Biomedical subjects

Kelvin Jordan

Publications and source records attributed to Kelvin Jordan.

24 records · Page 2Linked to original sources

PubMed2003

Does questionnaire structure influence response in postal surveys?

This study tested the effect of questionnaire structure on response, speed of return, and content of answers in a postal survey. All 259 patients aged 30-59 years who consulted with back pain at four UK general practices from March to June 2001 were randomly allocated to receive either a traditionally or chronologically structured self-completion questionnaire. The response was higher and the returns quicker (P =.05) for the chronologic questionnaire. There were no statistically significant differences in completion rates or scores on the SF-36, Chronic Pain Grade, Hospital Anxiety and Depression Scale, or Roland-Morris Disability Questionnaire between the two types of questionnaire, and test-retest reliability was high for all scales. Changing questionnaire structure to make questions chronologic does not substantially affect the answers given, but may make a questionnaire more acceptable and easier to complete and speed up returns.

Adult↗

PubMed2003

Increased vaginal bleeding and psychological distress: a longitudinal study of their relationship in the community.

OBJECTIVE: To explore the temporal relationship between the development of self-reported symptoms of vaginal bleeding and the development of psychological distress among women in the community. DESIGN: Prospective cohort study using postal surveys at baseline and at 6 and 12 months. SETTING: An urban four-partner general practice with 10000 registered patients. POPULATION: All women aged 18-54 years on the practice age-sex register. METHODS: Baseline postal questionnaire with follow up questionnaires sent at 6 and 12 months. MAIN OUTCOME MEASURES: The associations between the development of heavy periods and psychological distress. RESULTS: Two thousand and four hundred and thirty-five baseline questionnaires were sent out with an initial response rate of 76%. One thousand and five hundred and thirteen women (62%) responded to all three questionnaires. Women with psychological distress at baseline were more likely to develop heavy periods 6 months later than women without distress (adjusted odds ratio 1.87, 95% CI 1.15, 3.02). Women with heavy periods at baseline were no more likely to develop psychological distress 6 months later than women with non-heavy periods (adjusted odds ratio 1.09, 95% CI 0.73, 1.63). Similar findings existed with respect to intermenstrual bleeding and postcoital bleeding. Results of the 12-month analysis were similar. CONCLUSION: In the community, psychological distress appears to influence the future self-reporting of heavy periods and other symptoms of vaginal bleeding.

Adolescent↗

PubMed2002

Measuring the population impact of knee pain and disability with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).

This study has used the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in an unsolicited postal questionnaire to investigate the impact of knee pain and disability in the general older population. The study provides WOMAC population data for those aged over 50 and demographic and psychosocial associations with severity of WOMAC scores. A pilot survey (n=240) and repeatability study (n=80) were undertaken to test completion of the WOMAC in this new setting. The main questionnaire was mailed to 8,995 men and women aged over 50 registered with three general practices in North Staffordshire, UK. Completion rates for WOMAC items were high. Substantial reliability was found for pain and physical function scales (both >0.80). Fourteen percent of the over 50 population in this study had severe knee pain, 20% had severe difficulty with at least one area of physical functioning, 12% had both. The strongest link with severe difficulty with physical functioning was chronicity (odds ratio (OR)=6.49, 95% CI 4.65, 9.04). Other independent links were age over 75 years (odds ratio (OR)=4.11, 95% confidence interval (CI) 3.03, 5.58), depression (OR=2.80, 95% CI 2.22, 3.54), bilateral knee injury (OR=2.23, 95% CI 1.63, 3.06) and body mass index>30 (OR=2.00, 95% CI 1.51, 2.64). Similar associations were found for severe pain. The findings suggest that the WOMAC is a reliable measure for use in postal surveys. It has advantages over other instruments when measuring pain and physical function difficulty related to the knee. Chronicity, older age, injury, obesity and depression were all linked with higher WOMAC scores for knee pain severity and disability among knee pain sufferers in the general older population.

Activities of Daily Living↗

PubMed2002

Why women consult with increased vaginal bleeding: a case-control study.

