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PubMed1997

Patient satisfaction with emergency house calls.

STUDY OBJECTIVES: To identify determinants of patient satisfaction with emergency house calls and to assess the properties of a satisfaction measurement questionnaire. DESIGN: Patient survey, combined with routinely collected information on the circumstances of the house call. SETTING: Emergency house calls provided by an independent emergency care organization (ECO) in Geneva, Switzerland. PARTICIPANTS: Consecutive sample of 389 patients (67% response rate). MAIN OUTCOME MEASURE: Patient satisfaction. PREDICTOR VARIABLES: patient age and sex, type of medical problem, time of visit, waiting time, duration of visit, perceived effectiveness of treatment. RESULTS: The satisfaction questionnaire was easy to administer. Factor analysis identified 3 separate dimensions of satisfaction, which pertained to the visit itself, to access and to general attitude toward the ECO. Validation tests were consistent with expectations. In multivariate analysis, older patient age and greater perceived treatment effectiveness predicted independently all satisfaction scales. Presence of a mixed physical and mental problem reduced satisfaction with the visit itself only, a delay between the phone call and the visit exceeding one hour reduced satisfaction with access and worsened the attitude toward the ECO. CONCLUSION: The instrument used to measure patient satisfaction with emergency house calls performed well. Overall levels of satisfaction were high. Perceived effectiveness of treatment was the strongest correlate of patient satisfaction. Monitoring of patient satisfaction in emergency settings may contribute to improvements of quality of care.

Adolescent↗

PubMedDate not supplied

Effects of a tablet-splitting program in patients taking HMG-CoA reductase inhibitors: analysis of clinical effects, patient satisfaction, compliance, and cost avoidance.

OBJECTIVE: The primary objective was to determine the effect of a hydroxymethylglutaryl- CoA reductase inhibitor (HMG) tablet-splitting program on laboratory outcomes (lipid panel and liver enzyme tests). Other objectives were to assess patient compliance and satisfaction with splitting tablets and to measure the reduction in drug acquisition costs. METHODS: Patients at a Veterans Affairs Health Care System facility were included in this study if they participated in the HMG tablet-splitting program between April and September 2000. Patients taking the same drug and dosage before and after implementation of the program were asked to complete a mailed questionnaire designed to measure satisfaction and compliance with the program. Data collected through electronic charts included patient demographics, prescribed medication, and the values for lipid panel and liver function tests. RESULTS: A total of 2,019 patients were included in the study. The total cost avoidance achieved over one year for atorvastatin, lovastatin, and simvastatin was 138,108 dollars (N=2,019). The majority of patients who responded to the questionnaire were satisfied and compliant with tablet splitting. In the laboratory analysis (N=512), there was no difference between prevalues and postvalues for total cholesterol and triglycerides. There was a statistically, but not clinically, significant decrease in LDL (102 versus 97, P<0.001) and increase in HDL (46 versus 48, P<0.001), AST (26 versus 28, P<0.001), and ALT (24 versus 26, P=0.006) after the initiation of tablet splitting. CONCLUSION: Tablet splitting of HMGs had no short-term negative effects on laboratory outcomes and favorable effects on humanistic outcomes as measured by patient satisfaction and compliance. Tablet splitting of HMGs is an effective way to reduce costs and nearly double the number of patients who can be treated for the same expense.

Journal Article↗

PubMed2006

[Dermatosis and depressive symptoms].

