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PubMed2002

Self-reported visual dysfunction in multiple sclerosis: new data from the VFQ-25 and development of an MS-specific vision questionnaire.

PURPOSE: To examine vision-specific health-related quality of life in a cohort of patients with multiple sclerosis (MS) using the 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25), and to identify content areas for a brief MS-specific vision questionnaire. DESIGN: Cross-sectional survey. METHODS: The VFQ-25 and a modified version of the Optic Neuritis Treatment Trial (ONTT) Patient Questionnaire were administered by in-person interview to 80 patients at the University of Pennsylvania MS Center. Binocular visual acuities were obtained following a standard protocol using retroilluminated Early Treatment Diabetic Retinopathy Study charts. RESULTS: Despite a median binocular visual acuity of 20/16 (20/12.5-20/250), VFQ-25 subscale scores in the MS cohort were significantly lower (worse) compared with those of a published reference group of eye disease-free patients (P =.0001-0.009, two-tailed t tests). Rank-correlations of VFQ-25 composite (overall) scores with visual acuity were modest, but significant (r(s) = 0.33, P =.003), supporting construct validity for VFQ-25 scores in MS populations. Seven additional aspects of self-reported visual dysfunction in MS were also identified. CONCLUSIONS: Patients with MS have a high degree of self-reported visual dysfunction that is not entirely captured by visual acuity. The VFQ-25 is an effective measure of self-reported visual loss in MS. A brief MS-specific vision questionnaire may provide additional useful information when administered concurrently with the VFQ-25 in future investigations of MS and other neuroophthalmologic disorders.

Adult↗
PubMed1997

The influence of patients' hopes of receiving a prescription on doctors' perceptions and the decision to prescribe: a questionnaire survey.

OBJECTIVES: To measure patients' expectations of receiving prescriptions and general practitioners' perceptions of these expectations and to determine the factors most closely associated with the decision to prescribe. DESIGN: Questionnaires were completed by patients waiting to see their general practitioners, and by their doctors immediately after the consultations. SETTING: Four non-fundholding groups practices in southeast London. SUBJECTS: 544 unselected patients consulting 15 general practitioners. MAIN OUTCOME MEASURES: Doctor's perceptions of patients' expectations; doctors' decisions to prescribe. RESULTS: 67% (354/526) of patients hoped for a prescription; doctors perceived that 56% (305/542) of patients wanted prescriptions; and doctors wrote prescriptions in 59% (321/543) of consultations. Despite the close agreement between patients' hopes and doctors' perceptions, 25% (89/353) of patients hoped for a prescription but did not receive one. In 22% (68/313) of consultations in which prescriptions were written, they were not strictly indicated on purely medical grounds, and in only 66% (202/306) of consultations in which prescriptions were written were they both indicated and hoped for. Doctors' perceptions of patients' expectations were the strongest predictor of the decision to prescribe, but the final regression model also included patients' hopes and ethnic group, and the doctor's feeling of being pressurised. CONCLUSIONS: In an area of low prescribing and high expectations the decision to prescribe was closely related to actual and perceived expectations, but the latter was the more significant influence.

Adult↗
PubMed2004

Suicide attempts and risk factors among children and adolescents.

The purpose of this study was to determine the prevalence of suicide attempts, and to identify the risk factors for suicide attempts in Turkish children and adolescents between the ages 10 and 20 years. Multi-step, stratified, cluster sampling was used. A stratified sample of 4256 students was selected as representative of the city's school children population. Data was obtained with a pair of structured questionnaires designed to evaluate the presence and risk factors of suicide attempts, both in the children and adolescents and their parents. These questionnaires investigated family environment, subject characteristics, and various risk factors for suicide attempts. Child Beck Depression Inventory (CBDI) was administered to all children and adolescents. After the data quality control process, the study sample was reduced to 4143 children and adolescents. Children and adolescents were divided two groups according to the experience or non-experience of suicide attempts: group 1 (n=80) and group 2 (n=4063), respectively. Three categories of independent variables were assessed: adolescent, family, and socioeconomic characteristics. Logistic regression models were based on the children and adolescents and on parent reports. The prevalence of suicide attempts as reported by the children and adolescents was 1.93% (n=80). The mean age of group 1 was higher than that of group 2 (p=0.002, t=-3.172), as was the mean score of CBDI (p=0.000, t=-9.083). Logistic regression analysis indicated that having problems with parents, using illicit drugs, and psychiatric problems in relatives best predicted suicide attempts in Turkish children and adolescents.

