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Parental anxiety associated with participation in anaesthetic induction in children: questionnaire survey.

OBJECTIVES: To determine the reasons why Chinese parents accompany their child during anaesthetic induction; to explore the level of anxiety experienced by the parents; and to evaluate the factors that contribute to parental anxiety. DESIGN: Questionnaire study of Chinese parents who had chosen to be present during the anaesthetic induction of their child between January 1997 and July 1997. SETTING: Day Surgery Unit at a public hospital, Hong Kong. PARTICIPANTS: One hundred and fifty-one Chinese parents of 151 children undergoing general anaesthesia for surgery. MAIN OUTCOME MEASURE: Parental anxiety, as evaluated by a self-reported rating system and the State-Trait Anxiety Scale. RESULT: More than half (56%) of the participants graded their experience as either "very anxious but tolerable" or "a little anxious", and only 2% graded the situation as "very anxious, intolerable". All participants were either "satisfied" or "very satisfied" with their experience. The type of surgery and any history of previous surgical intervention were found to be factors that determined the level of anxiety (P<0.05). CONCLUSIONS: Most Chinese parents decide to be present at their child's anaesthetic induction because of a sense of duty and concern. Parental presence does not provoke further or intolerable parental anxiety. One limitation of this study is that the level of anxiety measured might be due to the combination of anaesthetic induction and surgery rather than to concerns about anaesthetic induction alone.

Journal Article↗

The internet--friend or foe? A questionnaire study of orthopaedic out-patients.

OBJECTIVE: To examine patients' use of the Internet to obtain medical information, their opinions on the quality of medical Web sites, and their attitudes towards Internet-based consultations. DESIGN: Questionnaire study. PARTICIPANTS AND SETTING: 398 patients, aged 10-95 years, visiting the orthopaedic outpatient clinics of a London district general hospital over a 2-week period. MAIN OUTCOME MEASURES: (i) The rate of Internet use by patients; (ii) the perception of the quality of medical web sites; (iii) future intentions and attitudes towards Internet-based consultations; and (iv) concurrence between information obtained from Web sites and advice given by the orthopaedic surgeon in the clinic. RESULTS: From 369 respondents (response rate 93%), 55.3% of patients had accessed the Internet. Of these, 52.0% had obtained medical information from this source. Access was linearly correlated with age (r2 = 0.975, P < 0.01) and was also related to social status. Of the 12.3% of patients who had researched their particular orthopaedic condition, 20% reported that the advice received from the surgeon in the clinic contradicted that obtained from the Internet. A total of 35.7% of patients would undergo an Internet-based consultation, whilst a further 25.5% would consider this, depending on the medical condition in question. CONCLUSIONS: Over half of the patients studied were willing to access the Internet for medical information, with younger patients more likely to undertake this activity. Moreover, a significant proportion of respondents were willing to undergo an Internet-based consultation. The increased use of medical Web sites by patients raises important issues regarding the need for quality control, and impacts significantly upon the surgeon-patient relationship.

Adolescent↗

Participants' evaluation of a weight-loss program.

OBJECTIVE: The purpose of this study was to evaluate participants' perceptions of the weight-loss intervention used in a hypertension prevention clinical trial. DESIGN: A total of 308 overweight and moderately obese subjects participated in the weight-management intervention. After the 18-month program, 281 participants completed a questionnaire designed to evaluate their perceptions of the program's effectiveness. SUBJECTS/SETTING: Adult participants (224 men and 84 women) in the weight-loss modality of the Trials of Hypertension Prevention Phase I, surveyed in 1991. STATISTICAL ANALYSES PERFORMED: chi 2 Analyses were used to test for statistical significance of group differences. RESULTS: Intervention components that were most useful are presented. Older participants (older than 50 years) were most likely to attend sessions and women were most likely to identify stress and frustration because of disappointing results. Successful participants were more likely to incorporate exercise into their daily activities, exercise regularly, and use self-monitoring strategies. Few participants found group exercise to be useful. CONCLUSION: These findings suggest that interventionists in weight-loss programs need to find flexible and creative ways to maintain contact with participants, continue to develop better methods of self-monitoring, obtain the skills needed to recognize frustration and provide timely support, continue to couple the message of diet and exercise, and emphasize helping participants develop their problem-solving skills. This may require training outside the traditional field of dietetics.