BACKGROUND: Dermatological diseases modify and impair patients' self-image and can result in considerable psychological suffering. The purpose of this study was to determine the prevalence of depressive symptoms in patients consulting for dermatological diseases. PATIENTS AND METHODS: A prospective study was carried out on 5 successive days at the dermatology department of the Saint-Louis Hospital in Paris. A questionnaire designed to assess depressive symptoms, the CES-D, was given to all patients consulting throughout the study period. This self-assessment scale for depression was devised by the National Institute of Mental Health and has been validated over more than 20 years by means of hundreds of large-scale epidemiological studies in both general and selected patient populations. RESULTS: On completion of the 5-day study, 879 questionnaires had been collected. The sex-ratio was 53.4% women to 46.6% men. The prevalence of depressive symptoms as evaluated by the questionnaire was 23.6% for a total of 774 evaluable dossiers. Patients consulting without an appointment (n = 172) represented 22% of study subjects versus 78% attending a scheduled visit (n = 602). Depressive symptoms were found in 31.4% of patients consulting without an appointment versus 21.4% of patients with an appointment (p<0.01). Male patients consulting without an appointment constituted the most fragile group, with depressive symptoms being seen in 38.8% of this population. DISCUSSION: The prevalence of depressive symptoms among patients seen at a hospital dermatology department was 23.6% in this study. This figure was significantly higher among patients consulting without an appointment, and among men in particular. It was equal to or higher than that seen among patients considered as having more incapacitating or painful conditions as assessed using the same questionnaire. The incidence of concomitant depression should prompt dermatologists to investigate for its existence and to take appropriate therapeutic measures in order to reduce the mental suffering of their patients.

Adolescent↗

PubMed2002

Contemporary measures of approach and avoidance goal orientations: similarities and differences.

BACKGROUND: In response to a resurgence of interest in and demonstrated utility of the approach-avoidance goal distinction, a number of researchers (Elliot & Church, 1997; Midgley et al., 1998; Skaalvik, 1997) have developed instruments to assess individual differences in the tendency to adopt approach-avoidance goals. However, to date there has been no attempt to examine the psychometric properties or conceptual and measurement overlap of these instruments. AIMS: (i) To determine whether three questionnaires designed to measure approach-avoidance goal orientations are assessing the same or different constructs, and (ii) to examine the psychometric properties of each of the approach-avoidance measures (i.e., internal consistency, convergent, discriminant, factorial, and construct validity). SAMPLE: Participants in this study were 475 undergraduate students (N = 228 males; N = 244 females; three missing information) enrolled at two large universities in the United Kingdom. METHOD: Participants completed a questionnaire which included measures of approach-avoidance goal orientations, effort regulation, test anxiety, perceived ability, and intrinsic motivation, extrinsic motivation, and amotivation. RESULTS: Results revealed a degree of convergence between the three instruments. Each of the instruments demonstrated good psychometric properties although construct validity results were inconsistent across the measures. CONCLUSION: There is a need for future research to clarify the operational definition and subsequent measurement of the performance avoidance construct, and in particular, to examine the role that effort, impression management, and anxiety/fear of failure play in its conceptualisation.

Adolescent↗

PubMedDate not supplied

Home blood pressure monitoring: a survey of potential users.

Fifty respondents were surveyed using a recently developed questionnaire designed to evaluate the educational needs of the users of self-monitoring blood pressure apparatus. The categories evaluated included each subject's background and family health history, general knowledge about blood pressure, lifestyle factors affecting blood pressure, and factors affecting the measurement of blood pressure, as well as questions about owning a home monitor and recalibration and maintenance factors. The results indicate considerable disparity between the subjects' levels of knowledge about lifestyle factors affecting blood pressure and the subjects' knowledge of factors essential to accurate self-monitoring of blood pressure. The implications of and need for the design of educational training protocols are discussed.

Adolescent↗

PubMed1995

Screening Parkinson's disease: a validated questionnaire of high specificity and sensitivity.

A questionnaire designed to screen Parkinson's disease (PD) in literate populations has been developed. It consists of nine questions, self-administered at medical facilities or by mail, and a scale of weights for ascribing scores to specific questions when the answer is positive. The questions were chosen to be symptom specific for PD and the weights were determined from answers provided by 37 PD patients in a neurological outpatient clinic. The questionnaire sensitivity was tested on a different PD population from the same outpatient clinic--50 individuals--and the specificity on a group of 100 ophthalmological patients. The sensitivity was 100% and the specificity was 100%. Three individuals who screened positive among the 100 ophthalmological patients were assessed and given a new diagnosis of PD. This questionnaire therefore constitutes an instrument that should prove valuable as the first stage of a door-to-door survey. It has high sensitivity and specificity.

Adult↗

PubMed1994

Predisposing factors differentiating adolescent dieters and nondieters.

