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PubMed1998

A questionnaire to assess neurological impairment in multiple sclerosis.

This study assessed the feasibility of using a self-report questionnaire to measure neurological impairment in multiple sclerosis (MS). Thirty patients aged 21-67 years participated. Each patient was examined and scored on three commonly used impairment scales; the extended disability status scale (EDSS), the neurologic rating scale (NRS) and the ambulation index (A1). Two other scales were also determined; the sum of the EDSS functional scores (SFS), and a five point scale rating functional status (FS). The physician also filled out a copy of the questionnaire based on interview and examination of the patient. All of these scores were determined and the physical questionnaire filled out blind to the patient's answers on their self-report questionnaire. The first 15 consecutive patients served as the pilot group to develop a computer program to convert answers on the questionnaire into predicted scores on each of the five scales. The second 15 patients served as the independent test group to assess the validity of the computer program. Using this program, both patient and physician questionnaires accurately predicted (r > 0.87) the scores on each of the five scales measured manually. In addition, the scores on all five scales were highly cross-correlated (r > 0.85) suggesting that, in fact, each measured a similar attribute of MS (i.e., impairment). Therefore, the five scales were combined into a single measure, the mean disability score (MDS), which showed the highest correlations (r > 0.95) of any scale between the predicted scores and the actual scores determined by examination. The results of this study indicate that the self-report questionnaire is a valid measure of neurological impairment in MS and, thus, that it can be used to survey this health outcome in an MS population. Moreover, this questionnaire can be filled out by a physician (based directly on the neurological examination) and, together with the computer program for scoring each patient, can be used to provide consistent scoring in clinical trials.

Adult↗
PubMed2006

Measuring changes in self-concept: a qualitative evaluation of outcome questionnaires in people having acupuncture for their chronic health problems.

BACKGROUND: Changes in self-concept are an important potential outcome for many interventions for people with long-term conditions. This study sought to identify and evaluate outcome questionnaires suitable for quantifying changes in self-concept in people with long-term conditions, in the context of treatment with acupuncture and Chinese medicine. METHODS: A literature search was followed by an evaluation of three questionnaires: The Wellbeing Questionnaire W-BQ12, the Patient Enablement Instrument (PEI), and the Arizona Integrative Outcome Scale (AIOS). A convenience sample of 23 people completed the questionnaires on two occasions and were interviewed about their experience and their questionnaire responses. All acupuncturists were interviewed. RESULTS: Changes in self-concept were common and emerged over time. The three questionnaires had different strengths and weaknesses in relation to measuring changes in self-concept. The generic AIOS had face validity and was sensitive to changes in self-concept over time, but it lacked specificity. The PEI was sensitive and specific in measuring these changes but had lower acceptability. The sensitivity of the W-BQ12 was affected by initial high scores (ceiling effect) and a shorter timescale but was acceptable and is suitable for repeated administration. The PEI and W-BQ12 questionnaires worked well in combination. CONCLUSION: Changes in self-concept are important outcomes of complex interventions for people with long-term illness and their measurement requires carefully evaluated tools and long-term follow-up. The literature review and the analysis of the strengths and weaknesses of the questionnaires is a resource for other researchers. The W-BQ12 and the PEI both proved useful for this population and a larger quantitative study is planned.

Acupuncture Therapy↗
PubMed2001

Translation and adaptation of a questionnaire to assess the group processes of rehabilitation team conferences.

OBJECTIVE: To investigate the internal consistency, the domain structure and the influence of social desirability with regard to a questionnaire translated and adapted to assess the quality of rehabilitation team conferences in the Netherlands. STUDY DESIGN: A questionnaire to determine group decision-making processes was translated and adapted to rehabilitation and completed by 44 rehabilitation professionals. RESULTS: The internal consistency of the domains Personal participation, Negative socio-emotional behaviour, Result satisfaction and Process satisfaction was found to be satisfactory (Cronbach's alpha ranges from 0.70 to 0.84). The domain structure is confirmed by item-total and item-rest correlations. From the original English questionnaire, one question concerning the domain Personal participation was omitted. The domain Informal leadership has been deleted from the questionnaire, because informal leadership is not an issue in a situation in which the Chairman is already known. Response to the questionnaire did not seem to be biased by social desirability. CONCLUSION: The translated and adapted questionnaire can be used to assess the group processes of rehabilitation team conferences. Results from the literature concerning the original questionnaire suggest that the translated and adapted questionnaire might be able to detect changes in the group process of rehabilitation team conferences.

