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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 周永強、林鼎博 | 鉛筆和紙張測試：一種新的工具來預測神經性疾病患者在實施清潔間歇性自我導尿時的能力 | 2011/10/27 上午 10:53:45 | 0 |
| 原 文 | 題 目 | Pencil and Paper Test: A New Tool to Predict the Ability of Neurological Patients to Practice Clean Intermittent Self-Catheterization |
| 作 者 | Gerard Amarenco, Amandine Guinet, Marylene Jousse, Delphine Verollet and Samer Sheikh Ismael | |
| 出 處 | The Journal of Urology , Vol. 185, 578-582, February 2011 | |
| 出版日期 | February, 2011 | |
| 評 論 | 神經性膀胱的患者常苦於慢性尿潴留之苦，目前清潔間歇性自我導尿法仍 為治療慢性尿潴留最有效的方法，它同時能兼顧病人的生活品質與改善病人因尿潴留產生的併發症，但因每個病人之年齡、教育水準與社經地位皆大相逕庭，臨床醫師常苦無準確的方法，來推估病人是否能有能力，在家完成這項需長期配合的醫囑。本文作者即設計出一利用紙筆來進行之測試，目的在預估病人是否能配合完成清潔間歇性自我導尿。作者僅僅利用鉛筆與白紙，設計出極具巧思的六項動作，藉由完成的程度為病人評分，滿分15，最低零分，之後請這些受試的病人接受自我導尿的訓練，再把紙筆測試的完成度與自我導尿的成功率加以比較，結果發現，紙筆測試超過十分者，有85%能完成自我導尿，紙筆測驗小於3分者，有94%無法完成自我導尿。這項結果讓我們可以有一個簡單的方法，在診間或在家裡就輕鬆預測神經性膀胱患者是否能獨立完成自我導尿的動作，各位讀者不妨也在家中自己試試看喔！ | |
| abstract |
Purpose: We d and validated the new pencil and paper test, which allows assessment of the ability of patients with a neurological disorder to practice clean intermittent self-catheterization. Materials and Methods: We developed a simple test including common gestures mimicking the usual maneuvers needed during clean intermittent self-catheterization, and involving the same cognitive and physical resources needed for this technique. We evaluated the test in 118 patients with a neurological condition. Instruments needed to perform the pencil and paper test are limited to a sheet of paper and a pencil. Each test item was quantified and graded with a total score of 15. A specific clean intermittent catheterization learning scale was used to classify the outcome of the ability to perform clean intermittent self-catheterization with a score range of 5—learning easy and self-catheterization complete to 0 —learning impossible. Results: Enrolled in the study were 118 patients with a neurological condition. There was strong correlation between the global pencil and paper test score, and the ability to perform clean intermittent self-catheterization, as evaluated by the learning scale (r = 0.82, p = 0.000091). At a test cutoff of 10 and a clean intermittent self-catheterization cutoff of 3, which was the limit needed to practice self-catheterization alone, the positive predictive value of the pencil and paper test was 85% and its negative predictive value was 94% (Cronbach’s a=0.88). Conclusions: The pencil and paper test is a valid way to predict the ability to practice clean intermittent self-catheterization in patients with a neurological disorder. 
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