OBJECTIVE: To examine whether certain biological, sociocultural, and psychological factors differentiate dieters from nondieters in male and female, black and white adolescents. DESIGN: In each race-sex group adolescents were divided into nondieters and dieters (those who had lost at least 5 lb through dieting) and compared using factors associated with overweight and dieting. SUBJECTS: Participants were 1,269 high school seniors, with a mean (+/- standard deviation) age of 17.5 +/- 0.6 years, from 10 schools in a large metropolitan area (72% of enrolled students). INTERVENTION: Each student completed a self-administered questionnaire designed for this research, the Culture-Free Self-Esteem Inventory, and the Eating Disorder Inventory. OUTCOME MEASURES: Comparisons were made of dieters and nondieters using their previous and current weights, parental weights, birth order, socioeconomic status, religious affiliation, self-esteem scores, and other psychological factors. STATISTICAL ANALYSES: Statistical analyses performed were chi 2 and t tests. RESULTS: Factors thought to be associated with overweight in adolescents, such as parental weights, birth order, and socioeconomic status, were not found to be significantly different in dieters and nondieters in any of the four race-sex groups. In fact, the majority of dieters in this study were not overweight (ie, above the 85th percentile of body mass index). Instead, what most clearly distinguished dieters from nondieters was their perception of being overweight before kindergarten, after kindergarten, and at the time of the study, and the feelings of body dissatisfaction and wanting to be thinner that being overweight engenders. APPLICATIONS: Because most adolescents diet because they perceive themselves to be overweight when they are not, adolescent dieters are not easy to identify. Instead, dietitians can offer educational programs that help all adolescents accept more realistic weights and adopt patterns of eating and exercise that remove or reduce the need to diet.

Adolescent↗

PubMed1988

A study of dental graduates at British medical schools in April 1987.

Seventy-nine dentally-qualified medical students studying at British medical schools were identified and sent a questionnaire designed to determine information regarding their past and present careers and their intentions for the future. Replies were received from 52 (65.8%) and the findings are reported and discussed.

Adult↗

PubMed2001

Usefulness of a psychometric questionnaire in exploring parental attitudes in children's dental care.

In this methodological study we investigated the usefulness and reliability of a questionnaire designed to capture 4 aspects of parental dental attitudes: dental knowledge, child oral health behavior, perceived importance of dental related aims, and parental responsibility. The study was undertaken in a group of 140 parents of schoolchildren aged 8-12 years from four comprehensive schools in Sweden. Test-retest reliability, quantified by the intraclass correlation coefficient (ICC) or by Cohen's kappa, varied from acceptable to excellent for different aspects of the questionnaire. The knowledge and responsibility-taking sections were also answered by a group of dental experts who showed a high level of internal agreement. Expert profiles, to which the parental assessments could be compared, were created. Exploration of the 4 aspects showed that this group of parents commonly had a multifocal view on the etiology and prevention of caries. Correlations between their knowledge assessments and the assessments made by the expert group varied from moderately negative to strongly positive. The parents revealed a high degree of dental-related motivation and responsibility, particularly according to oral health behaviors. In conclusion, the results indicate that this 4-part psychometric questionnaire might be a suitable instrument in investigations of priority and responsibility-taking as new aspects of parental dental attitudes, along with dental knowledge and child oral health behaviors.

Attitude to Health↗

PubMed1989

Food-based validation of a dietary questionnaire: the effects of week-to-week variation in food consumption.

The reproducibility and validity of responses for 55 specific foods and beverages on a self-administered food frequency questionnaire were evaluated. One hundred and seventy three women from the Nurses' Health Study completed the questionnaire twice approximately 12 months apart and also recorded their food consumption for seven consecutive days, four times during the one-year interval. For the 55 foods, the mean of correlation coefficients between frequencies of intake for first versus second questionnaire was 0.57 (range = 0.24 for fruit punch to 0.93 for beer). The mean of correlation coefficients between the dietary records and first questionnaire was 0.44 (range = 0.09 for yellow squash to 0.83 for beer and tea) and between the dietary records and the second questionnaire was 0.52 (range = 0.08 for spinach to 0.90 for tea). Ratios of within- to between-person variance for the 55 foods were computed using the mean four one-week dietary records for each person as replicate measurements. For most foods this ratio was greater than 1.0 (geometric mean of ratios = 1.88), ranging from 0.25 (skimmed milk) to 14.76 (spinach). Correlation coefficients comparing questionnaire and dietary record for the 55 foods were corrected for the within-person variation (mean corrected value = 0.55 for dietary record versus first questionnaire and 0.66 versus the second). Mean daily amounts of each food calculated by the questionnaire and by the dietary record were also compared; the observed differences suggested that responses to the questionnaire tended to over-represent socially desirable foods. This analysis documents the validity and reproducibility of the questionnaire for measuring specific foods and beverages, as well as the large within-person variation for food intake measured by dietary records. Differences in the degree of validity for specific foods revealed in this type of analysis can be useful in improving questionnaire design and in interpreting findings from epidemiological studies that use the instrument.