Adolescent↗
PubMed1988

[Persistence of psychological disorders in children 5-6 years of age to 10-11 years of age--a longitudinal study].

The sample covered 196 + 20 families and their children born between 1.7.1975-30.6.1976. The purpose of this study was to investigate the persistence of preschool aged childrens mental disturbances and to see what kind of problems show most stability. When the children of this sample were 5-6 years old their mental development was assessed by a child psychiatrist and a psychologist. Children were regarded as mentally normal or slightly or clearly disturbed. In addition children who showed mental symptoms were divided on the bases of the nature of their symptoms to emotionally disturbed and ego disturbed (conduct problems). When the children were at the age of 10-11 years the parents were sent a questionnaire designed by Rutter to find those children who had at that time mental problems. The children were sent a CDI-questionnaire, which measures the depression in children. According to the results of this study the mental disturbances in preschool age showed strong stability until the age of 10-11 years. Emotional disturbances at the preschool age predicted more later problems than conduct problems.

Child↗
PubMed2005

Thought suppression and cognitive vulnerability to depression.

OBJECTIVES: Cognitive reactivity (CR) has been defined as the relative ease with which maladaptive cognitions or cognitive styles are triggered by mild (nonpathological) mood fluctuations. CR has been found to predict relapse of depression (Segal, Gemar and Williams, 1999). This study compared different measures of CR, and also investigated the role of thought suppression as a possible mechanism underlying CR. DESIGN AND METHODS: Participants included 24 previously depressed, and 24 never depressed individuals who underwent a mood induction. They also completed a questionnaire designed to measure CR (LEIDS; Van der Does, 2002a), and participated in the scrambled sentences task (SST). The SST was designed to uncover thought suppression tendencies, and has been shown to discriminate between never depressed and previously depressed samples. RESULTS: LEIDS scores were higher for previously depressed than for never depressed individuals. However, CR as measured with the mood induction did not distinguish between these groups. The LEIDS was correlated with the results of the SST and with self-report measures of thought suppression. CONCLUSION: Active suppression of unwanted thoughts may be involved in the apparent inactive state of depressive cognitions during remission.

Adolescent↗
PubMed1984

Improving physician/teacher collaboration.

This paper describes a three-phase project designed to improve physician/teacher collaboration with exceptional school children. In phase 1, the school district's 54 special education personnel completed a 24-item questionnaire designed to identify communication and role-expectancy problems. Phase 2 consisted of a series of workshops in which physicians explained their evaluations and and treatments of exceptional children. In phase 3 a collaboration model linking the school district and a university-based medical center was developed and implemented. Questionnaire data, the collaboration model, and suggestions for other models are presented.

Child↗
PubMedDate not supplied

Using the Internet for surveys and health research.

This paper concerns the use of the Internet in the research process, from identifying research issues through qualitative research, through using the Web for surveys and clinical trials, to pre-publishing and publishing research results. Material published on the Internet may be a valuable resource for researchers desiring to understand people and the social and cultural contexts within which they live outside of experimental settings, with due emphasis on the interpretations, experiences, and views of 'real world' people. Reviews of information posted by consumers on the Internet may help to identify health beliefs, common topics, motives, information, and emotional needs of patients, and point to areas where research is needed. The Internet can further be used for survey research. Internet-based surveys may be conducted by means of interactive interviews or by questionnaires designed for self-completion. Electronic one-to-one interviews can be conducted via e-mail or using chat rooms. Questionnaires can be administered by e-mail (e.g. using mailing lists), by posting to newsgroups, and on the Web using fill-in forms. In "open" web-based surveys, selection bias occurs due to the non-representative nature of the Internet population, and (more importantly) through self-selection of participants, i.e. the non-representative nature of respondents, also called the 'volunteer effect'. A synopsis of important techniques and tips for implementing Web-based surveys is given. Ethical issues involved in any type of online research are discussed. Internet addresses for finding methods and protocols are provided. The Web is also being used to assist in the identification and conduction of clinical trials. For example, the web can be used by researchers doing a systematic review who are looking for unpublished trials. Finally, the web is used for two distinct types of electronic publication. Type 1 publication is unrefereed publication of protocols or work in progress (a 'post-publication' peer review process may take place), whereas Type 2 publication is peer-reviewed and will ordinarily take place in online journals.

Clinical Trials as Topic↗
PubMed1998

Identifying the content area for the 51-item National Eye Institute Visual Function Questionnaire: results from focus groups with visually impaired persons.

