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PubMed1999

Effects of prognosis, perceived benefit, and decision style on decision making and critical care on decision making in critical care.

OBJECTIVE: To assess the effects of prognostic estimates, perceived benefit of treatment, and practice style on decision-making in critical care. DESIGN: Randomized assignment of subjects to either of two versions of a questionnaire designed to elicit treatment decisions for six intensive care unit cases based on actual patients. One version offered optimistic survival forecasts; the other, pessimistic forecasts. SUBJECTS: A random sample of 120 clinicians obtained from the Canadian Critical Care Society was contacted by mail. One version of the questionnaire was randomly assigned and mailed to each. Thirty-four replies, 17 for each version (response rate, 28%), were received and analyzed. MEASUREMENTS AND MAIN RESULTS: A list of treatment/management options was developed for each case, in three categories: recommended, questionable, and unacceptable. Subjects were also able to list new options that they would order that were not on the list. The dependent variables were the number of actions ordered in each category and the total for each case. Perceived benefit was measured by comparing subjective estimates of the probability of survival with the optimistic/pessimistic forecast given in the case. Practice style was assessed by correlating the total number of actions ordered across all possible pairs of cases. There were no significant differences between the two questionnaires on actions ordered either by category or by amount per category. Perceived benefit did not appear to be an important factor in decision-making. However, statistically significant correlations provide evidence for practice style in intensive care unit decision-making on an interventionist/noninterventionist dimension. CONCLUSIONS: There is no evidence that erroneous or biased prognostic estimates affect intensive care unit treatment choices. Neither the principle of maximizing expected utility nor the Rule of Rescue appear to affect these decisions systematically, but practice style does.

Canada↗
PubMed1998

The purpose and use of questionnaires in research.

The questionnaire can be a cost-effective research tool for use in data collection. A number of sequential steps should be followed in planning and designing questionnaires. Questionnaires should be sent to a pilot sample to check reliability and validity before going to the research sample.

Cost-Benefit Analysis↗
PubMed2005

Using the Rasch model to develop a measure of second language learners' willingness to communicate within a language classroom.

The purpose of this investigation was to use Rasch measurement to study the psychometric properties of a 34 item questionnaire designed to measure second language learners' willingness to communicate (WTC) in English inside their language class. 490 Japanese university students' responses to the questionnaire were subjected to a number of different analyses. The first involved a comparison of the category threshold estimates produced by the Rating Scale and Partial Credit models. The questionnaire's items were then evaluated according to how well they defined the willingness to communicate construct. The potential dimensionality of using items that involved different speaking and writing tasks/situations in order to gain a more comprehensive understanding of students' willingness to communicate was also investigated. Next there was an examination of the questionnaire's four-point scale to ensure that it captured meaningful differences in students' WTC. Finally, the questionnaire items were compared using differential item functioning to determine if second year students were more willing than first year students in any of the different speaking and writing tasks/situations. This investigation closes with some suggestions on how the WTC questionnaire can inform second language instruction and curriculum design.

Communication↗
PubMed2002

Dieting patterns and related lifestyles of school-aged children in the Republic of Ireland.

OBJECTIVE: The aim of this study was to identify differences in food habits and lifestyle behaviours by dieting status among young people in Ireland. DESIGN: Cross-sectional survey. Participants responded to a self-completion questionnaire designed by researchers on the World Health Organization's collaborative study - Health Behaviour in School Aged Children. Pupils were selected by school and classroom and the sample was stratified to be representative of the geographical distribution of school students in Ireland. SETTING: Data were collected by teachers from school pupils in their classrooms. SUBJECTS: Data were collected from 187 schools which included 8497 pupils (51% girls) aged 9-17 years. RESULTS: While a minority of pupils (12% of girls, 4% of boys) reported that they were on a diet to lose weight, a substantial proportion (28% of girls, 18% of boys) said that they should be on a diet. Dieters reported consuming unhealthy foods less frequently than non-dieters, but did not report an increased consumption of fruit and vegetables. Rather, some categories of dieters reported higher levels of coffee and tobacco use and lower exercise levels than non-dieters. CONCLUSIONS: The results could indicate substitution of unhealthy foods by other unhealthy behaviours as opposed to an increased consumption of healthier foodstuffs, and suggest that both smoking and exercise need to be addressed alongside nutrition in youth health promotion.

Adolescent↗
PubMed2001

Epidemiology of headache in Hong Kong primary-level schoolchildren: questionnaire study.