Adult↗

PubMed1998

[The influence of school staffs willingness and dental health education intervention on the oral hygiene status of the elementary school children].

The main purpose of this study was to understand the influence of school administrator's and teacher's participation in oral hygiene promotion, and dental health education intervention on the oral hygiene status of the elementary school children. Questionnaires designed to evaluate the school staff's willingness to emphasize and proceed the oral hygiene programs were answered by the school administrators (principals, deans of pupils' affair, chiefs of physical education and hygiene departments, and nurses) in 75 public elementary schools of the Kaohsiung City, Taiwan. Two of the most, and of the least cooperative schools were randomly selected. The fifth grade teachers of those four schools were asked to answer the questionnaires. Pupils of the two classes whose teachers who had the greatest and the least willingness to participate were selected for further investigation. Pupils were asked to answer questionnaires, receive oral examinations and tooth-brushing instructions every other two weeks for a total of two times. The results were as follows: 1. Before active oral hygiene instruction, there is no significant difference in plaque scores among groups. However, DMFT scores are influenced by school administrators. 2. The oral hygiene education intervention actually significantly improved the school children's plaque scores. 3. The cooperation of school administrators and teachers has a positive influence on keeping (forming) school children's good oral hygiene habits. Furthermore, the influence from school administrators is more than that from teachers. 4. School children's knowledge of oral hygiene is influenced by school' administrators and teachers while teachers' attitude of oral hygiene is influenced by school administrators.

Child↗

PubMed2006

Analysis of self-reported problematic tasks for pregnant women.

The objective of this study was to identify major components of, and influential factors in, problematic tasks performed by pregnant women employed in education, health care and service areas. Seventy-two pregnant women were surveyed using specially designed questionnaires consisting of an Initial Survey, a Job Analysis Questionnaire and a Task Description Questionnaire. Forty-four subjects (60%) had difficulty performing at least one work task and reported 105 tasks that were problematic at work. Reaching above the head, bending forward, bending and twisting, pushing, repeating actions and working at a fast pace were identified as the task components requiring the greatest level of effort. Excessive effort, excessive time, getting tired, repetitive actions, stress and fear of injury were identified as factors that had strong associations with the six major task components. Findings of this study suggest that these task components and factors should be considered when designing, assigning or analysing tasks for working pregnant women.

Activities of Daily Living↗

PubMed2006

Communication deficiencies in research and monitoring by ethics committees.

AIM: To assess the range of issues that arise for researchers, research participants and ethics committee members in the setting of a hospital-based research environment and to develop a tool that could be used to assist in the process of monitoring. METHODS: A qualitative phase comprising focus group sessions and interviews involving research participants, researchers and ethics committee members of a public teaching hospital and a quantitative phase involving distribution of a questionnaire to research participants and researchers. The data from the qualitative phase were used to assist with the development of the quantitative instrument. Descriptive statistics were derived to describe the various attitudes and practices with respect to the conduct of research. RESULTS: The qualitative study identified issues concerning monitoring procedures and the quality of communication between researchers and study participants. The quantitative analysis showed that parts of the Explanatory Statement (also known as the Participant Information Statement) were incomprehensible to 21% of research participants; the Explanatory Statement was considered too long by 34% of researchers; 6% of researchers believed that explicit consent was not always necessary; of the participants who were out of pocket for attending a study, 53% were offered compensation; and 44% of research participants were unaware of the existence of the ethics committee. In addition, 12% of researchers felt that the quality of monitoring should be improved. CONCLUSIONS: Improvements are necessary in the communication between ethics committees and researchers and research participants, and there is a need for more effective monitoring by ethics committees of research practices. The questionnaire designed for this study could be applied in a prospective manner as a useful tool for monitoring the conduct of research.