Adult↗

Duodenal ulcer. Incidence, risk factors, and predictive value of plasma pepsinogen.

In 1958 the Yale freshman class gave blood samples as part of a study intended to determine the predictive value of plasma pepsinogen (PP) for the subsequent development of duodenal ulcer (DU). We report a long-term follow-up of this cohort. A self-administered questionnaire designed to ascertain information about the development of peptic ulcers, and the presence of risk factors was mailed to 861 subjects with "active" addresses. A second questionnaire was mailed to each respondent's physician(s) to verify the diagnosis of DU. Completed questionnaires were returned, after three mailings, by 604 (70%) of the subjects. They reported 18 documented DUs, 15 since 1958, for an incidence of 1.1/1000 person years. Only smoking (P less than 0.05) and undergraduate physical inactivity (P less than 0.01) were identified as risk factors for DU. Family history; blood type; blood antigen secretor status; ingestion of coffee, alcohol, milk, salicylates, soda, or tea; and COPD were not identified as risk factors for DU. Patients with DU had higher mean PP values than those who did not (391.6 +/- 99.6 vs 346.6 +/- 106.7, mean +/- SD) but this was not statistically significant (P greater than 0.05). The predictive value of an elevated PP (greater than 450) for the development of DU was 7.9%, but a low or normal PP predicted the absence of a DU in 97.5% of subjects over a 22-year span.(ABSTRACT TRUNCATED AT 250 WORDS)

Duodenal Ulcer↗

Reliability of the Wisconsin Sleep Questionnaire: a French contribution to international validation.

We evaluated the reliability of a French version of the Wisconsin Sleep Questionnaire designed to investigate snoring, obstructive apnoeas, and sleeping problems. The assessment of reliability included the study of internal consistency and the 3 months repeatability of the questionnaire. The questionnaire was first completed at a Center of Preventive Medicine by a random sample of 122 subjects from the community. Three months later the same form was mailed and 82 questionnaires were returned (67.2%). No significant differences existed between responders and nonresponders for anthropometric data or life habits. The internal consistency in each domain was good or satisfactory (Cronbach's alpha=0.67 to 0.81). The concordance between the answers at a 3-month interval was excellent for questions on ever snoring, frequency of snoring, gasping/choking during sleep, and breathing stops during sleep (Cohen kappa>0.60). The questions on snoring loudness, a history of sleep apnoea, and excessive daytime sleepiness were fairly reproducible (kappa 0.28 to 0.60). We found no difference in reproducibility by gender or age. In conclusion, this reliability assessment in a sample of middle-aged subjects from the community in northeastern France showed satisfactory internal consistency and 3-months reproducibility of the main questions of a French translation of the Wisconsin Sleep Questionnaire.

Age Factors↗

Perceptions of speech and language therapy amongst UK school and college students: implications for recruitment.

BACKGROUND: Communication disorders affect both sexes and people from all ethnic groups, but members of minority ethnic groups and males in the UK are underrepresented in the speech and language therapy profession. Research in the area of recruitment is limited, but a possible explanation is poor awareness and understanding of speech and language therapy as a profession. AIMS: To investigate factors influencing attitudes to a career in speech and language therapy amongst UK school and college students focusing on the similarities and differences between males and females, and between minority ethnic and white students. METHODS & PROCEDURES: A total of 651 male and female school and college students from a range of ethnic groups and all close to selecting degree courses completed a questionnaire designed to examine the attitudes and awareness of speech and language therapy. Eleven semi-structured follow-up interviews were conducted to help understand the questionnaire findings. Quantitative and qualitative analyses examined differences in attitudes and the awareness of speech and language therapy amongst these groups. OUTCOMES & RESULTS: Overall, one-third of participants said they knew nothing about speech and language therapy, and males were significantly less familiar with it. Less than half the participants were aware that speech and language therapy is a degree course, and minority ethnic participants were significantly less likely to know this. Compared with males, females were almost five times as likely to say they would consider a career in speech and language therapy. Participants with relatives in health-related jobs were significantly more likely to consider speech and language therapy than those without such relatives. Compared with white participants, minority ethnic participants said they placed greater importance on studying for a degree, a profession and a scientific career, and were more influenced by a career's prestige and a high salary. CONCLUSIONS: In order to increase the ethnic and gender diversity of speech and language therapists, the profile of the profession needs to be raised with increased awareness of the degree level courses, the scientific, evidence-based nature of the work, and current salary scales.