OBJECTIVE: To collect and analyse epidemiological data on childhood headache in the Hong Kong community. DESIGN: Questionnaire study. SETTING: Three primary schools, Hong Kong. PARTICIPANTS: Two thousand, one hundred and twenty pupils from 2156 replied to the questionnaire survey. One hundred and twenty-four pupils who were identified to have suspected recurrent headache were invited to a follow-up medical consultation. MAIN OUTCOME MEASURES: Age-groups and prevalence of tension-type and migraine headache, using the diagnostic criteria of the International Headache Society. RESULTS: The overall prevalence of headache in the 2120 respondents was 2.8%. The prevalence of tension-type headache, migraine, probable migraine, and unclassified headache were 1.2%, 0.5%, 0.7%, and 0.5%, respectively. The age-specific prevalence of headache from the age of 6 to 13 years showed a steadily increasing trend from childhood to the early teens. CONCLUSION: Headache is a common complaint for children, although it may be underrecognised. Further study will be beneficial for providing better management of headache in this population.

Adolescent↗
PubMed2005

Prevalence of symptoms possibly related to PADAM, in a Swedish population aged 55, 65 and 75 years.

OBJECTIVES: With age there is an average decline in the concentration of biologically active testosterone. It is still controversial if this leads to a clinically relevant deficit, "partial androgen deficiency of the ageing man" (PADAM). Our objective was to investigate the prevalence of a series of symptoms possibly associated with PADAM in an assumed normal-population of older men. METHODS: We developed a questionnaire including items about symptoms possibly associated with PADAM as well as background data covering demography, medical history, mood status, medication, castration therapy, as well as smoking, exercise and alcohol habits. The 10 items of the ADAM-questionnaire, designed to predict low bio-available T, were also included. The questionnaire was sent to all 1885 men 55, 65 or 75-years-old, living in Linköping, Sweden. RESULTS: We identified a number of symptoms that differed significantly (P < 0.01) between age groups, e.g., "increased abdominal circumference", "decrease in muscle strength and/or endurance", "decreased libido", "less strong erection" and "lack of energy". From factorial analysis we found that the symptoms co-varied in four different groups. CONCLUSION: The prevalence of a number of symptoms differed significantly between age groups, but we cannot infer that there is a causal connection between an average age-dependent decline in testosterone function and these symptoms. There are several other ways to interpret these results like the existence of concurrent somatic and/or mood disorders or ageing as such. For this purpose further studies including measurements of testosterone concentrations relating to the findings of this study have to be performed.

Abdomen↗
PubMed2004

Scalp hair analysis as a tool in assessing human exposure to heavy metals (S. Domingos mine, Portugal).

Hair samples from the scalp were used in a preliminary assessment of heavy metals exposure (As, Cd, Cr, Cu, Mn and Zn) of the human population living near an abandoned cupric pyrite mine (Mina de S. Domingos, Southeast Alentejo, Portugal). In parallel with the collection of hair samples, individuals from two different communities at the South and North of the mine area answered a questionnaire designed to obtain information about potential exposure pathways to these elements. The questionnaire allowed data collection about the most frequently consumed foodstuffs, drinking water sources, smoking habits, alcohol consumption and health condition. Higher concentrations, and subsequently higher ranges, of Cd, Cu and As were recorded in individuals living near the mine (MSD group), in opposition to individuals living several kilometers apart. Additionally, the concentrations recorded in the hair of some individuals from the MSD group were above the reference values for non-exposed individuals, suggesting their enhanced exposure. However, no significant differences were found for the average concentration of these elements between villages. Individuals from the CP and SC groups presented significantly higher concentrations of Zn and Mn in scalp hair. These results were in agreement with the concentrations of these elements recorded in soil samples. The water supplies of the area do not seem to be potential sources of trace elements for human beings. In opposition, individuals that frequently consume milk and cheese obtained from cattle that usually breeds in the area presented significantly higher concentrations of As and Mn in their scalp hair. Our results suggest that the population of S. Domingos mine area and neighbour localities may be exposed to some of the elements analysed namely Mn and Zn. The most likely exposure pathways seemed to be animal foodstuffs, however, a more detailed analysis of these products, as well as garden vegetables and fruits, should be performed.

Adult↗
PubMed2000

Patient and physician satisfaction with the Humulin/Humalog Pen, a new 3.0-mL prefilled pen device for insulin delivery.

