Multicenter Validation of the Emotional State Instrument for Dialysis Patients.

BACKGROUND: The Emotional State Instrument for Dialysis Patients (ES-D) is a brief semistructured questionnaire to assess emotional distress in patients undergoing dialysis. It was designed to be administered by a healthcare provider. A previous study showed preliminary indicators of its content and face validity. OBJECTIVE: The aim of the current multicenter study was to explore the ES-D's psychometric properties. METHODS: A total of 605 patients with kidney disease undergoing dialysis (524 hemodialysis and 81 peritoneal dialysis) in 19 Spanish dialysis centers completed the ES-D, along with anxiety, depression (Hospital Anxiety and Depression Scale), and resilience (Brief Resilience Scale) questionnaires. The 75 healthcare providers who performed the assessments completed a satisfaction survey. RESULTS: The ES-D showed adequate internal consistency (α = .73). Correlations between the ES-D scores and the scores for anxiety, depression, and resilience showed evidence of its convergent and concurrent validity. The receiver operating characteristic curve analyses showed that a cutoff of nine detected patients with moderate-to-severe emotional distress. According to these criteria, 35.4% of patients showed emotional distress. No significant differences were found between patients undergoing hemodialysis and peritoneal dialysis. The healthcare providers perceived the ES-D as useful for knowing the patients' emotional state, understanding patients' concerns, and establishing therapeutic relationships. CONCLUSIONS: The ES-D is a useful tool for healthcare providers to explore the emotional dimension of their patients. Thus, its development represents a step forward in the improvement of comprehensive assistance and the quality of life of patients with kidney disease undergoing dialysis.

Reliability of iCare ic100 Rebound Tonometry and Agreement With Goldmann Applanation Tonometry in Healthy and Post-myopic LASIK Patients.

PRECIS: Rebound tonometry offers excellent reliability for obtaining intraocular pressure (IOP) measurements in healthy and post-myopic laser-assisted in situ keratomileusis (LASIK) patients regardless of corneal parameters and axial length and regardless of the instillation of ocular topical anesthesia. PURPOSE: The purpose of this study was to assess the reliability of rebound tonometry, its agreement with Goldmann applanation tonometry (GAT) and its concordance after topical anesthesia in a group of nonoperated healthy patients and a group of post-myopic LASIK patients. PATIENTS AND METHODS: Fifty-four patients were included in this prospective observational, case-control study. Patients were divided into 2 groups: control (n=32, 26.7±6.1 y) and LASIK (n=22, 35.8±7.6 y). Measurements of IOP were carried out using the iCare ic100 tonometer and GAT. The repeatability, intersession and interobserver reproducibility, GAT interchangeability and concordance after topical anesthesia of the iCare ic100 tonometer were assessed. RESULTS: Clinical reliability of the iCare ic100 was excellent in terms of repeatability [intraclass correlation coefficient (ICC)=0.909 and 0.951 in control and ICC=0.938 and 0.961 in LASIK] as well as interobserver reproducibility (ICC=0.896 in control and 0.916 in LASIK) and concordance after anesthesia (ICC=0.910 in control and 0.972 in LASIK) in both groups. Intersession reproducibility was clinically good in nonoperated patients (ICC=0.758 and 0.849) and excellent in LASIK patients (ICC=0.878 and 0.904), although statistically significant differences were obtained in the control group for both examiners (P=0.003 for examiner 1 and P=0.04 for examiner 2). Agreement with GAT was good in both groups (ICC=0.805 in control and 0.790 in LASIK), although statistically different (P<0.001 and P=0.02, respectively). Finally, the iCare ic100 reliability was independent of corneal parameters and axial length in both groups (P>0.05 for all parameters). CONCLUSIONS: Rebound tonometry offers good or excellent clinical reliability in both healthy and post-myopic LASIK patients. This article highlights the efficacy of iCare ic100 rebound tonometry as a reliable tool for the measurement of IOP and the management of glaucoma in healthy patients and patients undergoing myopic LASIK surgery.