Attitude of Health Personnel↗
PubMed2001

Food frequency questionnaire and a screening test.

We assessed the accuracy of a 141-item food frequency questionnaire as a screening test to detect high or low consumption of nutrients associated with cancer. Fifty-five men and 58 women participating in two population-based cohort studies in Miyagi, Japan, provided four three-day diet records over a one-year period and subsequently completed the questionnaire twice with a one-year interval. Pearson correlation coefficients between 17 nutrients measured by the diet records and the first questionnaire ranged from 0.24 to 0.85 (median 0.43), and those between the two questionnaires ranged from 0.47 to 0.91 (median 0.68). The sensitivity and specificity of the questionnaire for detecting high-alcohol, high-fat, low-calcium, and low-ascorbic acid consumers were 86.7% and 96.7%, 50.0% and 85.7%, 48.8% and 76.4%, and 61.9% and 70.0%, respectively. Receiver operating characteristic curves indicated comparable performance of the questionnaire and a three-day diet record, regarded as another screening test. The questionnaire performed poorly for other nutrients. The results indicate that our questionnaire is reasonably reproducible, comparable with the diet records, and useful as a screening test to detect high or low consumers of several nutrients associated with cancer for subsequent enrollment in dietary intervention trials or dietary counseling.

Alcohol Drinking↗
PubMed2004

Screening for physical and psychological illness in the British Armed Forces: III: The value of a questionnaire to assist a Medical Officer to decide who needs help.

OBJECTIVES: To estimate the positive and negative predictive values (PPVT and NPVT), sensitivity and specificity of a full and abridged screening questionnaire of physical and psychological health, using primary care doctors' (medical officers [MOs]) assessments as to whether the servicemen needed medical help as a gold standard. METHODS: From a tri-service random sample of those who completed a questionnaire, all 'screen-positive' and an equal random sample of 'screen-negative' were selected to attend their medical centre. MOs were aware that the screening was aimed at detecting psychological illness, but were blind as to the 'screen-positivity' of any serviceman. The MO completed a questionnaire that asked whether the patient needed medical help and whether s/he was previously aware of this need. RESULTS: 314 subjects were available for analysis. The PPVT was 47% (95% confidence interval [CI] 36-59%) for the full questionnaire and 48% (95% CI 36-60%) for the abridged questionnaire. Of those 'screen-positive' subjects whom the MO rated as needing help, one third had problems already known to the MO, regardless of the length of the questionnaire. The sensitivity and specificity of the full and abridged questionnaires were 43% and 74%, and 36% and 83% respectively. The PPVT did not vary greatly between health dimensions nor did selection of servicemen with very high scores. CONCLUSIONS: The use of MOs as a gold standard is important because of their central role in initiating the management of any condition uncovered by a screening programme. Using MOs as a gold standard, the validity of the screening questionnaires for physical and psychological health in the military was mediocre.

Adult↗
PubMed2001

Appropriate questionnaires for knee arthroplasty. Results of a survey of 3600 patients from The Swedish Knee Arthroplasty Registry.

The Swedish Knee Arthroplasty Registry (SKAR) has recorded knee arthroplasties prospectively in Sweden since 1975. The only outcome measure available to date has been revision status. While questionnaires on health outcome may function as more comprehensive endpoints, it is unclear which are the most appropriate. We tested various outcome questionnaires in order to determine which is the best for patients who have had knee arthroplasty as applied in a cross-sectional, discriminative, postal survey. Four general health questionnaires (NHP, SF-12, SF-36 and SIP) and three disease/site-specific questionnaires (Lequesne, Oxford-12, and WOMAC) were tested on 3600 patients randomly selected from the SKAR. Differences were found between questionnaires in response rate, time required for completion, the need for assistance, the efficiency of completion, the validity of the content and the reliability. The mean overall ranks for each questionnaire were generated. The SF-12 ranked the best for the general health, and the Oxford-12 for the disease/site-specific questionnaires. These two questionnaires could therefore be recommended as the most appropriate for use with a large knee arthroplasty database in a cross-sectional population.

