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Social barriers to emotional expression and their relations to distress in male and female cancer patients.

OBJECTIVE: Emotional expression is an important means of coping with stressful experiences such as cancer. Social barriers to expression may have adverse effects. Research has suggested that men are less likely to express their emotions and have different patterns of social support compared to women. We examined whether male cancer patients have a lower tendency to express emotions, are less likely to perceive social barriers to expression, and are differentially affected by social barriers from different support sources as compared to women. DESIGN: Questionnaires were administered to 41 women and 41 men using a cross-sectional study design. METHOD: Patients diagnosed with gynaecological or prostate cancer within the past 5 years completed questionnaires on moods, intrusive thoughts, social constraints and emotional expressivity. RESULTS: There was a trend towards greater emotional expressivity in women as compared to men, but no significant gender differences in perceptions of social constraints from spouse/partner or others. Multiple regression analyses revealed that men experienced significantly greater distress in association with social constraints from their spouse/partner than did women. CONCLUSION: Men may be more vulnerable to social barriers to expression than previously assumed. Gender differences in emotional expressivity may be less important than the social context in which expression takes place.

Adaptation, Psychological↗

Parents' common pitfalls of discipline.

BACKGROUND: Problems of discipline are common among parents. These may be the results of the parents' pitfalls in disciplining their children. OBJECTIVE: To find out common pitfalls of parents in disciplining their children. MATERIAL AND METHOD: Parents of students with ages ranged between 60-72 months old in Bangkok-Noi district, Bangkok, were selected by random sampling. Total number of 1947 children ages between 60-72 months were recruited. Parents of these children were interviewed with a questionnaire designed to probe into problems in child rearing. There hindered and fifty questionnaires were used for data analyses. RESULTS: Parents had high concerns about problems in discipline their children and needed support from professional personnel. They had limited knowledge and possessed lots of wrong attitude towards discipline. Common pitfalls on the topics were problems in, 1) limit setting 2) rewarding and punishment 3) supervision on children watching TV and bedtime routines. CONCLUSION: Parents of children with ages 60-72 months old in Bangkok-Noi district, Bangkok, had several common pitfalls in disciplining their children, including attitude, knowledge and practice.

Adult↗

Predictive validity of a questionnaire that identifies older persons at risk for hospital admission.

OBJECTIVE: To determine the predictive validity of a mailed questionnaire designed to measure older adults' risk of repeated hospitalization. DESIGN: Prospective cohort study. SETTING: Ramsey County, Minnesota. PARTICIPANTS: Medicaid recipients aged 70 and older who completed the questionnaire. MEASUREMENTS: Responses were used to calculate the subjects' probability of repeated admission (Pra) to hospitals within 4 years. Subjects were classified as low-risk (Pra < 0.5) or high risk (Pra > or = 0.5). One year later, Medicaid claims data were analyzed to determine the subjects' actual use of hospitals. RESULTS: One-fifth of the respondents (20.6%) were classified as high-risk at baseline. During the following year, the high-risk subjects used hospitals at approximately twice the rate of the low-risk subjects (4.5 vs 2.4 days/person-year, P = .009). CONCLUSIONS: The instrument, which was previously found to be valid in a national sample of Medicare beneficiaries, appears to be valid also in a local sample of Medicaid beneficiaries. Older adults at risk of heavy hospital use can be identified prospectively through their responses to this brief, mailed, self-administered questionnaire. The instrument may be useful in targeting older persons for interventions designed to prevent the need for hospital care.

Age Factors↗

Trainee satisfaction before and after the Calman reforms of specialist training: questionnaire survey.