OBJECTIVE: To identify the content area for a questionnaire designed to measure vision-targeted health-related quality of life and to determine whether problems with vision-related functioning are qualitatively similar across different common eye diseases. DESIGN: Twenty-six condition-specific focus groups were conducted with 246 patients from 5 geographic regions to identify the content area for a questionnaire for use among persons with diabetic retinopathy, glaucoma, macular degeneration, cytomegalovirus retinitis, and cataract. A standard protocol was used to structure each focus group discussion. Sessions were audiotaped, transcribed, and coded in preparation for a content analysis. SETTINGS: Five university-based ophthalmology practices and 1 nonprofit eye care foundation. PARTICIPANTS: Eligible participants had to have 1 of the following eye conditions: age-related cataracts, age-related macular degeneration, diabetic retinopathy, primary open angle glaucoma, cytomegalovirus retinitis, or low vision from any cause. All eligible persons were older than 21 years, spoke English, and had sufficient cognitive function to provide informed consent. RESULTS: Among the 246 participants, 2623 problems with vision-related functioning were mentioned. The mean number of problems per person ranged from 13.5 for those with diabetic retinopathy to 7.9 for persons with glaucoma. For the sample overall, reading problems were mentioned most frequently, followed by driving, general problems with seeing clearly, and mental health complaints caused by vision. Although the proportion of persons who reported each problem varied by condition, at least some persons with each eye disease reported each problem. The 3 most common descriptors associated with each problem were difficulty or ease of performance (13%), psychological distress associated with performance of the activity (11%), and complete inability to participate in a visual activity (11%). CONCLUSION: An item-generation strategy for a new questionnaire using a standardized focus group method identified content areas and aspects of visual disability that are not included in currently available vision-specific instruments that assess the impact of common eye diseases on visual functioning in every-day life. Although participants mentioned problems that were unique to their disease, across conditions the problems mentioned were similar. These findings provide empirical evidence of content validity for a vision-targeted, health-related quality-of-life survey designed for use across conditions.

Adult↗
PubMedDate not supplied

Increasing self-efficacy through empowerment: preoperative education for orthopaedic patients.

PURPOSE: To examine whether patients who received an empowerment model of education for preoperative orthopaedic teaching had improved outcomes compared to patients who received the traditional education. DESIGN: An experimental (empowerment teaching method) group vs. comparison (traditional teaching method) group posttest design. SAMPLE: Seventy-four patients undergoing elective orthopaedic surgery. METHODS: Following the preoperative teaching session, patients in both groups completed a questionnaire designed to measure their perceptions of the teaching (empowerment) and self-efficacy (belief in their ability to carry out perioperative tasks). A chart audit and phone interview was done after discharge to assess length of stay, pain management, complications, and patient perceptions of the ability to complete perioperative tasks. FINDINGS: Patients in the empowerment group felt the educational approach was more empowering and had significantly higher self-efficacy scores than those in the traditional teaching group. There was much less variation in empowerment and self-efficacy scores in the empowerment group. The empowerment group reported feeling greater confidence in performing perioperative tasks. There were no differences in length of stay, complications or pain control. CONCLUSION: Use of an empowerment teaching approach enabled patients to become more confident in their ability to carry out perioperative tasks and become a more integral part of the preoperative teaching process. IMPLICATIONS FOR NURSING RESEARCH: The theoretical model will be used to structure other educational programs and guide research. More sensitive measures of complications and pain control should be considered for future studies.

Adolescent↗
PubMed1984

Instructional design strategies for developing an interactive video educational program for pregnant teens: a pilot study.

One hundred forty-six teens attending an urban maternity hospital's prenatal clinic completed a questionnaire designed to assist in the development of educational programs utilizing computer-assisted television instruction or interactive video. Ninety-five percent of the teens agreed that additional information about desirable health behaviors during pregnancy would be helpful. Forty-six percent preferred obtaining information from a health professional at the hospital. Although 90% said that the race of the narrator for a film show was unimportant, responses regarding racial preference corresponded to the racial distribution of participants. Seventy-six percent of the teens preferred the narrator to be younger than 35 years of age, and 54% preferred a female narrator. Race was associated with video game experiences, preferences about the narrator's age and race, and favorite television shows. Age was not associated with responses to any of the questions. Although only 19% had ever used a computer, 98% stated they would like to try a computer with assistance. More than half (55%) knew how to type and 83% had played video games; of those who had played video games, 93% said they enjoyed doing so. Eighty-three percent of the respondents always or sometimes enjoyed cartoons. Favorite television shows and cartoon characters were identified. The design implications of the teens' preferences to the development of instruction using computers coupled with other emerging technologies are discussed.