OBJECTIVE: This study assessed acceptability of a new 3.0-mL prefilled insulin pen device, the Humulin/Humalog Pen, as a method of delivering human insulin. Secondary objectives were to determine whether the pen device might facilitate initiation of insulin therapy in patients currently receiving oral antihyperglycemic agents and to monitor the safety of this pen device in clinical practice. BACKGROUND: For both the patient and health care provider, significant negative perceptions of the use of insulin therapy persist, including patient inconvenience, social stigma from insulin injections, and insufficient time for the provider to train the patient. METHODS: This 6-week, open-label, noncomparative study was conducted at 33 centers in the United States. Patients with type 1 or type 2 diabetes treated with insulin therapy or oral antihyperglycemic agents were enrolled in the study. Before the study, 62% (194 patients) had used a syringe and vial for insulin injection, 28% (87 patients) had used an insulin pen device, and 10% (30 patients) were insulin-naive. Prior therapy was unknown in 1% (4 patients). Patients used the Humulin/Humalog Pen for > or = 1 injection of insulin daily for 6 weeks. At the beginning and end of the study, patients completed a questionnaire designed to elicit their perceptions of the Humulin/Humalog Pen; physicians completed a questionnaire at the end of the study. Frequencies and percentages of all categoric responses were calculated and summarized. RESULTS: A total of 315 patients (136 type 1, 179 type 2 diabetes) were enrolled. Of the 299 patients who completed questionnaires at the end of the study, 76% (226 patients) were somewhat or extremely satisfied with the pen, 78% (234 patients) probably or definitely would continue to use the pen, and 80% (239 patients) probably or definitely would recommend the pen to others. Of the 33 physicians who completed questionnaires at the end of the study, 97% (32) thought that the pen was better overall compared with a vial and syringe, 88% (29) thought that it took less time to teach patients to use the pen, and 73% (24) thought that it took less time to initiate insulin therapy with the pen. CONCLUSIONS: The Humulin/Humalog Pen had an acceptable safety profile and was well accepted by patients and physicians.

Adult↗
PubMed2001

Hearing impairment and quality of life for the elderly in nursing homes.

OBJECTIVE: The purpose of this study is to find out the effects of hearing impairment on the QOL of nursing home residents. METHODS: We constructed the self-assessment questionnaire designed for evaluating the QOL for the elderly in nursing homes. The questionnaire is constructed of physical, social, communicational and psychological states. It was administered to 60 subjects >65 years of age (mean age: 79 years) living in nursing homes, with hearing threshold levels in the better ear ranging from normal to severe and their response were analyzed. RESULTS: Chronbach's alpha-values of the questionnaire obtained ranged from 0.66 to 0.91 and was 0.84 overall. The reliability and validity of the questionnaire as well as its brevity, simplicity, ease of administration and interpretation, all satisfied its use in assessing the QOL of the elderly in nursing homes. It tended to decrease the points of communication scale, sociability scale and psychological scale (PGC Morale Scale) accordingly to elevate the threshold. As for subscales of communication, hearing disability was correlated statistically to the sociability and psychological. CONCLUSION: Our questionnaire is regarded as a useful tool for evaluating the QOL of the elderly. Hearing loss affects the communication, sociability and psychological aspect of the QOL for the elderly in the nursing homes.

Aged↗
PubMed2004

Does visible atopic dermatitis affect quality of life more in women than in men?

BACKGROUND: Studies have suggested that women overreport symptoms in nondermatologic disease. Gender-dependent differences in patients' perception of dermatologic disease are poorly described. The description of possible gender differences in morbidity in a skin disease with comparable prevalence in men and women may therefore provide relevant data. OBJECTIVE: The goal of this study was to examine gender-dependent differences in the self-reported morbidity of patients with atopic dermatitis (AD). METHODS: Questionnaires from members of the Atopisk Eksem Forening (Danish Association of Atopic Eczema) aged > or = 15 years were analyzed. Data were gathered regarding age, sex, disease duration and severity, and localization of AD, including the results of the Dermatology Life Quality Index (DLQI), a quality-of-life questionnaire designed for use in adults (ie, patients aged > or = 15 years). RESULTS: Questionnaires from 112 patients were analyzed. The final study population comprised 88 females and 24 males; mean age was 35.3 years (range, 15-77 years). For women, a significant positive correlation was found between DLQI score and disease severity (P < 0.001) and also between DLQI score and visible regions affected by disease (P = 0.001); these correlations were not observed in men. For the total number of body regions affected, a significant correlation with severity was found for women (P = 0.001) but not for men. No significant differences between men and women were noted for age, disease duration, overall disease severity, or quality of life as assessed using the DLQI. CONCLUSION: Self-reported morbidity is highly consistent among women with AD, but not so among men. Normally visible areas of AD appear to affect women significantly more than men.

Adolescent↗
PubMed2004

Reliability and validity of the Norwegian version of the Functional Outcomes of Sleep Questionnaire.