OBJECTIVES: To evaluate the impact of the Calman reforms of higher specialist training on trainee satisfaction. DESIGN: Questionnaire surveys using portable electronic survey units, two years apart. SETTING: Postgraduate, teaching, district general, and community NHS trusts in North Thames. North Thames deanery includes London north of the Thames, Essex, and Hertfordshire. PARTICIPANTS: Trainees in all grades and all specialties: 3078 took part in the first survey and 3517 in the second survey. MAIN OUTCOME MEASURES: Trainees' satisfaction with training in their current post, including educational objectives, training agreements, induction, consultant feedback, hands on experience acquired, use of log books, consultant supervision, and overall satisfaction with the post. RESULTS: In the second survey respondents were more likely to have discussed educational objectives with their consultant, used a log book, and had useful feedback from their consultant. They were more likely to give high ratings to induction, consultant supervision, and hands on experience acquired in the post. Each of these elements was associated with increased satisfaction with the post overall. Improvements were most noticeable at the level of specialist registrar, but changes in the same direction were also seen in more junior grades. CONCLUSIONS: After the reforms of specialist training, trainees in all grades reported greater satisfaction with their current posts. The changes required extra training time and effort from consultants.

Education, Medical, Continuing↗

Full-body skin examinations: the patient's perspective.

OBJECTIVES: To determine (1). primary care practitioner (PCP) and dermatologist full-body skin examination (FBSE) rates by using a patient questionnaire and (2). whether patient risk factors for skin cancer alter these rates. DESIGN: Questionnaires pertaining to whether participants underwent regular FBSE, their feelings about this screening test, and their risks for developing skin cancer. SETTING: The primary care and dermatology clinics at the West Haven Veterans Affairs Medical Center. PARTICIPANTS: A convenience sample of 356 patients awaiting clinic appointments. Of those asked to participate, 251 (71%) agreed. MAIN OUTCOME MEASURES: Patient report of undergoing FBSE, attitudes regarding this examination, and risk factors for cutaneous malignancy. RESULTS: Thirty-two percent of all respondents reported undergoing regular FBSE by their PCP, whereas 55% of those with a history of skin cancer reported undergoing FBSE. Eight percent of participants reported embarrassment with FBSE, 83% reported that their PCP would be considered thorough by performing FBSE, and 87% would like their PCP to perform FBSE regularly. Only 2% of participants would refuse the examination if the PCP were of the opposite sex, whereas 8% would be more willing to be examined. CONCLUSIONS: Although patients report a low incidence of FBSE, those with a personal history of skin cancer are more likely to be screened. A low rate of embarrassment and a high rate of perceived PCP thoroughness are associated with FBSE. Patients have a strong preference to undergo FBSE. A sex difference between the PCP and the patient should not be a barrier to this examination.

Connecticut↗

Evaluation of a risk assessment questionnaire used to target tuberculin skin testing in children.

CONTEXT: Universal tuberculin skin testing of children has been shown to be costly and inefficient. In response, several authorities have recommended targeted screening based on epidemiological risk. In 1996, the New York City Department of Health (NYCDOH) developed questions to identify children who require a tuberculin skin test. OBJECTIVE: To determine the sensitivity, specificity, and predictive validity of the NYCDOH tuberculosis risk assessment questionnaire. DESIGN: Prospective criterion standard study in which tuberculin skin tests and the NYCDOH questionnaire were administered simultaneously between August 1996 and January 1998. Specific questions asked about contact with a tuberculosis case, birth in or travel to endemic areas, regular contact with high-risk adults, and human immunodeficiency virus infection in the child. SETTING: Ambulatory clinic in South Bronx, New York, NY. PARTICIPANTS: Consecutive sample of 2920 children aged 1 to 18 years. MAIN OUTCOME MEASURES: Sensitivity, specificity, positive and negative predictive values of the questionnaire, and odds ratio (OR) of reactive skin test results. RESULTS: The NYCDOH questionnaire identified 413 children (14%) as having at least 1 risk factor. Of these, 23 (5.6%) had a positive skin test result; 4 (0.16%) of the 2507 without risk factors had a positive result. Results for the full NYCDOH questionnaire were sensitivity, 85.2%; specificity, 86.0%; negative predictive value, 99.8%; positive predictive value, 5.4%; and OR, 35.2 (95% confidence interval, 12.1-102.4). CONCLUSION: The NYCDOH questionnaire is a valid instrument for identifying children for tuberculin skin testing.