Adolescent↗

Self-report measures of schizotypy as indices of familial vulnerability to schizophrenia.

While structured psychiatric interviews have generally succeeded in identifying higher rates of schizotypal personality disorder in relatives of schizophrenia versus control probands, self-report questionnaires designed to assess schizotypy have been less successful at distinguishing these groups of relatives. In the Roscommon Family Study, an epidemiologically based, case-controlled study conducted in the west of Ireland, relatives were administered a short form of Eysenck's Psychoticism scale and shortened and modified versions of the scales for magical ideation and social anhedonia developed by Chapman and colleagues. We compared, with relatives of matched controls, relatives of four proband groups: schizophrenia, other nonaffective psychoses (ONAP), psychotic affective illness (PAI), and nonpsychotic affective illness (NPAI). Only social anhedonia scores successfully differentiated, at modest levels of significance, relatives of schizophrenia versus control probands. Levels of magical ideation did not distinguish relatives of schizophrenia, ONAP, PAI, or NPAI probands from relatives of controls. Compared to controls, ONAP probands had significantly elevated psychoticism scores, but no such increase was seen in relatives of schizophrenia, PAI, or NPAI probands. Dimensions of schizotypy assessed at personal interview were significantly better at differentiating relatives of schizophrenia and control probands than our measures of social anhedonia, magical ideation, or psychoticism. Although psychiatric interviews in this sample have shown that clinically assessed schizotypal personality disorder and traits strongly aggregate in relatives of schizophrenia patients, of the three self-report instruments designed to assess schizotypy, only one even modestly identifies relatives of schizophrenia versus control probands. These results suggest that, compared with psychiatric interviews, self-report questionnaires are less successful at assessing underlying familial vulnerability to schizophrenia.

Family↗

Temporary vascular access in British hemodialysis units.

A questionnaire, designed to determine the current habits of British nephrologists regarding temporary vascular access for hemodialysis, was sent to 62 renal units. Forty-six (74%) completed questionnaires were returned. Cannulation of the subclavian vein with a single-lumen catheter is the most popular technique. There is only limited use of double- or dual-lumen catheters in the United Kingdom. Previously unreported fatal complications of subclavian hemodialysis catheters are described.

Catheterization↗

Telephone reminders are a cost effective way to improve responses in postal health surveys.

STUDY OBJECTIVE: To assess the effectiveness of a telephone reminder in increasing responses to postal surveys and to calculate the differential costs per completed questionnaire. DESIGN: Randomised controlled trial. SETTING: Australian university and rehabilitation medicine practice. PARTICIPANTS: The trial was conducted in 1999 among the 143 non-respondents to a questionnaire about work related neck and upper body disorders. The questionnaire was sent to two Australian female samples: 200 office workers (Sample A) and 92 former rehabilitation medicine patients (Sample B). A reminder letter, another copy of the questionnaire and a final letter were sent at two week intervals. Half of the non-respondents within each sample were randomly selected to receive a telephone reminder just after the second mailout of the questionnaire. All direct costs were calculated. MAIN RESULTS: Responses were significantly higher among those who received the telephone reminder intervention (relative risk 2.54, 95% confidence intervals 1.43 to 4.52). Analysed by intention to phone, 47% of non-respondents in Sample A and 38% in Sample B returned a complete questionnaire after the intervention, compared with 21% and 10%, respectively, in the control groups. For the 112 women (combined samples) who returned completed questionnaires before randomisation, the average cost per respondent was AUD14. There was a higher total cost for the intervention groups (AUD851 versus AUD386 for controls), but the significantly higher number of additional completed responses (31 versus 12) resulted in a 15% lower marginal cost per completed questionnaire in those groups. CONCLUSION: Telephone reminders are cost effective in improving responses to postal surveys.

Australian Capital Territory↗

A survey of the practice of regional anaesthesia.

A questionnaire designed to elucidate the popularity and practice of regional anaesthesia was circulated to all anaesthetists in the South East Thames Region. Two hundred and eleven completed questionnaires were received and subsequently analysed, a response rate of 65%. Regional anaesthesia was employed at least once per week by 83% of respondents usually in combination with general anaesthesia (77% of respondents). The provision of postoperative analgesia was cited as the main advantage by 86% of anaesthetists.

