German translation, cultural adaptation for Austria and validation of the Neurological Sleep Index - Multiple Sclerosis (NSI-MS).

STUDY OBJECTIVES: To translate, culturally adapt, and validate the Neurological Sleep Index - Multiple Sclerosis (NSI-MS) for use in Austrian German-speaking populations with multiple sclerosis (pwMS). METHODS: Following established guidelines, the NSI-MS diurnal sleepiness (DS), non-restorative nocturnal sleep (NRNS), and fragmented nocturnal sleep (FNS) scales underwent forward-backward translation, with content and face validity, and cultural adaptation to Austria established. Construct validity was evaluated using Rasch analysis. Known-groups validity was examined, and comparisons were made with scales measuring MS fatigue, daytime sleepiness, sleep quality, anxiety, and depression. Reliability was assessed through Cronbach's alpha, Person Separation Index, Lin's concordance correlation coefficient, measurement error, and floor and ceiling effects. Data were merged with a historic English dataset for comparison between English/German language versions. RESULTS: The translation and cultural adaptation of the NSI-MS-G were successful. Pretesting involved 30 pwMS, while the validation included 400 pwMS with mild-to-severe disability. The DS, NRNS, and FNS scales exhibited good fit parameters, were unidimensional, and invariant. NSI-MS-G scales demonstrated excellent convergent and known-groups validity, internal consistency, person separation reliability, test-retest reliability, adequate measurement error, and low floor and ceiling effects. Pooling English and German datasets revealed that person estimates for the NRNS and FNS scales are equivalent across versions, unlike the DS scale. CONCLUSIONS: The NSI-MS-G demonstrates validity, reliability, and responsiveness in assessing DS, NRNS, and FNS in pwMS, generating interval-level data, and shows equivalence between its English and German versions. CLINICAL TRIAL REGISTRATION: Register: German Clinical Trials Register (DRKS); URL: https://drks.de/search/en/trial/DRKS00025573; Identifier: DRKS00025573.

Insights into the use of telemedicine in primary care in times of the SARS-CoV-2 pandemic - a cross-sectional analysis based on the international PRICOV-19 study in Austria.

BACKGROUND: The SARS-CoV2 pandemic as well as the implementation of public health measures to decrease the spread of the virus re-sparked the call for "virtual" health or "distance" treatments. This paper aimed to assess the use of video consultations, the up-to-dateness of practice websites, and the views of GPs on whether eHealth is a positive aspect for the future of their practices in publicly -funded primary healthcare facilities in Austria. METHODS: The cross-sectional online questionnaire, part of the PRICOV-19 study, was conducted from December 2020 until July 2021. We randomly recruited 176 GP practices across Austria. Descriptive statistics as well as binary logistic regression models were applied to examine the associations between telemedicine use and practice factors. RESULTS: Compared with before the pandemic (3.8%), 7.6% of publicly funded GP practices have been using video consultations since the pandemic. In line with this, 93.9% of the practices had no increase in video consultation use. Fewer than half (44.3%) had an up-to-date webpage, and 27.8% assumed that the pandemic might have been a positive driver for eHealth in their practices. Positive associations with video consultation use could be found in practices with fewer patients aged 70 years and over than the average and more patients with chronic diseases than the average. CONCLUSION: The use of video consultations in general practice and the readiness for other telemedicine approaches are both very low in Austria. Austria has to urgently follow the example of countries with a transparent and comprehensive national digital health strategy that includes video consultation. Without a proper payment system, patient inclusion, and support with regard to administrative and organizational aspects, no substantial change will occur in spite of an increase in need due to the pandemic and changes in the patient population.

Bright light therapy as a non-pharmacological treatment option for multiple sclerosis-related fatigue: A randomized sham-controlled trial.

Background: Fatigue is a common symptom in people with multiple sclerosis (pwMS) that significantly impairs quality of life. Bright light therapy may be a cheap treatment option with little to no adverse events. Objectives: To evaluate the effectiveness of bright light therapy as a treatment option for MS-related fatigue. Methods: This was randomized sham-controlled trial including 26 pwMS with a Fatigue Severity Scale (FSS) Score ≥36. Participants were assigned to receive either bright white light therapy (n = 13) or dim red light (sham-intervention; n = 13). Participants used the respective intervention for 30 min each morning for two weeks, followed by a two-week washout period. The primary endpoint was the difference in FSS scores following light treatment as calculated by analysis of covariance. Results: There was no significant difference in FSS (F(1,23) = 2.39, p = .136, partial ⴄ2 = .094). However, FSS scores generally improved over the course of the study in a clinically relevant manner. Conclusion: Bright light therapy decreased FSS scores over the course of this study. However, this effect was not significant in comparison to a sham intervention.