Adolescent↗

Obstetrician-gynecologists are primary physicians to women. I. Practice patterns of Michigan obstetrician-gynecologists.

Michigan obstetrician-gynecologists were asked to complete questionnaires designed to determine what kinds of medical services they provide their patients. The questionnaires completed by 369 doctors, who had graduated from medical school between 1930 and 1964 and who are in active practice, form the basis of this report. More than 50% treat common non-obstetric-gynecologic disorders in their own patients and smaller numbers treat more serious medical conditions. This study confirms a previous one, derived from information obtained from patients, that obstetricians-gynecologists serve as primary physicians to women, not exclusively as specialist-consultants.

Female↗

A survey of delusional ideation in primary-care patients.

BACKGROUND: To assess the prevalence of delusional ideas in primary-care patients. METHOD: A survey was carried out with the Aquitaine Sentinel Network of general practitioners (GPs). Consecutive practice attenders were invited to complete the Peters et al. Delusional Inventory (PDI-21) self-report questionnaire, designed to measure delusional ideation in the normal population. GPs, blind to the questionnaire results, provided information on patients' psychiatric history. RESULTS: Of the 1053 attenders included in the survey, 348 (35%) had a lifetime history of psychiatric disorder, of whom 20 (2%) had a history of broadly defined psychotic disorder. The self-report questionnaire was completed by 790 patients. The range of individual PDI-21 item endorsement in subjects with no psychiatric history varied between 5 and 70%, suggesting that delusional ideation is a dimensional phenomenon lying on a continuum with normality. The main discriminative items between psychotic and non-psychotic patients were those exploring persecutory (OR = 15.2, 95% CI 4.3-53.7), mystic (OR = 6.4, 95% CI 1.9-22.4) and guilt (OR = 5.8, 95% CI 1.5-23.2) ideas. CONCLUSIONS: This survey demonstrates that questions that explore delusions and hallucinations are well-accepted by most primary-care patients. More research is needed on psychotic disorders in primary-care settings to improving early identification of these disorders.

Adolescent↗

Hearing conservation in the mining industry. Evaluation of a risk factor questionnaire.

The objectives of this study were to assess the validity of a self-administered hearing questionnaire in the assessment of risk to hearing, to amend the questionnaire design as necessary, and to give general guidance on the use of audiometric questionnaires in hearing conservation programmes. The study was carried out at a colliery in Staffordshire. The odds of deafness, according to the Health and Safety Executive definition, were analysed by exposure to the hearing risk variables in the questionnaire. The results of the hearing questionnaire were linked to a cross-sectional audiometric survey. There were 189 questionnaires eligible for inclusion. Noise exposure at work was reasonably well predicted by having to shout at work (OR 1.42, 95 per cent CI 0.58-3.54) and being exposed to noisy tools and machinery (OR 2.12, 95 percent CI 0.72-6.72). Risk to hearing from disease was predicted by having 'abnormal' hearing or discharging ears, but not by any of the other exposure variables. Risk to hearing from acoustic trauma was demonstrated for fire-arms (OR 1.23, 95 per cent CI 0.5-2.98). None of the hobbies included in the questionnaire usefully predicted hearing loss. The conclusions are that, contrary to Health and Safety Executive advice, audiometric questionnaires may reasonably be administered to all employees, as they are useful in the documentation of hearing loss risk factors. They should not, however, be used to detect ear disease. A revised questionnaire was drafted as the result of these findings, and will be piloted in a larger population.

Evaluation Studies as Topic↗

Motivation, vocational interests and job satisfaction of mentally retarded adults.

The relationship between vocational interests of 83 mildly to moderately retarded adults in a residential facility in Israel, their actual work and the factors which they perceived as the most important motivators for them at work and job satisfaction were investigated. Two questionnaires were used: the Illustrated Vocational Inventory (Whelan & Reiter, 1980) and a specially designed questionnaire on motivation to work based on Herzberg, Mausner, and Snyderman's (1959). The results demonstrate the importance of taking into consideration mentally retarded persons' vocational interests when assignig them to different jobs. It further demonstrates the importance of the environment in influencing mentally retarded individuals to seek instrinsic or extrinsic rewards and satisfaction from work.

