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PubMed2004

The psychosocial determinants of depression: a lifespan perspective.

This cross-sectional study compares depressive risk factors within and between two Western community cohorts. Six hundred eight primary care patients from the rural population of Farranfore, Ireland, and the suburban population of Penrith, Australia, completed a self-report questionnaire designed to be comprehensive in characterizing the psychosocial profile of patients with depressive symptoms. The survey included the Centre for Epidemiological Study Depression scale, Vulnerable Personality Style Questionnaire, Life Events Inventory, and Social Support Survey. Exposure to a range of early adverse childhood events was also assessed. The 3-month prevalence of depressive symptoms among Farranfore and Penrith respondents was 30% and 35%, respectively. The onset of depressive symptoms was positively associated with unfavorable childhood events, poorly perceived social supports, recent stressful life events, a vulnerable personality style, and previous depressive illness. The study identifies the person's social and internal world as a potent source of depressive risk over the lifespan.

Adolescent↗
PubMed1990

Validation of a self-administered urological questionnaire.

Self-administered questionnaires are widely used in clinical practice and as an aid to research. However, their reliability as a means of eliciting symptoms of urological disease has not been established. A questionnaire designed to elicit symptoms of urological disease was validated in 120 patients (36 out-patients, 27 in-patients and 57 community patients). All found the questionnaire acceptable and the completion rate was 99%. Only 3 of 648 answers were changed on the test-retest analysis. Consistency, as assessed by a comparison of responses by clinician and patient, was satisfactory in 11 of 15 questions relating to urological symptoms and the questionnaire successfully identified a high risk group of patients from the community requiring further urological evaluation. The need to include results of a preliminary validation study when reporting results obtained by a self-administered questionnaire is emphasised.

Humans↗
PubMed1981

Doctors' perspectives of epilepsy.

This study reports the results of a questionnaire designed specifically to define doctors' perspectives of epilepsy. Sixty-two percent of the registered junior medical staff of a major Australian teaching hospital responded to a questionnaire that established information regarding doctor identification, cognition concerning epilepsy and its management, and doctors' attitudes. The results gave evidence of a lack of knowledge regarding epilepsy and its management, as well as a lack of ability to maintain critical evaluation of new material. Many of the negative attitudes about people with epilepsy that have been identified within the general community were also found within the medical profession. This study determined that there is a real need to reappraise the approach to teaching the medical profession about epilepsy.

Attitude of Health Personnel↗
PubMed2005

Reliability and validity of the short form of the child health questionnaire for parents (CHQ-PF28) in large random school based and general population samples.

STUDY OBJECTIVES: This study assessed the feasibility, reliability, and validity of the 28 item short child health questionnaire parent form (CHQ-PF28) containing the same 13 scales, but only a subset of the items in the widely used 50 item CHQ-PF50. DESIGN: Questionnaires were sent to a random regional sample of 2040 parents of schoolchildren (4-13 years); in a random subgroup test-retest reliability was assessed (n = 234). Additionally, the study assessed CHQ-PF28 score distributions and internal consistencies in a nationwide general population sample of (parents of) children aged 4-11 (n = 2474) from Statistics Netherlands. MAIN RESULTS: Response was 70%. In the school and general population samples seven scales showed ceiling effects. Both CHQ summary measures and one multi-item scale showed adequate internal consistency in both samples (Cronbach's alpha>0.70). One summary measure and one scale showed excellent test-retest reliability (intraclass correlation coefficient >0.70); seven scales showed moderate test-retest reliability (intraclass correlation coefficient 0.50-0.70). The CHQ could discriminate between a subgroup with no parent reported chronic conditions (n = 954) and subgroups with asthma (n = 134), frequent headaches (n = 42), and with problems with hearing (n = 38) (Cohen's effect sizes 0.12-0.92; p<0.05 for 39 of 42 comparisons). CONCLUSIONS: This study showed that the CHQ-PF28 resulted in score distributions, and discriminative validity that are comparable to its longer counterpart, but that the internal consistency of most individual scales was low. In community health applications, the CHQ-PF28 may be an acceptable alternative for the longer CHQ-PF50 if the summary measures suffice and reliable estimates of each separate CHQ scale are not required.

