3) to estimate whether the presence of each CPE is associated with treatment effects. A systematic search identified 24 trials of programs targeting adolescent internalizing and/or externalizing symptoms, yielding 148 effect estimates. Discrete practices were coded into CPE categories across effective trials and the full sample. Eleven CPEs were identified and employed as moderators in three-level meta-analyses. We found large significant moderator effects of two elements on externalizing symptoms: Emotion recognition and differentiation, and Psychoeducation. No CPE was significantly related to effects on internalizing outcomes. The results illustrate the difference between CPE frequency and association with effect, favoring a combination of the two approaches. Emotion recognition and differentiation, and Psychoeducation should be prioritized in novel interventions targeting adolescent externalizing behavior in residential settings. [ABSTRACT FROM AUTHOR]

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After traumatic experiences, it is common to think about alternative scenarios or outcomes of the event. This is often referred to as counterfactual thoughts (CFT), and CFT after trauma have been associated with posttraumatic stress reactions (PTSR). In this study, we aimed to: (1) investigate the relationship between the vividness and frequency of CFT and PTSR, and to (2) examine the associations between exposure, peri‐traumatic reactions, physical injury and the loss of someone close, and the subsequent vividness and frequency of CFT. The participants (N = 289) were survivors of a terror attack in Norway. More vivid and frequent CFT were significantly and independently related to more PTSR. Exposure during trauma was significantly associated with more vivid CFT in the unadjusted regression model. No further significant relationships were found between exposure, peri‐traumatic reactions, physical injury and the loss of someone close, and the vividness and frequency of CFT. As CFT are common after trauma and potentially cause distress, clinicians should identify and validate CFT, and provide coping assistance. [ABSTRACT FROM AUTHOR]