Tina Hansen - Academia.edu (original) (raw)

Papers by Tina Hansen

Geriatrics, 2021

There is evolving evidence for an association between dysphagia and sarcopenia in older adults. F... more There is evolving evidence for an association between dysphagia and sarcopenia in older adults. For optimizing the acute health care initiative across health care settings, this study investigated prevalence and time-course of dysphagia in older patients admitted to an emergency department (ED) as well as its association with parameters for probable sarcopenia, inactivity, malnutrition, disease status, and systemic inflammation. A secondary analysis of data from the FAM-CPH cohort study on acutely admitted older medical patients (n = 125). Data were collected upon ED admission as well as four and 56 weeks after discharge. Using the Eating Assessment Tool cut-off score ≥ 2, signs of dysphagia were present in 34% of the patients at ED admission and persisted in 25% of the patients 56 weeks after discharge. Signs of dysphagia at 56-week follow-up were significantly (p < 0.05) associated with probable sarcopenia (low handgrip strength (OR = 3.79), low leg muscle strength (OR = 8.14),...

Disability and rehabilitation, 2011

This review aims to identify psychometrically robust assessment tools suitable for measuring elde... more This review aims to identify psychometrically robust assessment tools suitable for measuring elderly dysphagic patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; performance in eating for use in clinical practice and research. Electronic databases, related citations and references were searched to identify assessment tools integrating the complexity of the eating process. Papers were selected according to criteria defined a priori. Data were extracted regarding characteristics of the assessment tools and the evidence of reliability, validity and responsiveness. Quality appraisal was undertaken using developed criteria concerning the study design, the statistics used for the psychometric evaluation and the reported values. Eight of fourteen identified assessment tools met the inclusion criteria. Three assessment tools were specific to dementia, two were specific to stroke and three targeted a range of neurological and geriatric conditions. The rigor of the assessment tools&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; psychometric properties varied from no evidence available to excellent evidence. Only two assessment tools were rated adequate to excellent. &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;The Minimal Eating Observation Form-Version II&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; to be used for screening and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;The McGill Ingestive Skills Assessment&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; to be used for treatment planning and monitoring appeared to be psychometrically robust for clinical practice and research. However, further research on their psychometric properties is needed.

Disability and rehabilitation, 2012

The study aimed to validate the Danish version of the Canadian the &amp;amp;amp;amp;amp;a... more The study aimed to validate the Danish version of the Canadian the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;McGill Ingestive Skills Assessment&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; (MISA-DK) for measuring dysphagia in frail elders. One-hundred and ten consecutive older medical patients were recruited to the study. Reliability was assessed by internal consistency (Chronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha). External construct validity (convergent and known-groups validity) was evaluated against theoretical constructs assessing the complex concept of ingestive skills. Internal construct validity was tested using Rasch analysis. High internal consistency reliability with Chronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha of 0.77-0.95 was evident. External construct validity was supported by expected high correlations with most of the constructs related to ingestive skills (r(s) = 0.53 to r(s) = 0.66). The MISA-DK discriminated significantly between known-groups. Fit to the Rasch model (x(2) (df) = 12 (12), p = 0.424) and unidimensionality of the MISA-DK was confirmed after resolving disordered thresholds for 11 items and adjustment of local dependency. The psychometric properties of the MISA-DK equal the original Canadian version. Assessment of internal construct validity indicated multidimensionality due to local dependency. Although achieving good fit to the Rasch model after adjustments, additional studies are needed to establish cross-cultural validity. Finally, establishment of the inter- and intra-rater reliability of the MISA-DK is also needed.

e-SPEN Journal, 2013

Background & aims: In a number of countries, including Denmark, there are written guidelines desc... more Background & aims: In a number of countries, including Denmark, there are written guidelines describing the various types of texture modified foods and thickened fluids. None of these are based on a systematic review of texture modified food and thickened fluid as being more sufficient than regular food and fluid, and thereby preventing or reducing the impact of dysphagia. The present article aims to provide recommendations based on evidence for adults (!18 years) with oropharyngeal dysphagia as soon as possible after diagnosis in order to ensure sufficient and safe oral consumption of nutrition as long as possible and thereby preventing malnutrition, dehydration, aspiration and aspiration pneumonia. Methods: A systematic review was performed after definition of four clinical questions regarding prevention of malnutrition, dehydration, aspiration and aspiration pneumonia. Answers to the clinical questions led to the development of recommendations according to the evidence hierarchy (A indicates the highest level of recommendation). Results: To reduce risk of aspiration pneumonia, "chin down" procedure and thin fluid should be first choice rather than thickened fluid in cases of chronic dysphagia (A), and in the acute phase individual counselling with follow up and adjustment of the consistency of texture modified food and thickened fluid should be given (A). To improve nutritional status, special made and nutritionally enriched, texture modified foods (pureed and minced) and thickened fluids (nectar, honey and pudding consistency) are recommended for elderly persons with chronic dysphagia (B*). Conclusion: Since there are only a few, high quality studies, the evidence in favour of texture modified foods and thickened fluids as being effective in preventing or reducing the impact of dysphagia is not strong. More studies are needed to show whether texture modified foods and thickened fluids are effective in the management of chronic and acute dysphagia. Ó

