Journal of Rafsanjan University of Medical Sciences

Background and Objective: According to the complications of dementia, its screening is important in elderly stage. Dementia screening tests need to have acceptable sensitivity and specificity. This study aimed at determining the cut-off point of the Persian version of Clinical Dementia Rating (P-CDR) and testing its diagnostic accuracy in the early detection of dementia among the elderly.

Materials and Methods: This cross-sectional study was conducted by using the known-groups method. The purposive sampling of 50 patients with age-related dementia and 150 the elderly without dementia was recruited in kashan, Iran, 2014. The clinical interviewing and the findings of CT-Scan were used as the reference standard test. The index test was the P-CDR. A demographic questionnaire, the Geriatric Depression Scale (GDS-15), and the P-CDR were used for data collection. The median of CDR scores in two known groups were compared using Mann-Whitney U test. The Receiver Operating Characteristic (ROC) analysis was conducted for determining the cut-off point. The diagnostic parameters were calculated for determining the diagnostic accuracy of the test with 95% confidence interval.

Results: The cognitive state scores of the elderly with and without dementia differed significantly (8.36±1.76 vs. 0.82±1.69, respectively p< 0.001). The area under the ROC curve was 0.968 (p < 0.001). The Youden’s index showed that the optimal cut-off point for the test was 3.75. The sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratio, overall diagnostic accuracy, and diagnostic odds ratio of the test at the cut-off point of 3.75 were 1, 0.94, 0.88, 1, 0, 21.42, 0.96, and infinity, respectively.

Conclusion: The P-CDR is a sensitive and precise test for assessing cognitive state in the elderly. So, it can be used in dementia screening and the program of monitoring elderly people’s health.

Key words: Clinical dementia rating, Dementia, Diagnostic test, Sensitivity, Specificity

Funding: This research was funded by Kashan University of Medical Sciences.

Conflict of interest: None declared.

Ethical approval: The Ethics Committee of Kashan University of Medical Sciences approved the study.

How to cite this article: Lotfi MS, Tagharrobi Z, Sharifi K, Abolhasani J. Diagnostic Accuracy of Persian Version of Clinical Dementia Rating (P-CDR) for Early Dementia Detection in the Elderly. J RafsanjanUniv Med Sci 2015 14(4): 283-98. [Farsi]

Background and Objectives: In response to the community need, it is necessary for nursing staff to use complementary therapies in their professional performance. The related facilitators in various clinical settings are different and the exploration of these factors are essential and important. So, this study was designed to assess clinical nurses' perceptions about the facilitators of using complementary therapies in clinical nursing.

Materials and Methods: This qualitative content analysis study was done from June 2014 to July 2015 in Kashan and Isfahan cities. Sampling was done purposively and ended after reaching data saturation. The snowball sampling was used to access the eligible samples. In-depth and Semi-structured interviews were done with sixteen nurses and two physicians who had rich experience. Concurrently with data collection, the data were analyzed via the conventional content analysis approach.

Results: In relation to the research objective, the study participants’ perceptions fell into nine main categories of ‘client collaboration’; ‘the nurse's technical expertise and legal authority’; ‘the peers collaboration'; ‘compatible specialists'; ‘nursing manager-intelligent stimulator’; 'organizing, directing and supervising by nursing manager'; ‘active strategies'; ‘passive strategies', and ‘partial achievement in problem management’ from which, the four main themes of ‘supportive co-workers', ‘the nurse and client Synchronization', ‘intelligent nursing manager',and ‘effectives situational strategies ' were abstracted.

Conclusion: Client collaboration, nurse's technical expertise and legal authority, using situational strategies in operational problems management, and the support provided by peers,physicians,and nursing managers cause the nurses to use complementary therapies in care plan easierly. The awareness of these findings is useful for authorities and designers to design guidelines related to integration of complementary therapies into nursing practice.

Key words: Complementary therapies, Facilitators, Nursing, Qualitative Research

Funding: This research was funded by Tabiat Modares University.

Conflict of interest: None declared.

Ethical approval: The Ethics Committee of Tarbiat Modares University approved the study.

How to cite this article: Tagharrobi Z, Mohammadkhan Kermanshahi S, Mohammadi E.The Facilitators of Using Complementary Therapies in Clinical Nursing: A Qualitative Content Analysis. J Rafsanjan Univ Med Sci 2016; 15(8): 691-714. [Farsi]