ABSTRACT
Introduction: The purpose of this study is to determine the validity, reliability, and responsiveness of the Malay Shoulder Pain and Disability Index (M-SPADI) in Malay speakers suffering from shoulder pain. Materials and methods: The M-SPADI, the Numerical Rating Scale (NRS), and measurements of shoulder active range of motion (AROM) were completed by 140 patients with shoulder pain (68 with rotator cuff pathology and 72 with other shoulder pathology). Thirty-four patients were retested for test-retest reliability with M-SPADI after an average of 9.2 days. M-SPADI was performed on twenty-one individuals three months after completing treatment for rotator cuff disorders to assess response. Results: The results of exploratory factor analysis revealed a bidimensional structure for M-SPADI. M-SPADI disability score was significantly greater in patients with rotator cuff pathologies (median = 31.87, IQR 82.50) than in patients with other shoulder pathologies (median = 20.00, IQR 23.84). In multi-group factor analysis, measurement invariance revealed no significant difference between the two groups (p>0.05). There was a significant positive correlation between M-SPADI and NRS (Pain = 0.86, Disability = 0.75, Total = 0.82, p=0.005), and a significant negative correlation between M-SPADI and shoulder AROM (Pain = -0.34 to -0.67, Disability =-0.44 to -0.73, Total =0.43 to -0.72, p=0.005). M-SPADI had a high degree of internal consistency (Cronbach's 0.92 for pain and 0.95 for disability). Test-retest reliability was moderate to excellent (ICC Pain = 0.84, ICC Disability = 0.78, ICC Total = 0.81, p=0.001), and the smallest detectable change ranges (Pain = 8.74, Disability = 3.21, Total = 3.83) were less than the minimal detectable change ranges (Pain = 21.57, Disability = 6.82, Total = 8.79). The area under the receiver operating characteristic curve (AUC) for M-SPADI was greater than 0.90 (Pain = 0.99, Disability = 0.94, Total = 0.96). Conclusion: The M-SPADI has established construct validity, internal consistency, test-retest reliability, and responsiveness. The M-SPADI is a reliable and valid instrument for evaluating shoulder pain among Malay-speaking individuals. In addition, the M-SPADI disability subscale may be useful for monitoring functional score changes in patients with rotator cuff pathology.
ABSTRACT
Percutaneous peritoneal dialysis catheter (PDC) placement is a well-tolerated, rapidly performed side-room procedure that allows the rapid initiation of dialysis without the delay imposed in co-ordinating a surgeon, theatre time, and theatre staff. We retrospectively reviewed the clinical outcome of 230 PDC inserted over a 30-month period. Fifty were placed percutaneously (group P) and 180 were placed using conventional surgical techniques, 107 in patients commencing CAPD (group A) and 73 in patients commencing CAPD (group A) and 73 in patients previously established on CAPD (group B). Total experience accumulated was 2563 patient months: 270 patient months group P, 1381 patient months group A, 912 patient months group B. Percutaneous PDC insertion was non-elective, and reserved for patients unfit for general anaesthesia or haemodialysis. Group P patients were older (P < 0.001) and had increased early mortality (P < 0.005) due to underlying pathology. Death and early mechanical failure contributed to a shorter mean duration of catheter use in group P (9.0 +/- 2.3 months compared to 15.3 +/- 9.6 months group A and 17.3 +/- 9.7 group B) (P < 0.05). The peritonitis rate was similar in group P (1 per 6.75 patient months) and group B (1 per 7.4 patient months) but significantly lower in group A (1 per 15.7 patient months) (P < 0.01). We conclude that percutaneous PDC placement provides a safe, reliable access for peritoneal dialysis and is especially suitable for ill patients who would not tolerate general anaesthesia.