Assessing outcomes after partial and total tonsillectomy for sleep-disordered breathing in children using Clinical Assessment Score-15.

INTRODUCTION: The Clinical Assessment Score-15 (CAS-15) is an office-based tool for assessing the risk of sleep disordered breathing (SDB), a relatively common condition in the pediatric population. Change in CAS-15 following total tonsillectomy (TT) has been shown to have a large effect size, but it is unclear how it varies following partial intracapsular tonsillectomy (PIT). Thus, the objective of the present study is to evaluate the utility of the CAS-15 score in assessing the effectiveness of PIT and how this compares to change after TT. MATERIAL METHODS: Children ages 2-18 undergoing PIT (N = 16) or TT (N = 8) with or without adenoidectomy for SDB completed the CAS-15 before surgery and at their post-operative follow-up visit. Changes in CAS-15 score were assessed by paired t-test. The mean difference in CAS-15 change between PIT and TT was evaluated by unpaired t-test for unequal variances. Differences in participant characteristics were determined via unpaired t-test for unequal variances. RESULTS: Participants undergoing PIT did not differ significantly than those undergoing TT with regard to age, sex, BMI percentile, pre-op CAS-15 score or tonsil size, or admission rates following surgery (p > 0.05). The median follow-up after surgery was 5.2 (PIT) and 4.4 (TT) weeks. CAS-15 score improved significantly following PIT (42.8 ± 12.3 vs. 9.4 ± 5.6, p < 0.0001) and TT (45.5 ± 13.3 vs. 7.9 ± 5.8, p < 0.0002). The decrease in CAS-15 for PIT did not differ from TT (33.3 ± 11.8 vs. 37.6 ± 15.0, p > 0.49). DISCUSSION: CAS-15 decreases drastically following PIT and TT, indicating significant improvement of SDB symptoms. Because the change in CAS-15 after PIT was similar to TT, PIT may be preferred due to the decreased morbidity of the procedure. Given the cost, time required, inconvenience, and other limitations of overnight polysomnography (PSG), which is the gold standard method of diagnosing SDB, CAS-15 may be a suitable replacement or adjunct for the assessment of SDB following PIT in addition to TT.

The Italian Version of SCORE-15: Validation and Potential Use.

SCORE-15 (Systemic Clinical Outcome and Routine Evaluation) is a 15-item questionnaire for completion by family members aged 12 years and older to assess outcomes in systemic therapy. This study aimed to investigate (a) the psychometric properties and the internal consistency reliability of the Italian version of SCORE-15, (b) clinical responsiveness, and (c) normative (Italian) criteria. Furthermore, (d) the study sought to evaluate the participants' representation of both their family and their problems, analyzing open-ended questions included in the SCORE-15. Data were collected from two clinical centers for 208 families (n = 507). Results confirmed the three-factor structure (i.e., strengths, difficulties, and communication), a good internal consistency reliability, and indicated a cutoff threshold for the Italian version. Furthermore, results showed that SCORE-15 is a good instrument for clinical responsiveness and that it can be used to explore the way in which family members describe their families and problems. Overall, SCORE-15 is a brief, psychometrically robust family assessment instrument that may be used for both researchers and practitioners in several domains of clinical and social psychology.

El SCORE-15 (Evaluación de Rutina y Resultados Clínicos de la Terapia Sistémica) es un cuestionario de 15 preguntas para que lo contesten los miembros de la familia mayores de 12 años a fin de evaluar los resultados de la terapia sistémica. Este estudio tuvo como fin investigar a) las propiedades psicométricas y la consistencia interna fiabilidad de la versión italiana del SCORE-15, b) el grado de respuesta clínica y c) los criterios normativos (italianos). Además, (d) el estudio se propuso evaluar la representación de los participantes de su familia y sus problemas, analizando preguntas abiertas incluidas en el SCORE-15. Se recopilaron datos de dos centros clínicos para 208 familias (n = 507). Los resultados confirmaron la estructura de tres factores (p. ej.: puntos fuertes, dificultades y comunicación), una buena consistencia interna fiabilidad y indicaron un tope para la versión italiana. Además, los resultados demostraron que el SCORE-15 es un buen instrumento para evaluar el grado de respuesta clínica y que puede utilizarse para analizar la forma en la que los familiares describen a sus familias y a sus problemas. En general, el SCORE-15 es un instrumento de evaluación familiar breve y psicométricamente sólido que puede utilizarse tanto para los investigadores como para los profesionales en varias áreas de la psicología clínica y social.

Association between Family Functioning, Child Emotional and Behavioral Problems, and Parental Stress during the COVID-19 Pandemic in Thailand.

The COVID-19 pandemic has had a huge impact on people of all ages, especially children. This is a cross-sectional study in Thailand to explore the emotional and behavioral problems of school-aged children and associated factors during the lockdown. An online survey was conducted with 942 parents of school-age children. Strengths and Difficulties Questionnaire (SDQ) scores showed that total difficulties and all subscale difficulties (hyperactivity, conduct problems, peer problems, and emotional problems) were increased, whereas prosocial behaviors were decreased in the pandemic period. The factors significantly associated with higher parental stress were higher emotional and peer problems after the COVID-19 outbreak, high family difficulty, and sleep problems. Sleep problems were associated with all children's difficulties, except prosocial behavior. High score in family difficulty subscale was associated with increased emotional problems, whereas poor family communication was associated with increased hyperactivity. Appetite change was negatively associated with parental stress and some children's difficulties. Higher household income, family time, physical activities, and recreational activities were associated with a decreased level of some difficulties and family functioning problems, but positively with an increase in the prosocial behavior of children. Additionally, higher screen time was associated with a higher level of hyperactivity, conduct problems, and poor family communication. This study demonstrated that Thai children were at high risk of developing mental health problems during the pandemic lockdown. We suggest that intervention to promote physical activities and reduce screen time is needed. Moreover, efficient monetary policy is urgently required. The limitations here include a recall bias with no baseline to compare and a potential selection bias due to parental selection and a webpage announcement.