Aged↗
PubMed2003

Strengths and difficulties questionnaire (SDQ): a study of school children in Ribeirão Preto.

OBJECTIVE: The objective of this study is to investigate possible child psychiatric disorders using the strengths and difficulties questionnaire (SDQ). METHOD: SDQ is a questionnaire that screens child mental health problems, comprising a total of 25 items divided in five subscales: emotional problems, hyperactivity, relationship, conduct and pro-social behavior, with five items in each subscale. We also used the impact supplement that evaluates the impairment caused by symptoms. Out of 143 children randomly chosen from a public school of Ribeirão Preto, 107 questionnaires were correctly filled in by parents. Teachers received 114 questionnaires (regarding children with parents' consent), and 108 questionnaires were correctly filled in. As a final sample, we obtained 112 questionnaires answered by parents or teachers. RESULTS: In the questionnaires answered by the parents, we obtained high scorings such as 30.8% for emotional symptoms, 17,7% for conduct disorders, 16.8% for hyperactivity, 14% for interpersonal relationships, 18,7% for the total scores and 10.2% for the impact supplement. Questionnaires answered by the teachers had 1.83% for emotional symptoms, 8.25% for conduct disorders, 8.25% for hyperactivity, 2.75% for interpersonal relationships, 8.25% for the total scoring and 4.58% for the impact supplement. Combining the results obtained from parents and teachers we have diagnostic hypotheses in the frequencies of 7.14% for emotional disorders, 9.82% for conduct disorders, and 12.5% for psychiatric disorder not otherwise specified and no combination was noted between parents and teachers for hyperactivity. Mean age was 8.18 years, with 63% of the children being male and 37% female. CONCLUSION: SDQ can be useful for a preliminary screening in the investigation of possible psychiatric disorders in childhood.

Brazil↗
PubMed2006

Implementation of a self-administered questionnaire to identify patients at risk for medication-related problems in a family health center.

STUDY OBJECTIVE: To determine if a self-administered questionnaire can improve the identification of patients at risk for medication-related problems (MRPs) compared with usual methods of referral to a pharmacist. DESIGN: Prospective, randomized controlled study. SETTING: Multiprofessional primary care clinic at a tertiary care teaching hospital. PATIENTS: One hundred ninety-four ambulatory patients aged 18 years or older who were taking at least two drugs. MEASUREMENTS AND MAIN RESULTS: Patients completed a five-item, self-administered questionnaire modified from a tool that was previously validated in another population and statistically correlated with the risk of MRPs. Of 194 patients who completed the questionnaire, 89 were randomized to the control group (referral by usual methods) and 105 were referred according to their responses on the questionnaire (intervention group). Primary outcomes were the rate of referral and the number of at-risk patients identified. Referral rates were higher with the questionnaire than with usual methods (20% vs 6%, p=0.003). Of five patients referred by usual methods, one was at risk for MRPs according to questionnaire results. Of 84 patients in the control group who were not referred, 12 (14%) were at risk according to the questionnaire results; this finding suggested that several at-risk patients who were not referred by usual methods might have benefitted from a referral for a pharmacist's assessment. CONCLUSION: This self-administered medication risk assessment questionnaire effectively complemented the usual practices for identifying and referring patients at risk for MRPs.

Aged↗
PubMed1999

Short musculoskeletal function assessment questionnaire: validity, reliability, and responsiveness.