The aim of this study was to validate the Norwegian version of a self-administered 30-item quality of life questionnaire designed to assess disorders of excessive sleepiness, the Functional Outcomes of Sleep Questionnaire (FOSQ). In total 226 patients previously evaluated for obstructive sleep apnea were included in the study. The patients received a postal questionnaire with the FOSQ, the Short Form 36 (SF-36) questionnaire, and a scale for assessment of excessive daytime sleepiness, the Epworth sleepiness scale (ESS). Among the 178 respondents, all five subscales of the FOSQ showed good internal consistency reliability (Cronbach's alpha = 0.84-0.93). Test-retest on average 18 days apart was satisfactory with intraclass correlation coefficients ranging from 0.61 to 0.86. The pattern of Spearman's rank correlation coefficients between FOSQ scales and related and unrelated scales SF-36 scales gave support to the construct validity of the FOSQ. In conclusion, the Norwegian translation of the FOSQ showed satisfactory internal consistency reliability, test-retest reliability and construct validity, in line with the original version.

Activities of Daily Living↗
PubMed1987

Prevention of spinal cord injuries in Australia.

An Awareness and Prevention Team of five lecturers has been employed for 5 years funded by the Spinal Research Foundation at the Royal North Shore Hospital of Sydney, New South Wales. An evaluation of the effectiveness of the lecture programme in increasing knowledge and preventing the incidence of spinal cord injury was carried out to demonstrate the justification for continuing the Programme. This evaluation was achieved using a questionnaire designed for sample responses by school students in target age range. The questionnaires were distributed to 27 schools in five categories in order to obtain a spread of responses and a workable control group of schools which had not been visited by the Team. Results of 3823 questionnaires were tabulated and analysed by computer. The schools which had been visited by the Lecture Team showed both higher levels of knowledge on the structure of the spinal cord and effects of injury and also a more balanced attitude and awareness towards people requiring wheelchairs for mobility.

Adolescent↗
PubMed2001

Validation of questionnaires to estimate physical activity and functioning in end-stage renal disease.

BACKGROUND: Patients on dialysis are less physically active than sedentary persons with normal kidney function. To assess the consequences of inactivity and the results of efforts to increase activity in the end-stage renal disease (ESRD) population, valid instruments to measure physical activity and physical functioning in this group are needed. METHODS: We performed a cross-sectional study to establish the validity in ESRD of several questionnaires designed to measure physical activity or physical functioning in the general population. Questionnaires studied included the Stanford 7-day Physical Activity Recall questionnaire (PAR), the Physical Activity Scale for the Elderly (PASE), the Human Activity Profile (HAP), and the Medical Outcomes Study Short Form 36-item questionnaire (SF-36). Physical activity was measured using three-dimensional activity monitors (accelerometers) over a seven-day period (the "gold standard"). Patients also underwent physical performance tests, including measurement of gait speed, stair climbing time, and chair rising time. Study questionnaires were administered, and questionnaire results were compared with each other and with activity monitor and physical performance test results. RESULTS: Thirty-nine maintenance hemodialysis patients participated in the study. Dialysis patients scored worse than previously published healthy norms on all tests. All questionnaires correlated with seven-day accelerometry and with at least one measure of physical performance. The HAP correlated best with accelerometry (r = 0.78, P < 0.0001). Seventy-five percent of the variability in physical activity measured by accelerometry could be explained by a model that combined information from the HAP and the PASE. The HAP and the physical functioning scale of the SF-36 were about equally well correlated with physical performance measures. CONCLUSIONS: These questionnaires are valid in patients on hemodialysis and should be used to study the physical activity and rehabilitation efforts in this population further.

Cross-Sectional Studies↗
PubMed2002

A qualitative evaluation of questions and responses from five occupational questionnaires developed to assess exposures.

Questionnaires are increasingly being used in the workplace to assess exposures to chemicals and other agents. Although the literature contains much information on questionnaire design in general, little information is available on the challenges related to questionnaires applied to the occupational setting. Questionnaires on dry cleaning workers, nurses, farmers, car mechanics, and truck drivers were administered to a total of 25 people currently performing one of these jobs. After asking each question, the interviewer probed to identify the difficulties the respondents had in answering the questions. Overall, the respondents were able to answer the questions. Problems were found, however, with particular questions that reduced the effectiveness of the questionnaire. These included the use of unclear terms, questions open to multiple interpretations, difficult computational requirements (e.g., asking for averages for highly variable tasks), ineffective transitions between topics, and overlapping response categories. This type of testing is a crucial part of questionnaire development and can be used to effectively identify potential problems with questions and, therefore, improve them to enhance collection of higher-quality data for assessments of occupational exposures.