Adult↗

PubMed2003

Psychosocial factors at work and self reported health: comparative results of cross sectional and prospective analyses of the French GAZEL cohort.

BACKGROUND: Psychosocial factors at work have been found to be significant contributors to health, especially cardiovascular health. AIMS: To explore the relation between psychosocial factors at work and self reported health, using cross sectional and prospective analyses for a large occupational cohort of men and women. METHODS: Psychosocial factors at work were evaluated using the Karasek questionnaire, designed to measure psychological demands, decision latitude, social support, and physical demands. Self reported health was used as health outcome. Covariates included chronic diseases, and sociodemographic, occupational, and behavioural factors. The cross sectional and prospective analyses concerned respectively 11 447 and 7664 workers. Men and women were analysed separately. RESULTS: Cross sectional analysis revealed significant associations between psychological demands, decision latitude, social support, and physical demands, and self reported health for both men and women. Prospective analysis showed that high psychological demands for both genders, low decision authority for men, and low social support and high physical demands for women were predictive of poor self reported health. These results were independent of potential confounding variables. CONCLUSIONS: Results highlight the predictive effects of psychosocial factors at work on self reported health in a one year follow up study. They also underline the need for longitudinal study design and separate analyses for men and women in the field of psychosocial factors at work.

Adult↗

PubMed2005

[Prevalence and risk factors for substance abuse and dependence among anaesthetists: a national survey].

OBJECTIVE: Addiction behaviours in the anaesthetist population have been recognized as a significant health-related issue and its scope is a matter of concern. METHODS: A national survey conducted among French anaesthetists consisted of a questionnaire designed to elicit information related to demographics, and work conditions, as well as substance consumption status. The study investigated the following: tobacco, alcohol, tranquillizers-hypnotics, and other agents such as cannabis, cocaine, opiates and anaesthetic agents. Respondents were classified in two categories: (no use and use)-(abuse and dependence). An univariate and multivariate analysis were performed to determine risk factors associated with drug abuse and dependence. RESULTS: 3,476 physicians responded to the questionnaire (38.0% response rate); 22.7% were daily tobacco smokers; 10.9% were abuser or dependent to one or more substances other than tobacco i.e. alcohol (59.0%), tranquillizers and hypnotics (41.0%), cannabis (6.3%), opiates (5.5%), and stimulants (1.9%). Sleep disturbances and negative perception of work environment were more frequently reported among addicted anaesthetists. CONCLUSION: In French anaesthetists, addiction is mainly related to alcohol consumption but includes a broad spectrum of substances. Addicted subjects report issues around work environment that may have contributed to the development of their pathology.

Adult↗

PubMed2003

Surgical and patient reported outcomes of 'clam' augmentation ileocystoplasty in spinal cord injured patients.

OBJECTIVE: To study the outcomes and effectiveness of 'clam' augmentation ileocystoplasty in the treatment of suprasacral spinal cord injured patients with detrusor hyperreflexia refractory to pharmacological and other conservative therapy. METHODS: A retrospective review of spinal injured patients who had undergone 'clam' augmentation ileocystoplasty was performed, followed by a specifically designed questionnaire/telephone interview to assess patient satisfaction and other issues from this specific group of patients with suprasacral spinal cord lesions. 32 patients were followed up for a mean of 6.0 +/- 3.6 years. RESULTS: Complete continence was found in all patients. There was a significant improvement in bladder capacity from a mean 143 +/- 81 ml pre-operatively to 589 +/- 188 ml post-operatively, and the maximum detrusor pressure fell from a mean of 108 +/- 43 cm H(2)O to 19 +/- 15 cm H(2)O. Pre-operative vesico-ureteric reflux resolved completely in 4 out of 5 patients and improved from grade IV to grade II in one, illustrating the need for achieving low bladder pressures rather than the performance of an anti-reflux procedure at the time of cystoplasty. The use of the questionnaire, designed to evaluate this subset of patients after augmentation cystoplasty, highlighted the high levels of satisfaction with the operation in this group of patients with 96.2% of patients reporting an improvement in quality of life parameters. CONCLUSION: Using an appropriate questionnaire we have found high satisfaction rates, in addition to successful surgical outcomes, in spinal cord injured patients following augmentation cystoplasty. We recommend using this questionnaire as part of the work-up and ongoing assessment of spinal injured patients undergoing 'clam' augmentation ileocystoplasty.