Adolescent↗
PubMed2001

Evaluation of a modified German version of the Q16 questionnaire for neurotoxic symptoms in workers exposed to solvents.

OBJECTIVES: To assess sensitivity and specificity of a questionnaire designed to detect neurotoxic symptoms in workers exposed to solvents and in patients with a psycho-organic syndrome. METHODS: The Swedish Q16 is a self administered questionnaire for neurotoxic symptoms. The modified German version consists of 18 questions. The results were analysed from 1166 questionnaires which were completed by adults belonging to the following groups; 483 workers with occupational exposure to solvents and 193 non-exposed controls, 25 patients with a psycho-organic syndrome, 25 sex and age matched patients with a lung disease, and a sample of 440 people from the general population. RESULTS: The German Q18 was easy to handle and quick to perform. Workers exposed to solvents reported significantly more complaints than controls (2.9 v 2.5). All patients with a psycho-organic syndrome had five or more complaints. This was true for only 32% of patients with lung disease. These comparisons showed that chronic exposure to solvents was associated with subjective complaints related particularly to cognitive functions. In the sample of the general population, age, education level, smoking habits, and time of performance showed no significant influence on the Q18 result. Women had significantly more complaints than men (3.2 v 2.3). People who reported drinking alcohol occasionally or moderately had significantly fewer complaints than teetotalers. CONCLUSIONS: The German Q18 has an acceptable sensitivity and reliability, a reasonable specificity, and a good practicability. It is a useful instrument for screening workers exposed to solvents. A cut off point of 5 for men is recommended, and a cut off point of 6 for women is proposed.

Adult↗
PubMed1981

A prospective study of response error in food history questionnaires: implications for foodborne outbreak investigation.

To explore the problem of response error in food history data, a prospective study examined the validity of food questionnaire data obtained five days after the study meal. Unobtrusive observation of 64 persons selecting two different foods at a buffet-style luncheon were compared with subsequent histories of food consumption. The predictive value of a positive response was 0.73 for one food and 0.82 for the second food. The response error measures obtained were then applied to data from a published foodborne outbreak to illustrate the impact of predictive value positive and predictive value negative levels on the significance of a food-illness association. Public health workers engaged in food questionnaire administration and analysis must consider response error and should explore methods of reducing this problem through attention to both interviewer-respondent interaction and questionnaire design.

Adult↗
PubMed1984

The experience of a mental health team involved in the early phase of a disaster.

The reactions of a volunteer mental health team which convened in the aftermath of the 1983 Ash Wednesday bushfires are reported. A questionnaire designed to explore psychological and physical responses was completed by the 19 staff who made up the team. Using both open-ended and closed questions, the questionnaire tapped such areas as motivation, goals, expectations and observations, initial and later emotional and physical reactions, fantasies and evoked memories; an evaluation of the service and the experience was also included. Analysis of responses indicated that team members experienced considerable stress during their post-disaster work but also gained a great deal at both professional and personal levels. Sources of stress are discussed as are recommendations for their alleviation.

Adaptation, Psychological↗
PubMed2003

Irritable bowel syndrome in health care professionals in Pakistan.

OBJECTIVE: To evaluate the symptomatology of irritable bowel syndrome (IBS) among health care professionals attending an IBS symposium in a tertiary care university hospital. METHOD: A questionnaire designed to incorporate Manning and Rome II criteria was distributed among participants of an IBS symposium, most of them were health care professionals. A total of 100 questionnaires were distributed, 41 had symptoms fulfilling criteria of IBS. In these patients male: female ratio was 28:13 with age range 18-68. RESULTS: The predominant symptom was abdominal pain 87.8 % (36/41) which was aggravated post-prandially 72.2% (29/41), relieved following defecation in 87% (35/41) with a sense of incomplete evacuation 85.3% (35/41) and distention after defecation in 80.4% (33/41). Anxiety and depression was present in 80% (33/41) as an extraintestinal symptom. CONCLUSION: Irritable bowel syndrome is common in health care workers with intestinal and extraintestinal manifestations being equally common.