Humans↗
PubMed2000

Adaptation to oscillopsia: a psychophysical and questionnaire investigation.

In this study we explore the reasons why patients with bilateral vestibular failure report disparate degrees of oscillopsia. Twelve bilateral labyrinthine-defective (LD) subjects and twelve normal healthy controls were tested using a self- versus visual-motion psychophysical experiment. The LD subjects also completed a questionnaire designed to quantify the severity of handicap caused by oscillopsia. Additional standardized questionnaires were completed to identify the role of personality, personal beliefs and affective factors in adaptation to oscillopsia. During the psychophysical experiment subjects sat on a motorized Barany chair whilst viewing a large-field projected video image displayed on a screen in front of them. The chair and video image oscillated sinusoidally at 1 Hz in counter-phase at variable amplitudes which were controlled by the subject but constrained, so that the net relative motion of the chair and video image always resulted in a sinusoid with a peak velocity of 50 degrees /s. The subject's task was to find the ratio of chair versus video image motion that subjectively produced the 'most comfortable visual image'. Eye movements were recorded during the experiment in order that the net retinal image slip at the point of maximum visual comfort could be measured. The main findings in the LD subjects were that, as a group, they selected lower chair motion amplitude settings to obtain visual comfort than did the normal control subjects. Responses to the questionnaires highlighted considerable variation in reported handicap due to oscillopsia. Greater oscillopsia handicap scores were significantly correlated with a greater external locus of control (i.e. the perception of having little control over one's health). Retinal slip speed was negatively correlated with oscillopsia handicap score so that patients who suffered the greatest retinal slip were those least handicapped by oscillopsia. The results suggest that adaptation to oscillopsia is partly related to the patient's personal attitude to the recovery process and partly associated with the development of tolerance to the movement of images on the retina during self-motion. The latter is likely to be related to previously described changes in visual motion sensitivity in these patients.

Adaptation, Physiological↗
PubMedDate not supplied

Evaluating chronic pain impact among patients in primary care: further validation of a brief assessment instrument.

OBJECTIVE: To evaluate the psychometric properties of the Profile of Chronic Pain: Screen (PCP:S) in primary care. The PCP:S is a brief assessment device designed to gauge pain severity, interference, and emotional burden. DESIGN: Questionnaire survey with short-term reliability and validity follow-up. METHODS: Two hundred and forty-four outpatients (52% female) with chronic pain recruited from five primary care settings completed the 15-item PCP:S at an initial testing session. Approximately 1 week later, two subgroups participated in a retest reliability and validity follow-up. The battery of follow-up questionnaires included a measure of social desirability response bias and several instruments designed to provide convergent validity for the PCP:S. RESULTS: Retest reliability, internal consistency, factor structure, and social desirability bias were all found to be acceptable. Likewise, preliminary evidence suggests that, by virtue of its correlation with established measures of pain adjustment, the PCP:S is a valid pain assessment device. CONCLUSIONS: Although the PCP:S was initially developed and validated using a national community sample of adults with chronic pain who provided data via telephone interviews, the present findings support its use as a brief and psychometrically sound paper-and-pencil measure for the assessment of three key components of chronic pain in primary care.

Chronic Disease↗
PubMed1992

Bar coding--a functional tool in survey research.

STUDY OBJECTIVE: The aim was to assess the value of bar coding, together with developed microcomputer programs, as a tool to speed up mailing and handling of return responses of a survey where over 4000 adolescents received a mailed questionnaire. DESIGN: Bar codes were used for displaying the identification number of a questionnaire, as well as each response alternative and number of the question. These bar codes were read by a wand, a handhold scanner, connected to a microcomputer and the data were automatically entered into a computer data file. RESULTS AND CONCLUSIONS: Compared with previous similar surveys, the use of bar codes did not seem to affect a manner of responding. Bar coding saved human steps in handling of return responses, reduced an error rate, and helped to control the process of work. Bar coding is recommended as a new technical tool for preparations of future large scale surveys.

Attitude to Computers↗
PubMed1997

The proper use of self-report questions in effective measurement of health outcomes.

Outcomes research often relies on the use of general population survey data. The recent efforts to employ cognitive science theory in the development of data collection instruments has led to the establishment of new questionnaire design research methods. Intensive cognitive techniques are used in laboratory interviews to develop and pretest self-report survey questions with the goal of reducing non-sampling response error. This article presents the theoretical and applied approach used in the cognitive laboratory to study the ways people respond to surveys, and offers guidelines for improving self-report survey questions.

Cognition↗