Adolescent↗

PubMed2005

Health-related quality of life in childhood cerebral palsy.

OBJECTIVE: To describe the health-related quality of life (HRQOL) of a cross-section of children with cerebral palsy (CP) using the Child Health Questionnaire. DESIGN: Survey of the parents or guardians of children with CP. SETTING: Outpatient clinics at a tertiary care children's hospital. PARTICIPANTS: Children (N=177; 98 boys, 79 girls; mean age +/- standard deviation [SD], 8.6+/-4.2y) with CP were enrolled as a convenience sample. Study subjects were stratified by severity of CP using the Gross Motor Function Classification System. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: HRQOL scores, as determined by the Child Health Questionnaire-Parent Form 50. RESULTS: Parents reported reduced HRQOL for their children with CP. In the physical function domain, most children scored over 3 SDs below a normative sample, and scores in parental impact domains were at least 1 SD below the normative sample. Psychosocial domains were less impaired. Most of the effects on physical and parent impact domains were greater in children with more severe CP, although they were significant in most strata of severity. CONCLUSIONS: Children with CP have reduced HRQOL and the degree to which it is reduced is related to the severity of their CP.

Adolescent↗

PubMed2003

Exploring sex differences in the relationship between depressive symptoms and dementia incidence: prospective results from the PAQUID Study.

OBJECTIVES: To estimate the predictive relationship between depressive symptoms and 8-year dementia incidence in a large prospective community sample of French older adults and to compare the effect magnitude for men and women. DESIGN: Prospective population-based cohort with four interview waves and complete vital status ascertainment. SETTING: Urban and rural communities in the Aquitaine Region (Gironde and Dordogne), southwest France. PARTICIPANTS: Three thousand seven hundred seventy-seven adults aged 65 and older residing in noninstitutional settings at study baseline. MEASUREMENTS: Each participant was interviewed by a neuropsychologist and screened for dementia with the Mini-Mental State Examination, a cognitive test battery, and a standardized questionnaire designed to ascertain the presence of the criteria for dementia according to the Diagnostic and Statistical Manual for Mental Disorders, Third Edition, Revised (DSM-III-R). Dementia status and subtype were confirmed using neurological examination and categorized according to DSM-III-R criteria for dementia and the National Institute of Neurological Disorders and Stroke/Alzheimer's and Related Disorders Association criteria. The Hachinski score was calculated to specify the etiology: possible or probable Alzheimer's disease, vascular dementia, and other types of dementia. Depressive symptomatology was evaluated using the Center for Epidemiologic Studies-Depression scale. Statistical analyses were weighted to correct for attrition not due to mortality. RESULTS: Ninety-seven men (incidence rate: 14.4/1,000) and 183 women (Incidence rate: 19.0/1,000) developed dementia during 8 years of follow-up. Baseline prevalence of depressive symptomatology was 12.9% for men and 14.7% for women. Depressive symptoms increased risk of dementia at subsequent interview wave, but only for men (odds ratio (OR) (men) = 3.5, 95% confidence interval (CI) = 1.9-6.5; OR (women) = 1.2, 95% CI = 0.7-2.0, P-value for sex difference = 0.03). The hypothesis that vascular depression might explain the observed sex difference was studied, and it was found that risk was 50% higher for men with hypertension who were depressed than for normotensive men. For women, hypertension status did not modify the absence of an association. CONCLUSION: This study supports the hypothesis of a relationship between proximal depressive symptomatology and dementia in men, but distant depression did not increase dementia risk in this sample. The results suggest that depression in older men might reflect a form of vascular depression associated with cerebral vascular pathology or multiinfarct disease that may amplify the dementing or declining process, hence accelerating the onset of manifest symptoms of dementia.

Aged↗