BACKGROUND: Many women with heavy periods and irregular bleeding do not consult about them. It has been suggested that some of these symptoms are associated with psychological distress and that this influences consultation behaviour which may account for why some women present with a menstrual disturbance and others with apparently the same problem do not. AIM: To explore the relationship between symptom severity, psychological distress, and the seeking of medical help in primary care among women aged 54 years or less with increased vaginal bleeding. DESIGN OF STUDY: Case control. SETTING: An urban four-partner general practice of 10,000 patients. METHOD: Questionnaires were sent to women who were consulting with new episodes of 'increased vaginal bleeding' and two groups of controls: consulting controls with 'acute respiratory tract infection' (RTI) or 'other illness' as identified by weekly computerised searches, and community controls, selected from the practice age-sex register. RESULTS: Nine hundred and forty-three questionnaires were sent out to 108 cases and 835 controls with an 80% response rate. Of these, 60.9% of the cases, 47.0% of the consulting controls, and 39.7% of the community controls were subjects with probable psychological distress on the General Health Questionnaire (chi2 test, P = 0.002). Cases were more likely than community controls to have heavy periods (odds ratio [OR] = 2.86, 95% confidence interval [CI] = 1.53-5.35) and heavy periods interfering with life (OR = 3.69, 95% CI = 2.02-6.75). After controlling for heaviness of periods, cases were still more likely to have psychological distress (OR = 1.80, 95% CI = 1.00-3.24). The same relationships prevailed when comparing cases and consulting controls. CONCLUSION: Interference in life caused by heaviness of periods appears to be a powerful initiator of consultation with increased vaginal bleeding. Perceived heavy periods and psychological disturbance are weaker predictors. Women presenting to primary care with increased vaginal bleeding are more likey to have a psychological disturbance than women from the community or those consulting with another illness.

Adult↗

PubMedDate not supplied

Systematic review of sexual problems: epidemiology and methodology.

We conducted a comprehensive systematic literature review of five sexual problems in order to estimate their population prevalence and to investigate issues arising from the reviewing of epidemiological literature. Two independent reviewers scrutinized abstracts, extracted data, and assessed methodological quality. Twenty-eight relevant studies were identified. Prevalence figures varied considerably, and meta-analysis was not possible because of heterogeneity in study quality and design. Prevalence depends on case definition, characteristics of the study population, and time frame of the prevalence estimates, therefore, design, implementation, and reporting of epidemiological studies needs standardization before systematic reviews and meta-analyses can be carried out.

Dyspareunia↗

PubMedDate not supplied

Sensitivity to change and internal consistency of the Northwick Park Neck Pain Questionnaire and derivation of a minimal clinically important difference.

OBJECTIVES: To estimate the sensitivity to change and internal consistency of the Northwick Park Neck Pain Questionnaire (NPQ) and derive its minimal clinically important difference (MCID). METHODS: Data on 311 participants in a randomized controlled trial of physical therapy for neck pain were analyzed, between baseline and 6-month follow-up. Cronbach alpha was used to estimate internal consistency. Three methods of evaluating the NPQ's sensitivity to change were used; Cohen's effect size, standardized response mean, and Guyatt's responsiveness statistic. The smallest change on the NPQ that can be construed as clinically important (the MCID) was obtained by (1) comparing values derived from different methods that account for the measurement error of the questionnaire with improvements in other neck pain-specific measures, and then (2) examining the impact of the addition of an independent measure ("anchor") relating to participants' subjective rating of improvement. RESULTS: Cronbach alpha was 0.79 for the whole scale. Using all participants, Cohen's d was 0.78, standardized response mean was 0.71, and Guyatt's responsiveness statistic was 0.93. Using only participants who stated they had improved, the estimates were 1.35, 1.27, 1.45, respectively. The MCID for the NPQ was determined as a 25% reduction in score from baseline together with a patient's global rating of their neck pain of at least "better." CONCLUSIONS: These results show high internal consistency and sensitivity to change for the NPQ, and provide an MCID that allows participants with varying levels of severity to demonstrate improvement.

Adult↗