BACKGROUND: A short questionnaire on functional status was designed for use in community-based outcome studies and in the management of individual patients who have musculoskeletal disease. As most musculoskeletal care is delivered in community practices, short, validated instruments are necessary to perform clinical studies on the effectiveness of treatment in this setting. METHODS: A forty-six-item questionnaire was created as an extension of the work to develop the longer, 101-item Musculoskeletal Function Assessment (MFA) questionnaire. The Short Musculoskeletal Function Assessment (SMFA) questionnaire consists of the dysfunction index, which has thirty-four items for the assessment of patient function, and the bother index, which has twelve items for the assessment of how much patients are bothered by functional problems. The SMFA questionnaire was evaluated for reliability, validity, and responsiveness in a population of 420 patients who had a musculoskeletal disease or injury. RESULTS: The SMFA questionnaire demonstrated excellent internal consistency and stability, with most values greater than 0.90. Content validity for the dysfunction and bother indexes was supported with very little skew (less than 1.00), few ceiling effects (less than 5 percent), and no floor effects. Convergent validity was supported with significant correlations between the SMFA dysfunction and bother indexes and the physicians' ratings of patient function (for example, activities of daily living, recreational and leisure activities, and emotional function [rho > or = 0.40]) and standard clinical measures (for example, grip strength and walking speed [r > or = 0.401). Convergent and discriminant construct validity of the SMFA indexes were demonstrated (p < 0.01) in comparisons with clinical, demographic, Short Form-36 (SF-36), and life-change data. The responsiveness of the SMFA questionnaire to change over time was demonstrated with standardized response means ranging from moderate (0.76) to large (-1.14) for patients who had changes in health status. CONCLUSIONS: The SMFA questionnaire may be used for clinical assessments of the impact of treatment in groups of patients who have musculoskeletal disease or injury. It also may be used in clinical settings to provide reliable and valid assessments of the health status of an individual patient.

Adolescent↗
PubMed2000

Reliability and validity of the questionnaire to determine the biosocial rhythms of daily living in the disabled elderly.

The questionnaire to determine the biosocial rhythms of daily living in the disabled elderly was newly developed. This questionnaire was aimed to evaluate a state of synchronization of biological rhythms in the disabled elderly. Eighteen items of the questionnaire relating to the synchronization of biological rhythms were finally selected by the test-retest method that was conducted for 68 disabled elderly living in a community with a duration of one year. The factor analysis showed that the questionnaire consisted of five factors: outdoor activities, ultradian rhythms, subjective evaluation of health status, social support, and sleep habits. The cumulative contribution rate of five factors was 53.2%. Reliability of the questionnaire was confirmed by a calculation of the Equal-length Spearman-Brown coefficients ranging from 0.60 to 0.80. Regarding the construct validity of the questionnaire, results of factor analysis showed five factors that were consistent with the synchronizers known in chronobiology. The total score of the questionnaire was significantly correlated to Barthel Index score and the competence score, suggesting that it partly reflects the activities of daily living of the disabled elderly. We conclude that a new questionnaire to determine the biosocial rhythm of daily living in the disabled elderly is useful to evaluate the biosocial synchronization of the disabled elderly because of its high reliability and validity.

Activities of Daily Living↗
PubMed1992

Quality-of-life assessment in respiratory disease: an examination of the content and validity of four questionnaires.

Four recent questionnaires for measuring the quality of life of patients with respiratory disease (Chronic Respiratory Disease Questionnaire, St George's Respiratory Questionnaire, Living with Asthma Questionnaire, and Asthma Quality of Life Questionnaire) differ in the content and style of the items used. Differences in content arise over the use or emphasis on symptom items, functional limitation (activity) items, and emotion items. These differences stem in part from the different methods used for item selection and refinement, which include selecting the most 'important' items, qualitative analysis for clarity, ratings of distress, and psychometric analysis. Despite these differences, there is considerable evidence for content validity of all four questionnaires. Because quality of life is so poorly developed as a theoretical construct, the demonstrable statement that all 4 questionnaires have construct validity provides little information about the questionnaires.

Humans↗
PubMed2002

Validation of walking questionnaire for population-based prospective studies in Japan: comparison with pedometer.

PURPOSE: To assess the reproducibility and validity of a single-item, self-administered questionnaire on walking used in two population-based prospective cohort studies in northern Japan, using pedometer counts as the reference standard. METHODS: Fifty-one men and 55 women participating in the main cohort studies (mean age: 61.7 years) responded to a question on the average duration of walking per day five times at 3-month intervals. The subjects also provided 3 consecutive days of pedometer counts four times along with the first four questionnaire surveys. RESULTS: For the first and the fifth questionnaires administered one year apart, 55% of the subjects chose concordant categories among three options (< or = 30 min/ between 30 and 60 min/> or = 60 min), and 13% chose the highest category in one questionnaire and the lowest in the other questionnaire. The sex- and age-adjusted mean daily numbers of walking steps counted by the pedometer were 5,857, 7,047, and 7,621 for the three categories of walking duration in the fifth questionnaire, and it showed significant linear associations with all of the five questionnaire measurements. CONCLUSION: The single-item questionnaire on walking is reasonably reproducible and valid, and useful in studying the health effects of walking among the Japanese population.