Analgesia↗

Assessing coughing and wheezing in lung cancer: a pilot study.

PURPOSE/OBJECTIVES: To establish reliability and validity of two self-report questionnaires, the Lung Cancer Cough Questionnaire and the Lung Cancer Wheezing Questionnaire. DESIGN: Prospective, exploratory pilot study. SETTING: Clinical oncology settings in the southern United States. SAMPLE: 31 adult women with lung cancer. METHODS: Content validity of both questionnaires was assessed through a comprehensive literature review and an expert judge panel. Concurrent validity was established by Spearman rank correlation coefficients and Wil-coxon Rank Sum tests with items from other valid tools. Test-retest reliability was assessed by percent agreement, kappa, paired t tests, and correlations. Internal consistency was determined by Cronbach's alpha. MAIN RESEARCH VARIABLES: Cough, wheeze. FINDINGS: Cronbach's alpha showed excellent internal consistency and percent agreement, and kappa showed similarity of item responses across test-retest administrations. Nonsignificant paired t tests indicated similar mean scores, and significant test-retest correlations supported test-retest reliability. CONCLUSIONS: Preliminary testing indicates good reliability and validity for both questionnaires. Both instruments can identify people with problems of coughing and wheezing and have the potential for monitoring these symptoms over time and determining effectiveness of interventions. IMPLICATIONS FOR NURSING: Assessment of coughing and wheezing is an important component of monitoring respiratory symptoms of lung cancer. Both of these symptoms can be amenable to interventions. Further research is needed to confirm psychometrics and sensitivity of these tools.

Cough↗

Inter-generational conflict and psychiatric symptoms.

Secondary school pupils and their parents were investigated using the scaled version of the General Health Questionnaire (GHQ-28) and by a questionnaire designed to study attitudes involved in inter-generational conflict in psychiatric patients. Parent-pupil and inter-parental conflict in answers to the attitude questionnaires were taken as measures of intergenerational and intra-generational conflicts respectively. The former significantly exceeded the latter. Parent-student conflict was higher when the students involved were females, Kuwaiti, or had less educated fathers. The tendency of the number of reported GHQ symptoms to be higher in members of families with higher inter-generational conflict did not reach statistical significance. There is an apparent discrepancy between this finding and the prominence of inter-generational conflict in clinical material.

Adolescent↗

[Relevance of design and structure of data-bases in research].

Research studies require a methodological frame providing concepts and approach procedures. The so-called scientific method encompasses systematic data collection and problem solving notions. Epidemiology and statistics are essential disciplines in this process. The goal of this course is to provide knowledge for design of databases, with special attention to the definition of variables and to measurement scales. A small database on headache is made using fictitious information. A questionnaire designed for this purpose is used as a foundation. Finally, we present a graphic design on the percentage distribution of the variable gender, as an example of the summary statistics.

Databases as Topic↗

A randomized study of the efficacy of the PROPATH Program for patients with Parkinson disease.

OBJECTIVES: To assess (1) the effects of the PROPATH Program, a health management program designed for patients with Parkinson disease, on perceived general health and psychological well-being and satisfaction with medical care, (2) utilization of health care resources by patients with Parkinson disease, and (3) physician impressions of the PROPATH Program. DESIGN: Patients were randomized to receive either the PROPATH Program in addition to usual care or usual medical care only. All patients and their physicians completed periodic questionnaires designed to assess the study variables. SETTING: Staff model health maintenance organization from June 1992 through June 1993. PATIENTS: Forty-six English-speaking patients diagnosed with Parkinson disease of Hoehn-Yahr stages I through IV. RESULTS: Enrollment in the PROPATH Program resulted in a statistically significant improvement in patient perception of general health and psychological well-being after 1 year. There was no significant difference in patient satisfaction with medical care or utilization of health care resources. The large majority of physicians did not find the PROPATH Program to be helpful for development of a treatment plan, management of the illness, identification of problems sooner than by usual treatment, or identification of drug side effects. CONCLUSIONS: The PROPATH Program may play a useful role in assisting patients to deal with the psychological aspect of Parkinson disease by improving perception of general health and psychological well-being. The program had no significant effect on patient satisfaction with medical care or medical resource utilization.