Adolescent↗
PubMed2006

Women's knowledge about breast cancer risk and their views of the purpose and implications of breast screening--a questionnaire survey.

OBJECTIVES: To assess women's knowledge and perception of breast screening, including its benefits and disadvantages, and explore whether demographic and other personal characteristics are associated with accurate knowledge. DESIGN: Questionnaire survey of a random sample of 1000 women aged between 49 and 64 years registered with GPs in Oxfordshire. RESULTS: Thirty-six per cent of women knew the lifetime risk of developing breast cancer, and the interpretation of numeric risks varied among women. There was an association between inaccurate knowledge and lower formal education (P = 0.05). Forty-five per cent of women believed that screening prevents breast cancer. Women were of the opinion that screening helps early detection, could result in less invasive treatment and reassured them. Sixty-three per cent had no concerns about breast screening. The main causes of concern were that they would not be invited for further screening (exclusively women in their 60s), screening is not offered earlier or more frequently, painful mammography and effects of radiation. A minority of women were concerned that the pressure exerted on the breasts during mammography may itself trigger cancer by displacing and spreading cancer cells. CONCLUSIONS: Women's knowledge about breast screening was variable and sometimes incorrect, and those with less formal education were more likely to have inaccurate knowledge.

Breast Neoplasms↗
PubMed1980

An assessment of physician knowledge of epidemiology and biostatistics.

A review was conducted of 585 articles in the medical literature, and the articles were categorized by study design and by statistical techniques employed. In the majority, statistics were utilized primarily for data description and hypothesis-testing. Descriptive studies were most frequent, and only a minority were epidemiological investigations. A questionnaire designed to assess knowledge of biostatistics and epidemiology relevant to this literature was administered to internists and medical house staff at a teaching hospital. Of 229 questionnaire recipients, 141 responded and achieved a mean score of 7.4 with 10.0 possible. Practicing physicians had a significantly lower mean score than house staff and full-time faculty. Scores were higher for the 44 percent of respondents who reported prior training in epidemiology or in biostatistics. The results of the journal review suggest that knowledge of basic biostatistics and of study design is important for reading medical literature. Physicians with prior training in epidemiology and in biostatistics appear to be better prepared for this task.

Biometry↗
PubMed1987

The development and preliminary validation of an instrument to assess patients' attitudes toward pain.

This paper describes the development and preliminary validation of a questionnaire designed to assess five attitudes considered important in the long-term adjustment of chronic pain patients. The specific subscales of the questionnaire were chosen to represent attitudes believed to influence the ways by which chronic pain patients manage their pain. Following the development of five reliable subscales, correlations of the subscales with self-reported pain behaviors and coping strategies were calculated, providing preliminary support for the concurrent validity of the instrument.

Adaptation, Psychological↗
PubMedDate not supplied

Juror and expert knowledge of child sexual abuse.

Mental health professionals with expertise in child sexual abuse (CSA) often testify as expert witnesses in court. There is significant controversy over the admissibility of this type of evidence. To be admissible, the testimony of an expert must be beyond the common knowledge of the jury and based on information generally considered to be reliable within the professional community in which it is used. To date, no empirical data have existed to allow courts to make an informed judgement as to the extent of either juror knowledge or professional acceptance of CSA data. The present study addresses this issue. Jurors and experts completed a questionnaire designed to reveal their understanding of CSA. Results indicate that experts demonstrated strong consensus on 29 of 40 items included in the questionnaire, and that relative to experts, jurors have limited knowledge of these issues. These results suggest that many of the scientific findings concerning CSA are reliable and that the information is often beyond the common knowledge of the jury. These findings argue for the use of expert testimony in select cases of child sexual abuse.

Adolescent↗
PubMed1989

Development and use of a self-administered questionnaire for assessment of psychologic attitudes toward pregnancy and their relation to a subsequent premature birth.