The development of a reliable change index and cutoff score for the SCORE-15.

The Systemic Clinical Outcome and Routine Evaluation version 15 (SCORE-15) is a measure used to assess family-level change in family therapy. The SCORE-15 has been demonstrated to be a reliable and valid measure, with high clinical utility; however, the SCORE-15 lacks the ability to determine whether the change in family functioning during the course of therapy is clinically significant. This study aimed to establish a reliable change index (RCI) and clinical cutoff score so that researchers and clinicians can determine clinically significant change in family therapy. US samples of 71 clinical participants and 244 community participants completed the SCORE-15. Results indicated a cutoff score of 40.37 and an RCI of 9.52. Consequently, family members who improve their SCORE-15 score during the course of therapy by at least 9 points and who cross the threshold of 40 during the course of therapy are considered to have experienced clinically significant change.

Validation Study of Korean Translated Systemic Clinical Outcome Routine Evaluation-15 as Self-Report Family Assessment Measure: Focusing on Adolescent in Daegu and North Gyeongsang Province.

BACKGROUND: Systemic Clinic Outcome and Routine Evaluation (SCORE-15) is a compact scale that contains the most critical family function assessment tools including assessments of the strengths, adaptability, and communication among family members. It has been translated into other languages in the United States and Europe. This study aimed to verify the reliability and validity of SCORE-15 with a small research population and justify its applicability in Korea. METHODS: SCORE-15 is a self-reporting family function measurement tool for each family member over the age of 11 years. This study used the Family Communication Scale (FCS) included in the Family Adaptability and Cohesion Evaluation Scales (FACES) IV package and FACES in FACES-III to verify the validity of the Korean-translated SCORE-15. Cronbach's α value was calculated to check the reliability of SCORE-15. Data were analyzed using STATA ver. 15.0 (Stata Corp., College Station, TX, USA). RESULTS: The study analyzed the correlation between FACES-III and SCORE-15 and FCS and SCORE-15 so that there was a significant static correlation in both comparisons (r=0.72 and r=0.81, respectively). Also, the research compared each subscale to analyze the correlation and the range was 0.47 to 0.95. The total SCORE-15 Cronbach's α value was 0.92 and those values of the subscales for family strengths, family communication, and family difficulty were 0.89, 0.73, and 0.87, respectively (P<0.001). CONCLUSION: Our study was the first to validate the Korean SCORE-15, which can be used as an appropriate shortform indicator for evaluating family function and changes in detecting therapeutic improvements in Korea.

Family therapy process - works on the Polish version of SCORE-15 tool. / Badanie przebiegu terapii rodzin - prace nad polska wersja narzedzia SCORE-15.

OBJECTIVES: The aim of the paper is to demonstrate progress of the works on the Polish version of SCORE-15 and the results of the preliminary data analysis of changes in the process of family therapy, obtained with this tool. The works on the Polish version, ongoing since 2010, were inspired by the Research Committee European Family Therapy Association EFTA. Since the Polish version of SCORE-15 will be make public and published on EFTA website in the near future, therefore, it is important that people interested in the tool know the context of its development. METHODS: The Polish version of SCORE-15, the tool designed to examine the process of family therapy, was used. RESULTS: The comparison of the results obtained by family members before the first family session and before the fourth one and psychotherapists' assessments show that the perception of the weight of the problem with which the family members came to therapy is indeed significantly lower already after three sessions of family therapy. Additionally, the obtained results show great coherence of the assessment of the family therapy progress in families and their therapists. CONCLUSIONS: The preliminary analysis of data obtained during the research project conducted in Outpatient Family Therapy Clinic, Department of Adult, Child and Adolescent Psychiatry, University Hospital in Krakow and in Laboratory of Psychology and Systemic Psychotherapy, Department of Child and Adolescent Psychiatry, Jagiellonian University Medical College between 2010 and 2014 revealed that SCORE-15 is a useful tool in research on changes in the systemic family therapy process.

The 15-item Systemic Clinical Outcome and Routine Evaluation (SCORE-15) Scale: Portuguese Validation Studies.

This study reports on the validity of the 15-item Portuguese version of the Systemic Clinical Outcome Routine Evaluation (SCORE-15; Vilaça, Silva, & Relvas, 2014), a brief and comprehensive measure of family functioning. Previous studies with SCORE-15 show that this version replicates the three-factor solution found for the original English version: Family strengths, Family communication and Family difficulties. In addition to reviewing previous studies, this article analyses the discriminant, convergent and predictive validity of the Portuguese SCORE-15. To do so, the SCORE-15 was administered to family members attending systemic family or couple's therapy at the start of the first and fourth sessions and also to a group of non-clinical individuals. Overall, data are reported from 618 participants, including 136 from families attending systemic therapy and 482 community family members. Comparisons of community and clinical samples (discriminant validity) showed statistically significant differences for the total scale and subscales (p < .001), with the community participants presenting healthier family functioning than the clinical ones. Analyses using SCORE-15 and the Quality of Life - adult version, another family measure applied simultaneously (convergent validity), indicate that both scales are significantly (p < .01) and moderately (r = -.47) correlated. Mean score analysis of SCORE-15's therapeutic sensitivity to change (predictive validity) showed that only the Family communication subscale was sensitive to statistically significant improvement (p < .05) from session 1 to session 4, whereas the SCORE-15's reliability change index points to its ability to detect clinical improvements (RCI = 14%).