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Henry Mandin

Publications and source records attributed to Henry Mandin.

3 recordsLinked to original sources

Convergence of health ratings across nephrologists, nurses, and patients with end-stage renal disease.

We evaluated a health rating for renal failure patients that was completed by patients, nurses, and nephrologists. The study was a prospective inception-cohort follow-up design. Measurements were taken before initiating dialysis (n=206) or at the initiation of dialysis (n=200) and at 18 (n=225), 30 (n=181), 42 (n=162), 54 (n=137), and 66 (n=112) months after initiating dialysis. Patients, nurses, and nephrologists independently rated patients' health at each measurement occasion. Objective measures of health status, abstracted from the medical record, included emergency and non-emergency admissions, smoking, diabetes mellitus, pulmonary edema, history and number of myocardial infarctions (MI), basal rales, comorbid illnesses, and uremic symptoms. Simultaneous multiple regression analyses examined the correspondence between objective measures of health status and subjective health ratings separately for each rater and measurement occasion. Health ratings were averaged and submitted to the same analyses. Raters showed good agreement (average Pearson r=.43 overall), although agreement was higher between nephrologists and nurses (average r=.64) than between health professional and patients (average r=.34 and .31, respectively). All three ratings and the combined rating corresponded significantly to objective measures of health status. Uremic symptoms, emergency hospital admissions, diabetes mellitus, and recent MI correlated uniquely and most consistently with subjective health ratings. Despite overall convergence, objective measures of health status related to the groups' ratings in a complementary fashion. The health rating is reliable and relates to the current status of the patient. Performance was superior for the combined score that incorporated ratings by patients, nurses, and nephrologists.

Adult↗

Using "concept sorting" to study learning processes and outcomes.

PURPOSE: First, to evaluate "concept sorting" as a tool for assessing knowledge organization in the memories of first-year medical students, and second, to study the relationship between knowledge organization and examination performance. METHOD: During 2001, first-year medical students taking the Renal Course at the University of Calgary Faculty of Medicine were given a questionnaire on scheme use and were given a concept-sorting task in the domain of metabolic alkalosis. The sophistication of their concept sorting was graded using the number of physiology-based groups they formed. Review of the course's examination scores allowed correlation with concept-sorting scores. Statistical analyses used Fisher's exact test and the two-sample t-test. Pearson's correlation coefficient and the kappa statistic were used for correlation between raters. RESULTS: A total of 81 of 99 students completed the study. The concept-sorting score (mean +/- SEM) for students who used the scheme was higher than was the score for students who did not (2.5 +/- 0.14 versus 1.91 +/- 0.12, p =.016). Students who scored higher in the concept-sorting task, referred to as "deep learners," scored higher than did "surface learners" on exam questions on metabolic alkalosis (2.81 versus 2.29, p =.02). There was no difference in the overall examination performances between the two groups. CONCLUSIONS: Concept sorting may be a useful tool for studying the learning process. Scheme use by students produces a positive outcome on examination performance.

Education, Medical, Undergraduate↗

Recurrent pain, illness intrusiveness, and quality of life in end-stage renal disease.

Repeated episodes of headache and muscle cramp were hypothesized to contribute to increased patient perceptions of illness intrusiveness and to compromised quality of life. Standard measures of pain, illness intrusiveness, and quality of life were obtained on 2 occasions, each 6 weeks apart, from 100 end-stage renal disease patients. The impact of recurrent muscle cramps on perceptions of illness intrusiveness was conditional upon the occurrence of headache symptoms. Perceptions of illness intrusiveness were significantly higher when both muscle cramp and headache symptoms occurred during one or more assessment intervals as compared to when muscle cramps or headaches, only, occurred. Illness-related concerns and general feelings of pessimism were also significantly higher among patients who experienced recurrent episodes of muscle cramp. Although no direct relations were observed between pain and other quality of life indicators, previous research has documented a relation between illness intrusiveness and quality of life. Recurrent pain problems, thus, appear to contribute to increased illness intrusiveness and to reduced quality of life in end-stage renal disease patients.

Headache↗