Clinical Assessment of Judgment in Adults and the Elderly: Development and Validation of the Three Domains of Judgment Test-Clinical Version (3DJT-CV).

(1) Background: This article discusses the first two phases of development and validation of the Three Domains of Judgment Test (3DJT). This computer-based tool, co-constructed with users and capable of being administered remotely, aims to assess the three main domains of judgment (practical, moral, and social) and learn from the psychometric weaknesses of tests currently used in clinical practice. (2) Method: First, we presented the 3DJT to experts in cognition, who evaluated the tool as a whole as well as the content validity, relevance, and acceptability of 72 scenarios. Second, an improved version was administered to 70 subjects without cognitive impairment to select scenarios with the best psychometric properties in order to build a future clinically short version of the test. (3) Results: Fifty-six scenarios were retained following expert evaluation. Results support the idea that the improved version has good internal consistency, and the concurrent validity primer shows that 3DJT is a good measure of judgment. Furthermore, the improved version was found to have a significant number of scenarios with good psychometric properties to prepare a clinical version of the test. (4) Conclusion: The 3DJT is an interesting alternative tool for assessing judgment. However, more studies are needed for its implementation in a clinical context.

Back-related functional limitations among full-time homemakers: a comparison with women employed full-time outside the home.

STUDY DESIGN: Two-year prospective study with repeated measurements. OBJECTIVES: To describe back-related functional limitations and their evolution among full-time female homemakers and to compare them to that of women employed full-time outside the home. SUMMARY OF BACKGROUND DATA: Back pain is not limited to the formal "working" population. However, there is little information on the consequences of back pain in "nonworking" individuals. METHODS: Subjects were members of a large Health Maintenance Organization who consulted a physician for nonspecific back pain. Telephone interviews were conducted 4 to 6 weeks after the consultation and 1 and 2 years later. Back-related functional limitations were measured with a modified 16-item Roland-Morris scale. Analyses were conducted on 104 full-time homemakers and 288 women employed full-time outside the home. RESULTS: The mean Roland-Morris score among homemakers was 34.4% at baseline and dropped to 22.8% at 2 years. In multiple regression analyses, 2-year back-related functional limitations were significantly associated with symptoms of depression, pain intensity, and the number of days with back pain in the past 6 months measured at baseline, but not with employment status. Functional limitations were not different between homemakers and women employed outside the home, even after adjustment for confounders. CONCLUSIONS: In this study, the functional consequences of back pain had a similar nature and 2-year evolution among full-time homemakers and women employed full-time outside the home. These results did not demonstrate an effect of formal employment on the functional consequences of back pain among women.