Adolescent↗
PubMedDate not supplied

[Analysis of the etiologic significance of nutrition factors in the occurrence of peptic ulcer in railroad workers].

Unified encoding questionnaires designed for special purposes were used to study the etiological importance of nutrition factors in the occurrence of peptic ulcer in workers of the locomotive teams at the Alma-Ata railway. The medico-information questionnaire consisted of 296 items. The processing of 898 questionnaires with the use of computer made it possible to discover a number of risk factors of the development of peptic ulcer in the given occupational group. The use of the method of balanced groups (paired copies) enabled one to specify certain factors promoting the occurrence of peptic ulcer in workers of the locomotive teams. The following factors turned out to be statistically significant: irregular meals (less than 3 times a day), living on cold food, the daily use of fried dishes, hurried meals, and hearty supper consisting of three courses. The data obtained may be of importance for the design of the methods preventing the disease under consideration.

Diet↗
PubMed2004

Influence of manufacturing practices on quality of pharmaceutical products manufactured in Kenya.

OBJECTIVE: To establish the quality of pharmaceutical products manufactured by the respective industries in Kenya and determine the effect of manufacturing practices on the quality of these products. DESIGN: Cross-sectional study. SETTING: Industries examined are in Nairobi, Kenya. Laboratory analysis was carried out using available facilities at Kenya Medical Research Institute and University of Nairobi, Faculty of Pharmacy. INTERVENTIONS: Structured Questionnaires were administered to examine how the code of good manufacturing practices has been used in the production of each pharmaceutical product by respective companies. Questionnaires designed to evaluate the distribution and carry out limited post-market surveillance study were administered to community pharmacy outlets. Drugs were sampled and analyzed for their quality according to the respective monographs. MAIN OUTCOME MEASURES: The questionnaires administered to the industry included the source of raw materials, quarantine procedure before and after manufacture, manufacturing procedure, quality audit, quality assurance procedure, equipment, and staff. That administered to the pharmacy outlet included availability, affordability and acceptability of locally manufactured pharmaceutical products. Quality analysis of products involved the establishment of the chemical content, dissolution profile, friability, uniformity of weight and identity. For antibiotic suspensions the stability after reconstitution was also determined. RESULTS: There were 15 respondents and two non-respondents from the industry and six out of nine respondents from the pharmacy outlets. The ratio of qualified staff to product range produced seemed to influence product quality. Industries producing several products with only limited number of pharmaceutical staff had more products failing to comply with pharmacopoeia specifications compared to those producing only few products. Nevertheless, all companies are well equipped with quality control equipment, in accordance with type of product manufactured. Private pharmacies stocked few of the locally manufactured products. The reason, they said, was due to low doctor and/or patient acceptance. Compliance with quality specifications as set out in respective monographs was overall 76%. CONCLUSION: Although the local pharmaceutical industries have adopted good manufacturing practices leading to many good quality products currently in commerce, these manufacturing practices are not comprehensive and measures need to be taken to continue improving them.

Cross-Sectional Studies↗
PubMed2006

Nutrition, hydration, and dysphagia in long-term care: Differing opinions on the effects of aspiration.

OBJECTIVES: This study examined the management of aspiration in skilled nursing settings, by determining speech-language pathologists' and nursing staff members' agreement about aspiration, interventions, and impact on residents' nutrition and hydration status, as determined by agreement scores on a questionnaire. DESIGN: Cross sectional descriptive. SETTING: Health care; skilled nursing facility. PARTICIPANTS: Seventy-eight speech-language pathologists (SLPs) and 83 nursing caregivers. INTERVENTION: Participants completed a survey questionnaire requesting a level of agreement with statements about aspiration and interventions for aspiration. Questionnaires also included demographic questions for analysis purposes. MEASUREMENTS: Agreement scores on a modified Likert scale. RESULTS: There were no significant differences in agreement scores for SLPs by formal training or years of experience. Nurses showed differences by experience for 2 statements, and by level of certification for 3 statements. There were significant differences between responses for nurses and SLPs for 7 of the 10 items. Both groups demonstrated content knowledge that conflicts with principles documented in the medical literature. CONCLUSION: Results suggest that both SLP and nursing training programs should include more evidence from multidisciplinary sources, specifically the medical literature, to improve the knowledge base of clinicians providing care to residents with swallowing disorders.