Adult↗

Associations of attributional dimensions with emotions in academic achievement.

To examine relationships between causal dimensions and affects in academic achievement, 87 college students were asked to complete a questionnaire, designed to assess their reactions to the outcome of a midterm examination. The questionnaire consisted of two kinds of measures, causal dimensions and affects. Multiple regression analysis showed the relations of attributional dimensions and the midterm examination outcome to the affective reactions; these results were discussed.

Achievement↗

Functional Outcome Questionnaire for Aphasia: overview and preliminary psychometric evaluation.

OBJECTIVE: To perform a preliminary evaluation of a questionnaire designed to assess functional outcomes of treatment for aphasia. METHODS: The Functional Outcome Questionnaire for Aphasia (FOQ-A) is an inventory consisting of 32 caregiver-completed items rating the person with stroke's ability to perform various communication behaviors on a 5-point scale. The total score for the FOQ-A is reported as a mean of all completed items. The FOQ-A was administered by research assistants to caregivers of patients with left hemisphere stroke (n = 18). RESULTS: The FOQ-A showed acceptable initial reliability and validity properties. As predicted, the FOQ-A displayed high positive correlations with standardized functional communication measures. The FOQ-A also showed only weak associations with other measures (health-related quality of life, caregiver strain). CONCLUSIONS: Overall results of our preliminary psychometric examination of the FOQ-A were promising. The findings suggested that the FOQ-A may be a sensitive measure of functional communication abilities and does not appear to be biased heavily by caregiver strain. Plans for further evaluation of the FOQ-A are discussed.

Adult↗

Stages in the development of a needs assessment questionnaire.

This article describes the stages in the development of a questionnaire for use in a large-scale needs assessment study as the basis for a staff development program. While a considerable literature exists on questionnaire design in general, we emphasize the need for a conceptual framework behind the questionnaire, proceeding from analysis of the objectives of the needs assessment and guiding both the construction of variables and the reduction and analysis of the questionnaire's data.

Data Interpretation, Statistical↗

Scholastic attainment and employment of drug users in Singapore.

A study of the educational and employment aspects of drug use, which was carried out in 1980 in Singapore, included 100 drug users randomly selected from those who had been, because of drug addiction, registered for treatment and rehabilitation by some major voluntary organizations dealing with drug abuse problems, and 100 non-users individually matched for sex, approximate age, ethnic group, education and neighbourhood. The respondents were interviewed on the basis of a questionnaire designed to collect data for this study. Data on 11 items of the questionnaire were available in official records which were used to check the truthfulness of the responses of the drug users. The agreement between the two sources of data ranged from 83 to 100 per cent. The drug users were found to have significantly lower levels of educational attainment and poorer scholastic results than the non-users. Similarly, significantly more drug users than non-users had a lower career status, higher instability in employment and greater job dissatisfaction. The author suggests that educational and vocational guidance, counselling service, welfare schemes and in-service training should cater to this group of people.

Adolescent↗

Quality of life in patients after meningioma resection.

OBJECTIVES: To evaluate quality of life in patients after tumour resection, to assess different dimensions of quality of life, to compare a newly designed questionnaire with the Nottingham Health Profile. SUBJECTIVE: A non-selected neurosurgically treated series of patients with meningiomas was investigated with reference to quality of life as a judgement of one's own needs and concerns and subjective disease dependent perception. METHODS: A postal survey was sent out to 155 patients who underwent resection of a meningioma between 1977 and 1993 at our clinic. The survey consisted of the specifically designed "Innsbruck Health Dimensions Questionnaire for Neurosurgical Patients" IHD(NS) and the Nottingham Health Profile NHP. The data were put into categories and analysed statistically (Chi-square, Mann Whitney U, Kruaskal-Wallis H-tests). RESULTS: 82 patients (53 female, 29 male) responded (response rate 59%). 10 had died and 7 had moved. The majority of patients (50/61% on NHP and 49/59.7% on IHD) had mild to moderate impairment of quality of life. 20% of the patients showed moderate to severe impairment of the dimensions: physical handicap and energy level. Physical impairment correlated to tumour size. This group was characterised by mainly belonging to the over 70ies age group and taking anti-epileptics. CONCLUSIONS: The quality of life impairments in most patients after tumour resection can be classified as mild to moderate. However, other disease and age effects are difficult to distinguish without a control group. The IHD(NS) correlated well with the NHP questionnaire.