Cohort Studies↗
PubMed1993

Reproducibility and validity of a postal questionnaire. The abdominal symptom study.

OBJECTIVE: To find out whether it is possible to examine abdominal/gastrointestinal symptoms by a postal questionnaire. DESIGN: In the Abdominal Symptom Study a postal questionnaire was sent to a representative sample of adults (n = 1290) on two occasions, one year apart. The questionnaire was sent a third time to a subsample (n = 110), and to another sample (n = 213) who had not seen the questionnaire before. A subsample (n = 150 of the 1290) was subjected to a medical interview and examination. SETTING: The municipality of Osthammar, Sweden. PARTICIPANTS: A sample (9.3%) of all Swedish citizens (20-79 yrs) in the municipality. MAIN OUTCOME MEASURE: Reproducibility and validity of a postal questionnaire. RESULTS: The response rate was 90%. Roughly 50% of the study population reported abdominal symptoms. The reproducibility of the results was satisfactory, as was the validity of the questionnaire evaluated by medical interview and examination. Non-responders did not report more symptoms than responders. CONCLUSION: It is possible to examine abdominal/gastrointestinal symptoms with a postal questionnaire. The questionnaire used in The Abdominal Symptom Study seems to be useful for this purpose.

Abdominal Pain↗
PubMed2004

Binners, fillers and filers--a qualitative study of GPs who don't return postal questionnaires.

BACKGROUND AND OBJECTIVES: Postal questionnaires are a frequently used method of obtaining information from general practitioners. However, getting GPs to return questionnaires or participate in research can be challenging. We wanted to ascertain reasons why GPs identified as 'routine non-responders' to postal questionnaires, do not participate in this type of research. METHODS: Qualitative study using semi-structured interviews of 14 GPs who had returned only one or none of five questionnaires sent to them during a five-year period between 1994-1999. RESULTS: Participants were classified into one of three groups--binners, filers and fillers--according to their behavior when faced with a questionnaire. Each group had slightly different attitudes toward research in general practice. Although standard strategies such as incentives and good design could influence the decision to complete a questionnaire, poor research experiences or a poor relationship between the participant and researchers were also very important. CONCLUSION: The decision not to return a postal questionnaire is multifactorial and reflects personal and professional attitudes, experiences and organisation of individual GPs as well as time pressure and interest. The development of a positive relationship with a researcher or academic department may be influential in encouraging the return of postal questionnaires and when trying to enhance response rates amongst 'routine non-responders' researchers should take into account the broader values ans practices GPs bring to their work.

Adult↗
PubMedDate not supplied

New-patient self-history questionnaires in primary care.

BACKGROUND: In the current environment of increasing health care efficiency, the benefits of patient self-history questionnaires need to be fully explored. The utility and reliability of new-patient self-history questionnaires have been documented in the medical literature. This study investigates the prevalence of these patient self-history forms in primary care offices. METHODS: A sample of primary care offices listed in the yellow pages by specialty were surveyed by telephone. Survey questions included the use of new-patient self-history questionnaires as well as other characteristics about the offices. Findings from offices using questionnaires were compared with findings from offices not using questionnaires. RESULTS: Of 129 offices contacted by telephone, 116 (90 percent) responded. Of the 116 offices surveyed, 53 percent were using new-patient self-history questionnaires. Offices using questionnaires had more patients in managed care (P = 0.028) and fewer patients insured by Medicare or Medicaid (P = 0.002). There were no significant differences in other office characteristics. CONCLUSIONS: This study shows that primary care offices underutilize new-patient self-history questionnaires.

Humans↗
PubMed2006

Development and psychometric properties of the Vertebral Compression Fracture Pain and Functional Disability Questionnaire.