Aged↗
PubMed2005

Culture, organization, and management in intensive care: construction and validation of a multidimensional questionnaire.

OBJECTIVE: The objective of this study is to develop and validate a questionnaire designed to assess the culture, organization, and management of intensive care units. DESIGN: This is a prospective multicenter study. SETTING: The study was conducted in 26 intensive care units located in Paris. PARTICIPANTS: All personnel were asked to complete the questionnaire. INTERVENTION: The questionnaire was developed in 2 steps: (1) development of a theoretical framework based on organizational theory and (2) testing of the reliability and validity of a comprehensive set of measures. METHOD: The internal consistency of the items composing each scale was tested by using the Cronbach alpha. Convergent, and discriminant validity was assessed by factor analysis with varimax rotation. RESULTS: The overall completion rate was 74% with 1000 respondents (750 nurses, 26 head nurses, 168 physicians, and 56 medical secretaries). Starting with a 220-item questionnaire, we constructed a short version-conserving metrological characteristics with good reliability and validity. The short questionnaire, entitled Culture, Organization, and Management in Intensive Care, consists of 106 items distributed in 9 dimensions and 22 scales: culture (n = 3), coordination and adaptation to uncertainty (n = 3), communication (n = 3), problem solving and conflict management (n = 2), organizational learning and organizational change (n = 2), skills developed in a patient-caregiver relationship (n = 1), subjective unit performance (n = 3), burnout (n = 3), and job satisfaction and intention to quit (n = 2). All the scales showed good-to-high reliability, with Cronbach alpha scores higher than .7 (with the exception of coordination [.6]). Team satisfaction-oriented culture is positively correlated with good managerial practices and individual well-being. CONCLUSIONS: The Culture, Organization, and Management in Intensive Care questionnaire enables staff and managers to assess the organizational performance of their intensive care unit.

Attitude of Health Personnel↗
PubMed1999

Paroxysmal vertigo in children--an epidemiological study.

BACKGROUND: Little is currently known about the prevalence of vertigo in children. METHODS: In a questionnaire designed to examine the prevalence of migraine and migraine equivalents in children of school age, we included an item on 'attacks of dizziness in the past year'. The questionnaire was applied to 2165 children (10% of the school population in the city of Aberdeen, Scotland). RESULTS: 314 children had experienced at least one episode of dizziness in the previous year, unexplained in 44% of cases. A total of 57 children with three attacks, either unexplained or attributed to migraine, were interviewed and examined. Forty-five fulfilled our criteria for benign paroxysmal vertigo. Other symptoms suggestive of migraine were found in a small majority, but in 47% paroxysmal vertigo was an isolated symptom. The age of onset peaked at 12 years, but it was seen in all age groups. Paroxysmal vertigo was commonly accompanied by features that are common in migraine, i.e. pallor, nausea, phonophobia and photophobia, and migraine was twice as common in first degree relatives compared to controls. CONCLUSIONS: Paroxysmal vertigo is common in children and although it is seldom diagnosed, it appears to cause few major problems to the affected children. In common with previous studies, we found that it appears to be related to migraine.

Adolescent↗
PubMed1997

Validating a satisfaction questionnaire using multiple approaches: a case study.