Aged↗

Decreasing prevalence of cigarette smoking in the middle income country of Mauritius: questionnaire survey.

OBJECTIVES: To describe changes in the prevalence of cigarette smoking in the middle income country of Mauritius from 1987 to 1998, and to relate these changes to legislative and health promotion efforts over the same period. DESIGN: Questionnaire survey. SETTING: Mauritius, an island in the Indian Ocean with a population of about 1.2 million (about 70% south Asian, 2% Chinese, and 28% Creole). PARTICIPANTS: Data were obtained from 5072 participants in 1987, 6573 in 1992, and 6281 in 1998. MAIN OUTCOME MEASURES: Prevalence of current smoking in 1987, 1992, and 1998, sales of cigarettes in Mauritius, and information on activities for control of tobacco. RESULTS: Self reported cigarette smoking has been decreasing in Mauritius since 1987, with the largest decrease between 1987 and 1992. From 1987 to 1998 smoking prevalence decreased by 23% in men and 61% in women. Smoking decreased across all age and ethnic groups and across different levels of income and education. Sales of cigarettes also decreased in line with smoking prevalence. CONCLUSIONS: The introduction of cigarette taxes, a limited health promotion programme, and the absence of massive promotional campaigns by the sole tobacco company on Mauritius have led to a striking and continued decrease in smoking prevalence and cigarette consumption on the island.

Adult↗

The validity of the Dutch Sleep Disorders Questionnaire (SDQ).

The Sleep Disorders Questionnaire (SDQ) is a 176-item questionnaire designed to diagnose the presence of common sleep disorders. This study set out to assess the validity of a Dutch translation of the SDQ. Scores on 145 questionnaires were analyzed. A cluster analysis of these scores revealed the following clusters: healthy, depression, insomnia, narcolepsy, and apnea. The cluster classification proved correct for 67% of the subjects, as determined on the basis of polysomnography. These results show that the Dutch SDQ is a reasonably valid instrument for diagnosing sleep disorders.

Adolescent↗

[A validated questionnaire for measuring patient satisfaction in general and specialist ambulatory medical care: the Qualiskope-A].

PURPOSE: To develop a reliable and valid questionnaire to measure patient satisfaction in ambulatory care, enabling a detailed analysis of the determinants of patient satisfaction that is applicable in GP and specialist outpatient care. DESIGN: Questionnaire with 27 single items subdivided into four categories: "professional competence", "physician-patient interaction", "information", and "practice organisation". Survey of 3,487 patients in 123 medical practices. 1,151 patients were in specialist care and 2,336 patients in general medical care. RESULTS: Qualiskope-A is a reliable and valid instrument for measuring patient satisfaction in ambulatory care. All item-total correlations for single items were greater than r = 0.40. Coefficients for Cronbach's alpha for the four dimensions ranged between 0.87 and 0.94. CONCLUSIONS: The increasing political importance of patients' attitudes and satisfaction for the development of policy measures to ensure and improve the quality of care is beyond doubt. To make sure that the measurement of patient satisfaction does not only serve to meet regulatory requirements but helps to improve the quality of care and provides reliable data for health services research, a high standard is required for the questionnaires to be used. The Qualiskope-A and only few other instruments meet this high standard.

Adolescent↗

What do patients and rheumatologists regard as an 'acceptable' risk in the treatment of rheumatic disease?

A questionnaire designed to ascertain the risk of adverse effects which patients with rheumatic conditions would accept for a particular therapeutic outcome was administered to 50 patients. The same questionnaire together with 'potted' histories of five of the patients was sent to 10 consultant rheumatologists. The willingness of both patients and doctors to risk side-effects varied with both the severity of the side-effect and the potential therapeutic benefit. Doctors were more willing than patients to risk death or serious disability (Wilcoxon, P less than 0.01) for a particular expected benefit. Doctors were also more willing to risk side-effects in treating seropositive rheumatoid arthritis than in treating non-articular rheumatism. No correlation was seen for patients between acceptable risk and diagnosis, pain or smoking habits. The risks which both groups stated they were willing to accept were less than those apparently associated with antirheumatic therapy. The results disagreed markedly with those of a previous study, demonstrating the importance of the methods used in this type of work.

Attitude of Health Personnel↗