Scandinavian Journal of Occupational Therapy, 2012

To establish measurement equivalence in terms of reliability of the Danish version of the Canadia... more To establish measurement equivalence in terms of reliability of the Danish version of the Canadian McGill ingestive skills assessment (MISA) for use by occupational therapists. A cross-sectional two-rater and test-retest design was applied. A total of 102 elderly medical patients were included consecutively, and were video-recorded during a meal. Raters were paired randomly for each video-case, which was re-scored within three to eight weeks. Reliability was evaluated with the intra-class correlation coefficients (ICC), the standard error of measurement (SEM), the smallest detectable change (SDC), and limits of agreement (LOA). Inter-rater reliability was good to excellent (ICC (1.1) 0.61-0.84) and intra-rater reliability was excellent (ICC (3.1) 0.84-0.93). For the total scale, SEM was 7% between raters and 4% in repeated measurement by the same rater. For the absolute total scale range on 86 points, the SDC was 15.8 between raters and 10.3 in repeated measurement by the same rater. The reliability of the Danish MISA equals the original version and is suitable for clinical practice. When extending the evaluation of the reproducibility, weaker precision was evident when measurements are repeated by different raters than by the same rater. Therefore further investigation of rater effects is recommended.

Scandinavian Journal of Occupational Therapy, 2011

This study addresses the first steps in the cross-cultural adaptation of a Danish version of the ... more This study addresses the first steps in the cross-cultural adaptation of a Danish version of the McGill Ingestive Skills Assessment (MISA), which quantifies eating and drinking abilities by scoring a meal observation. The original Canadian MISA was translated and adapted into Danish (MISA-DK). For content validation of the MISA-DK, a judgemental quantification process was applied using 13 experts. Thereafter, the MISA-DK was pilot tested by 16 occupational therapists. Finally, the MISA-DK was linked to the International Classification of Functioning, Disability and Health (ICF). Content validity of 43 items was found for 93% in terms of adequacy, 67% in terms of clarity of item description, 86% in terms of clarity of score descriptions, and 93% in terms of relevance. Thirteen of 14 sections of the instruction manual and score sheet were content valid. In light of these results, a revised MISA-DK was produced for the pilot test, which then found content validity for all sections and 98% of the items. The ICF linking resulted in 41 ICF-categories, which may reflect the complexity of eating and drinking as well as a multidimensional structure of the MISA-DK. In conclusion, the MISA-DK is prepared for psychometric testing using classical as well as modern test theory.

Physical & Occupational Therapy in Geriatrics, 2012

Scandinavian Journal of Occupational Therapy, 2009

The objective of this study was to produce a valid Danish translation of the Dutch &amp;a... more The objective of this study was to produce a valid Danish translation of the Dutch &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Occupational therapy guideline for assessment and treatment of apraxia in CVA clients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;; to investigate the inter-rater reliability of the assessment instrument in terms of ADL observations; and to determine the content validity of the translation. The inter-rater reliability was investigated using video observations and multiple raters, who also judged the content validity quantitatively. For the scores of the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s occupational performance the study found moderate to good inter-rater reliability for three of four variables and poor to fair inter-rater reliability for one variable, indicated by intra-class correlation coefficient and Kappa statistic. For the conclusion variables the results demonstrated fair inter-rater reliability for five of six variables and poor inter-rater reliability for one variable, also indicated by Kappa statistic. The content validity was judged valid for 100 and invalid for 28 of the guideline&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s defined elements. The conclusion, taking the complexity of the ADL observations and the study design into consideration, is that the Danish version can serve as a guideline within Danish occupational therapy practice. However, a translational recheck, further psychometric testing, and a minimum two-day training course is recommended before implementation in practice.