We examined the validity of a questionnaire designed to measure the satisfaction of users of health services, using multiple tests of construct validity. Members of 2 health insurance plans in Geneva (Switzerland) answered a mailed questionnaire in 1992 (n = 1007) and 1993 (n = 1424). Response rates were 82% participants were 18-44 years old in 1992. The questionnaire included 22 questions on satisfaction with medical care received during the past 12 months. Most items were adapted from the Patient Satisfaction Questionnaire. Four dimensions of satisfaction were measured: satisfaction with physician services (8 items), communication (8 items), access (4 items) and insurance services (2 items). Reliability (Cronbach's alpha) was satisfactory for the 2 former dimensions (alpha = 0.81 and 0.82 respectively), but lower than desired for the 2 latter (alpha = 0.63 and 0.49 respectively). Participants who gave positive open-ended comments had satisfaction scores 0.7-1.2 standard deviation units higher than participants who gave negative comments. Satisfaction scores were weakly correlated with satisfaction with private life, which indicates that the instrument did not simply measure a general tendency to be satisfied. Participants who said that care received in 1993 was worse than care received in 1992 (retrospective assessment) experienced a decrease in satisfaction scores between 1992 and 1993 (prospective assessment). Most validation procedures provided independent but partial evidence for the validity of the instrument. Triangulation of several validation methods, as illustrated in this paper, may greatly improve the understanding of an instrument's properties.

Consumer Behavior↗
PubMedDate not supplied

Reliability of a patient-rated forearm evaluation questionnaire for patients with lateral epicondylitis.

PURPOSE: To determine the reliability of a questionnaire designed to assess forearm pain and function in patients with lateral epicondylitis. METHODS: Forty-seven patients with unilateral lateral epicondylitis completed a patient-related forearm evaluation questionnaire (PRFEQ) on two occasions. Intraclass correlation coefficients (ICC 2,1), standard error of measurement (SEM), and 95% confidence intervals (CIs) were determined for the whole group and for three subgroup comparisons of male vs. female subjects, subacute vs. chronic lateral epicondylitis, and work-related vs. non-work-related lateral epicondylitis. RESULTS: The test-retest reliability for the overall PRFEQ (ICC, 0.89), and its pain (ICC, 0.89) and function (ICC, 0.83) subscales was excellent. Test-retest reliability for patients with work-related lateral epicondylitis (ICC, 0.80) was significantly (p = 0.018) less than for patients with non-work-related lateral epicondylitis (ICC, 0.94). CONCLUSIONS: The PRFEQ can provide a simple, quick, and reliable estimate of arm pain and function in patients with lateral epicondylitis. However, large SEM and 95% CIs limit its ability to accurately predict individual scores.

Female↗
PubMed1997

The effects of midazolam on propofol-induced anesthesia: propofol dose requirements, mood profiles, and perioperative dreams.

UNLABELLED: This study examined the effects of midazolam on the doses of propofol required for the induction of hypnosis and the maintenance of propofol/nitrous oxide anesthesia. In addition, the effects of midazolam on the time to patient recovery, perioperative mood profiles, incidence of perioperative dreams, patient satisfaction scores, and requirement for postoperative analgesics were assessed. This investigation was a prospective, randomized, and double-blind study of female patients undergoing dilatation and curettage. Patients received midazolam (30 microg/kg, n = 30) or an equal volume of placebo (n = 30) immediately before the induction of anesthesia. Recall of dreams was assessed immediately postoperatively, in the postanesthesia care unit (PACU), and on the day after surgery using a questionnaire designed for surgical patients. Mood profiles were quantified using the Multiple Affect Adjective Check List-Revised, which was completed preoperatively and 1 h postoperatively. The Client Satisfaction Questionnaire-8, an eight-item self-administered version of the Client Satisfaction Questionnaire, was used to assess patient satisfaction on the day after surgery. Our results indicate that although the time to the loss of the lid reflex was significantly shorter in patients receiving midazolam (43.8 +/- 2.7 vs 74.7 +/- 7.6 s, P < 0.0003), there was no significant difference in the dose of propofol required to induce hypnosis or maintain anesthesia. There were no group differences in postoperative sedation and orientation scores, perioperative mood profiles, incidence of dreams, and patient satisfaction scores. More patients who received midazolam requested analgesics in the PACU (11 vs 4, P < 0.05). In conclusion, midazolam did not reduce the anesthetic dose requirement of propofol in patients undergoing anesthesia with nitrous oxide, nor did it accelerate patient recovery. Our results call into question the benefit of coinducing anesthesia with propofol and midazolam. IMPLICATIONS: Midazolam, administered immediately before anesthetic induction with propofol, did not decrease the dose of propofol necessary for hypnosis, nor the maintenance of surgical anesthesia, in female patients undergoing diagnostic dilatation and curettage. In addition, midazolam did not alter patient recovery characteristics, postoperative mood, incidence of perioperative dreams, or patient satisfaction. The use of midazolam was associated with an increased need for postoperative analgesics. Our study calls into question the benefit of administering midazolam immediately before anesthetic induction with propofol.