Activities of Daily Living↗

Characteristics and satisfaction of the patients of male versus female dentists.

With rising numbers of women entering dental practice, and relatively little known about these practices, this study seeks to characterize the practices of female dentists. Characteristics and satisfaction differences of patients between male and female practitioners were examined. A matched-pair design of 13 men and 13 women in general private practice in Connecticut was conducted. Questionnaires, designed to evaluate satisfaction and patient sociodemographics, were distributed to 25 patients from each practice. Patients were similar to utilizers as described by the US National Health Interview Survey, and scored slightly higher on the Dental Satisfaction Questionnaire than a national sample. Few differences were found between the patients of male and female dentists, but significant differences were found in patient incomes, satisfaction with cost, and satisfaction with access, with the patients of women giving more favorable satisfaction ratings on cost and access. These findings are encouraging to women entering private practice as they are perceived by patients to deliver care equal in quality to their male counterparts.

Adult↗

Compliance with prescription filling in the pediatric emergency department.

OBJECTIVES: To determine the rate of compliance with filling of prescriptions written in a pediatric emergency department and to examine the reasons for not filling the prescriptions. DESIGN: Compliance with filling prescriptions was determined using a follow-up standardized telephone questionnaire, designed so that it was not obvious that assessing prescription filling was the major reason for the study. Compliance herein was defined as having the prescription filled on the same or next day of the pediatric emergency department visit. SETTING: Pediatric emergency department of a tertiary care hospital. SUBJECTS: Pediatric patients discharged home with a drug prescription. MAIN OUTCOME MEASURE: The proportion of prescriptions written in the pediatric emergency department that were filled on either the same or next day as determined by telephone follow-up. This outcome is expressed as a proportion with 95% confidence interval. RESULTS: Follow-up was completed in 1014 (83%) of the 1222 children, aged 4.5 +/- 4.2 (mean +/- SD) years. Compliance with prescription filling was 92.7% (940/1014). Parental reasons for not filling the prescription included medication unnecessary (27%), financial (6.8%), and not enough time (6.8%). Dissatisfaction with the explanation of the medical problem, instructions for treatment, and instructions for follow-up treatment were significantly associated with noncompliance by univariable logistic regression (P<.05). CONCLUSION: The rate of prescription nonfilling in children seen in a pediatric emergency department is at least 7%, although lower than that in adults in a similar setting.

Child, Preschool↗

Methodological considerations of undertaking research with clinical mentors in the UK: a critical review of the literature.

The subject of this paper is critical review of the reported research approaches used when undertaking clinical mentor research in the UK. The term 'Mentor' is used to denote a clinical practitioner who is responsible for the teaching, assessing and supervision of student nurses undertaking clinical practice. Imperatives such as new quality assurances in the UK are cited as part of the rationale for conducting the review. In these new initiatives, clinical placements are viewed as an integral feature of Higher Education Institution's (HEI) nurse education provision. Within these new quality assurance processes, there is an emphasis on the importance of clinical learning environments and the impact that mentors have on student learning. A critical review of 19 reports that have clinical mentors as their target population was undertaken. Factors such as the subject areas of the studies reviewed, research methodologies, sampling issues, responses rates and ethical considerations were the focus of the critical appraisal. It was found that most studies used postal survey approaches. Methodological weaknesses were found to relate to such things as questionnaire design, sampling and poor response rates. It is concluded that the study gives further insights into the debate about the rigor of nursing research and particularly nurse education research and therefore is of interest not only to nurse education researchers but also to nurse researchers generally.

Clinical Competence↗