OBJECT: Vertebral compression fractures (VCFs) result in severe and disabling pain, diminished quality of life, and substantial medical costs. There exists no standard instrument with which to measure pain and functional status before and after treatment of VCFs. METHODS: A questionnaire was specifically developed to assess pain and disability in patients with VCFs before and after undergoing percutaneous polymethylmethacrylate-augmented vertebroplasty. The first section of the baseline questionnaire (before treatment) contains 11 items that address the patient's previous and current levels of back pain and distress. The second section of the baseline questionnaire lists 24 activities of daily living (ADLs), each measured on a four-point scale ranging from "able to do without pain" to "cannot do because of pain." The follow-up questionnaire (after treatment) is similar in format. Among 72 vertebroplasty-treated patients, the internal consistency reliability of the 24 ADLs ranged from 0.87 to 0.98, with similar results observed before and after treatment. Correlations of 0.29 to 0.72 were observed among the 24 ADLs and the internal measures of pain and distress measured on both visual analog and adjectival scales. Similar correlations (range 0.35-0.63) were observed between the questionnaire and 10 dimensions of the Oswestry Disability Index's low-back pain questionnaire, an external instrument used to assess criterion-referenced validity. Evidence in support of the validity of the questionnaire was present before and after treatment. CONCLUSIONS: The Vertebral Compression Fracture Pain and Functional Disability Questionnaire appears to be a reliable and valid instrument for assessing back pain and functional ability in patients before and after treatment for VCFs.

Activities of Daily Living↗
PubMed1999

[The validation of a questionnaire for measuring the organizational climate in health centers].

OBJECTIVE: To check the reliability and to analyse the validity of a questionnaire on organisational atmosphere (OA). DESIGN: Crossover and observational. SETTING: Primary care teams (PCTs). PARTICIPANTS: Two questionnaires were offered to all the doctors, nurses and social workers (548 professionals) from the 29 PCTs in an autonomous community. One questionnaire was on the OA and the other was a subjective assessment of satisfaction with the structure and functioning of their own team. MEASUREMENTS AND MAIN RESULTS: When the results were analysed (initial factorial analysis), 3 items with only slight discrimination were eliminated from the OA questionnaire. Construction validity (factorial analysis with varimax method), reliability of the questionnaire (Cronbach's alpha and Spearman-Brown coefficient) and of criterion (correlation between OA and variables in the subjective assessment questionnaire) were calculated. The overall response rate was 77.5% (402 professionals). Three dimensions which explained 57% of total variability and which confirmed adequate construction validity were identified: team-work, cohesion and commitment. "Team-work" comprised 9 items and explained 27.18% of total variability. "Cohesion" had 7 items, which explained 16.55% of variability. Lastly, "Commitment" explained 13.47% of variability, with 5 items. The validity of criterion was adequate (close correlation between OA and subjective assessment of structure and operation). Reliability was high (0.89 alpha and 0.92 Spearman-Brown for the entire questionnaire and > 0.7 for the dimensions). CONCLUSIONS: The reliability and validity of the adapted questionnaire are sufficient and permit its routine primary care use in our health system to be recommended.

Community Health Centers↗
PubMed2000

[A new questionnaire for assessing the quality of life of patients with intermittent claudication].

BACKGROUND: Quality of life assessment is becoming increasingly relevant for evaluating the impact of disease and treatments and for deciding priorities when allocating resources. This is especially true in intermittent claudication where the goal of therapy is not the cure of the disease but rather to alleviate its symptoms and improve the patient's functional capabilities. At present, however, no generic scale fits all criteria for the ideal quality of life measuring in intermittent claudication. METHODS: We developed a questionnaire aimed at evaluating the specific limitations encountered by claudicants in the physical activity and in the social and emotional functioning. The present study evaluated the questionnaire for validity, reliability, and sensitivity to change, attributes considered to be essential for a questionnaire to be useful. RESULTS: In 30 patients with intermittent claudication, the scores of the four sections of the questionnaire significantly correlated with the scores of the corresponding sections of the Nottingham Health Profile. This indicates that the questionnaire is valid. For each of the four subscales, the intraclass correlation coefficient was > 0.75, thus showing a high test re-test reliability. Also the internal consistency is strong with alpha coefficient ranging from 0.79 to 0.89. Finally, the questionnaire was administered to 9 patients before and 4 weeks after percutaneous transluminal angioplasty for claudication. After the intervention, the improvement in walking performance paralleled the improvement in quality of life. This indicates that the questionnaire is sensitive to change. CONCLUSIONS: Our questionnaire appears to be a valid and reliable quality of life measure in intermittent claudication.

Aged↗