Affect↗
PubMed2004

The Liverpool Oral Rehabilitation Questionnaire: a pilot study.

There are several validated health-related quality of life (HRQOL) questionnaires designed to record patient-derived outcomes in head and neck cancer. None deals specifically with oral rehabilitation. The aim of this study was to pilot a new questionnaire, the Liverpool Oral Rehabilitation Questionnaire (LORQ). The questionnaire consists of 25 items about oral function and denture satisfaction. A four-point Likert scale is used. Sixty-one consecutive patients attending oral rehabilitation clinics completed the LORQ in combination with the University of Washington Head and Neck questionnaire version 3 (UW-QOL) and European Organisation for Research and Treatment of Cancer H and N quality of life questionnaire (EORTC H and N 35). Forty-two patients received questionnaires at baseline, whereas the rest were provided with the questionnaires at various stages of oral rehabilitation. For each item on the questionnaire, a full range of possible responses were given by patients. Kappa coefficients of agreement for test-retest data indicated moderate to very good agreement between repeat questionnaires. There were significant correlations (P < 0.001) between items in the LORQ and those in the UW-QOL and EORTC HN questionnaires. The LORQ also identified differences in responses between non-cancer and cancer groups of patients undergoing oral rehabilitation. This study of the LORQ is encouraging, although data on its responsiveness over time and to intervention is awaited.

Atrophy↗
PubMed1997

Comparison of outcome measures for patients with chronic obstructive pulmonary disease (COPD) in an outpatient setting.

BACKGROUND: To assist clinicians and researchers in choosing outcome measures for patients with chronic obstructive pulmonary disease attending routine outpatient clinics, a comparative assessment was undertaken of four questionnaires designed to reflect the patients' perception of their physical and emotional health in terms of their feasibility, validity, reliability, and responsiveness to health change. METHODS: Two condition specific questionnaires, the St George's Respiratory Questionnaire (SGRQ) and Guyatt's Chronic Respiratory Questionnaire (CRQ), and two generic questionnaires, the Short Form-36 Health Survey (SF-36) and Euroqol (EQ), were compared for their discriminative and evaluative properties. Spirometric tests and a walking test were also performed. One hundred and fifty six adults who were clinically judged to have COPD and who attended an outpatient chest clinic were assessed at recruitment and six and 12 months later. Patients were also asked whether their health had changed since their last assessment. RESULTS: Completion rates and consistency between items for dimensions of the SGRQ were lower than for dimensions of the other questionnaires. The distributions of responses were skewed for certain dimensions in all questionnaires except the CRQ. Validity was supported for all instruments insofar as patients' scores were associated with differences in disease severity. The generic questionnaires better reflected other health problems. All instruments were reliable over time. The condition specific questionnaires were more responsive between baseline and first follow up visit but this difference did not persist. While certain dimensions of the SF-36 were responsive to patient perceived changes, this did not apply to the derived single index of the EQ. The rating scale of the EQ, however, provided a quick and easy indicator of change. CONCLUSIONS: Evidence from this study supports the CRQ and the SF-36 as comprehensive outcome measures for patients with longstanding COPD.

Aged↗