This paper describes both the development of and results of the use of a self-administered questionnaire designed specifically to investigate the relation between the psychologic attitudes of pregnant women toward pregnancy and an eventual subsequent premature birth. The questionnaire (entitled Pregnancy Psychologic Attitudes Test--in relation to Premature Birth [PPAT(p)]) was derived from the synthesis of interviews with women who had given birth prematurely, comprised 40 questions grouped in six dimensions, and was used in a prospective survey. All women who had an antenatal visit in their fifth to sixth month of pregnancy in one of four maternity hospitals in Lyon, France, between October 1983 and March 1985 were asked to complete this questionnaire. A quantitative PPAT(p) score (ranging from 0 to 6) was constructed in a working sample (n = 643), and its relation with a subsequent premature birth was analyzed in a study sample (n = 1,500). Application of the logistic regression model showed, after controlling for personal and medical factors, that this relation was statistically significant. The risk of premature birth increased from 1 to 1.5 when the PPAT(p) score increased one point (p less than 0.001). This study contributes to a better understanding of psychologic factors that may affect pregnant women and be associated with premature birth. This new component must be considered in the development of policies for preventing premature birth.

Adult↗
PubMed1988

Substance use by fourth-year students at 13 U.S. medical schools.

Fourth-year medical students at 13 medical schools in different regions of the United States received an anonymous questionnaire designed to examine their current and prior use of 11 substances and their attitudes toward substance use among physicians. Of 1,427 questionnaires distributed, 41 percent were returned. The questionnaire and distribution method were derived from an ongoing survey on drug use in order to permit comparison of the medical students with a national sample of age- and sex-matched cohorts. The rates of substance use during the 30 days preceding receipt of the questionnaire were: alcohol, 87.8 percent; marijuana, 17.3 percent; cigarettes, 9.0 percent; cocaine, 5.6 percent; heroin, 0.0 percent; other opiates, 0.9 percent; LSD, 0.2 percent; other psychedelics, 0.5 percent; barbiturates, 0.5 percent; tranquilizers, 2.2 percent; and amphetamines, 1.2 percent. Compared with their age and sex cohorts nationally, the medical students reported less use of marijuana, cocaine, cigarettes, LSD, barbiturates, and amphetamines. However, their use of other opiates was approximately the same and their use of tranquilizers and alcohol was slightly higher than that of the other cohorts. Data on their sources of knowledge about drug abuse indicate the need for greater attention to this issue in the medical curriculum.

Adult↗
PubMed2005

Incidence of sleep disorders in children with presumed normal variant short stature.

OBJECTIVE: To determine whether unrecognized obstructive sleep apnoea (OSA) is present in some children diagnosed with normal variant short stature. METHODS: One hundred and fifty-eight children aged less than 15 years and previously diagnosed with familial short stature or constitutional delay of growth were identified from the endocrine clinic database. A validated, standardized questionnaire designed to screen for symptoms of sleep disorders in children was mailed to the parents of eligible children. RESULTS: Fifty-three questionnaires were returned. Fifteen of these had an abnormal score (greater than the mean + three standard deviations in 1157 normal control children). Of these, 10 agreed to a sleep study. Overnight polysomnography showed no evidence of OSA or other sleep/breathing disorders. However, five (half) children showed frequent periodic leg movements of 6.3, 9.2, 9.4, 10.2 and 15.4 per h (adult normal <5 per h). CONCLUSIONS: We did not find OSA among a group of children with normal variant short stature. However, we found frequent periodic limb movements during sleep in a large proportion of the subjects, the significance of which remains to be determined.

Adolescent↗
PubMed2002

Minimizing the risks of latex allergy: the effectiveness of written information.

BACKGROUND: Latex allergy has been identified as an occupational risk for the dental profession. This study assessed whether identified latex-allergic dental personnel changed their practices after receiving verbal and written information about the management of latex allergy. METHODS: A survey conducted at the 1998 Australian Dental Association Congress identified 157 dental personnel with clinical latex allergy, or at high risk from latex exposure. The workplace implications were then explained to them by a consultant allergist. Four weeks later, follow up written information on latex allergy was mailed out. The information sheet outlined possible symptoms and cross-reactions, implications for the workplace, hand care advice and management strategies to reduce latex exposure in the workplace. After six weeks, a questionnaire, designed to assess whether appropriate steps to reduce latex exposure had been taken, was mailed out. RESULTS: Seventy per cent of the questionnaires were returned. All respondents felt the information was easy to understand and informative. While 50 per cent of respondents indicated that they had changed to powder-free or non-latex gloves, only five respondents were fully compliant with all instructions. CONCLUSION: Compliance with instructions regarding minimizing exposure to latex in a group of latex-allergic dental personnel was poor.

Adult↗