Screening for Self-Medication Safety Post-Stroke Scale (S-5)

Purpose

The Screening for Self-Medication Safety Post-Stroke Scale (S-5) is a screen for clinicians to identify patients’ self-medication safety and readiness following stroke. The tool can also be used by health professionals to make recommendations to improve self-medication skills of patients post-stroke (Kaizer, Kim, Van & Korner-Bitensky, 2010).

In-Depth Review

Purpose of the measure

The ScreeningTesting for disease in people without symptoms.
for Self-Medication Safety Post-Stroke Scale (S-5) is a screen for clinicians to identify patients’ self-medication safety and readiness following strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain.. (Kaizer, Kim, Van & Korner-Bitensky, 2010). It is a quick, inexpensive test that uses a checklist-style interview format.

Available versions

There is only one version of the ScreeningTesting for disease in people without symptoms.
for Self-Medication Safety Post-Stroke Scale (S-5), which was developed by Kaizer, Kim, Van and Korner-Bitensky in 2010.

Features of the measure

Items of the measure:

The S-5 consists of 16 items that assess five domains:

• Cognition (orientation; immediate and delayed memory recall)
• Communication (comprehension; reading)
• Motor function
• Visual-perception
• Judgement/executive functions/self-efficacy.

The patient must be able to correctly answer 2 of the first 3 questions regarding orientation to time and space in order to progress with the screen.

Scoring and Score Interpretation:

Each item is scored according to a yes/no response. There is no cumulative score. A score of “no” on any 1 item indicates the need for further assessment regarding this domain, or can be used to guide intervention planningPlanning ability involves anticipating future events, formulating a goal or endpoint, and devising a sequence of steps or actions that will achieve the goal or endpoint" (Anderson, 2008, p. 17)
to address this area of difficulty.

Each item also has a “concern” box, where the clinician can identify any concerns regarding the particular item. A summary “Concerns and Recommendations” section at the end of the tool also enables the clinician to document specific concerns and suggestions.

Equipment:

• Pill bottle with childproof cap
• Pill bottle without childproof cap
• Pill bottle with a pharmacy label: must include the information commonly found on a label (medication name, dosage, frequency, time of day to take medication and the name of a person)
• Liquid bottle with “push and turn” cover and a medicine cup
• 1 syringe without needle
• 8 disc-shaped white pills (e.g. shape of a vitamin C)
• 1 oval-shaped blue or green gel-capsule pill
• 1 oval shaped orange pill
• 1 small and 1 larger disc-shaped white pill
• Three objects: pen, coin & a key

Time:

The S-5 takes approximately 10 minutes to administer.

Training requirements:

No training requirements specified.

Subscales:

None.

Alternative forms of the S-5

Not applicable

Client suitability

Can be used with:

• Clients following strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain..

Should not be used in:

• Not specified.

In what languages is the measure available?

English.

Summary

What does the tool measure?	Self-medication safety.
What types of clients can the tool be used for?	Patients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain..
Is this a screeningTesting for disease in people without symptoms. or assessment tool?	ScreeningTesting for disease in people without symptoms. tool.
Time to administer	Approximately 10 minutes.
Versions	There are no alternative versions.
Other Languages	There are no official translations.
Measurement Properties
ReliabilityReliability can be defined in a variety of ways. It is generally understood to be the extent to which a measure is stable or consistent and produces similar results when administered repeatedly. A more technical definition of reliability is that it is the proportion of "true" variation in scores derived from a particular measure. The total variation in any given score may be thought of as consisting of true variation (the variation of interest) and error variation (which includes random error as well as systematic error). True variation is that variation which actually reflects differences in the construct under study, e.g., the actual severity of neurological impairment. Random error refers to "noise" in the scores due to chance factors, e.g., a loud noise distracts a patient thus affecting his performance, which, in turn, affects the score. Systematic error refers to bias that influences scores in a specific direction in a fairly consistent way, e.g., one neurologist in a group tends to rate all patients as being more disabled than do other neurologists in the group. There are many variations on the measurement of reliability including alternate-forms, internal consistency , inter-rater agreement , intra-rater agreement , and test-retest .	Test-retest: The test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society). of the S-5 is currently under study.
ValidityThe degree to which an assessment measures what it is supposed to measure.	Content: This tool is not intended as a comprehensive assessment of self-medication safety. Some daily self-medication tasks were intentionally not included due to its intended use as a screen only. Accordingly, content validityRefers to the extent to which a measure represents all aspects of a given social concept. Example: A depression scale may lack content validity if it only assesses the affective dimension of depression but fails to take into account the behavioral dimension. of this tool was reported as satisfactory. Criterion: Concurrent: The concurrent validityTo validate a new measure, the results of the measure are compared to the results of the gold standard obtained at approximately the same point in time (concurrently), so they both reflect the same construct. This approach is useful in situations when a new or untested tool is potentially more efficient, easier to administer, more practical, or safer than another more established method and is being proposed as an alternative instrument. See also "gold standard." has not been examined as there is currently no gold standardA measurement that is widely accepted as being the best available to measure a construct. for assessing self-medication safety with this population. Construct: Known groups: The known groups validityKnown groups validity is a form of construct validation in which the validity is determined by the degree to which an instrument can demonstate different scores for groups know to vary on the variables being measured. of the S-5 is currently under study.
Floor/Ceiling Effects	Not yet examined.
Does the tool detect change in patients?	Not yet examined.
Acceptability	The S-5 is a quick and simple test to administer, with minimal equipment requirements and specific instructions for the assessor to follow.
Feasibility	Administration of the S-5 is quick and easy, and can be performed by any member of the multidisciplinary team. Feedback from expert clinicians and patients indicates acceptable administration time, effort and complexity.
How to obtain the tool?	Click here to see a copy of the S-5.

Psychometric Properties

Overview

Please refer to the article by Kaizer et al. (2010) for information regarding the psychometric properties of the S-5

References

• Kaizer, F., Kim, A., Van, M. T., & Korner-Bitensky, N. (2010). Creation and preliminary validation of the Screening for Self-Medication Safety Post-Stroke Scale (S-5). Journal of Rehabilitation Medicine, 42, 239-245.

See the measure

How to obtain the Assessment?

Click here to see a copy of the S-5