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PubMed2002

Reliability of a questionnaire screening restless legs syndrome in patients on chronic dialysis.

BACKGROUND: The aim of this study is to evaluate the reliability of a self-administered questionnaire on leg discomfort and restlessness as a screening tool for restless legs syndrome (RLS) in a population of chronically dialyzed patients. METHODS: One hundred twenty-seven patients on chronic hemodialysis therapy filled in a self-administered questionnaire including 4 diagnostic questions for RLS and 12 subsequent questions on clinical characteristics of leg discomfort. Two neurologists trained in sleep medicine blinded to questionnaire answers evaluated all patients and diagnosed RLS according to criteria of the International Restless Legs Syndrome Study Group. We compared questionnaire results in terms of RLS diagnosis with direct patient evaluation performed by neurologists used as a gold standard. RESULTS: The questionnaire showed a low sensitivity and specificity and did not prove reliable for screening for RLS in uremic patients. False-positive results seem to be caused by the presence of other leg symptoms and neurological objective signs suggesting peripheral neuropathy; false-negative results may be caused by the moderate severity of leg discomfort and its poor appraisal. CONCLUSION: Our study suggests caution in evaluating results of questionnaires to screen for RLS in patients with chronic renal insufficiency on dialysis therapy.

Adult↗
PubMed2002

Importance-rating using the University of Washington quality of life questionnaire in patients treated by primary surgery for oral and oro-pharyngeal cancer.

BACKGROUND: There are now several validated and widely accepted head and neck cancer questionnaires. These record patients subjective levels of function and dysfunction, as well as symptoms related to their cancer and its treatment. One popular measure is the University of Washington head and neck cancer questionnaire (UW-QOL). Domain importance-ratings were added to the second version of the questionnaire, which was published in 1997. It is unique amongst head and neck cancer questionnaires in this respect. AIM: The purpose of the study was to evaluate UW-QOL with particular reference to domain importance-rating. It was also the intention to investigate how the importance-ratings related to 'quality of life' and comment on the cumulative scoring of the questionnaire. METHODS: Forty-eight patients with previously untreated oral or oro-pharyngeal cancer were recruited. All were treated by primary surgery. Questionnaires were completed pre-operatively, 6 months and 1 year post-operatively. RESULTS: This study demonstrates a wide variation in importance-ratings. Both pre- and post-treatment there was a general lack of correlation between importance-rating and domain scores. At all time points, patients tended to rate speech, chewing and swallowing as more important than the other UW-QOL domains. The cumulative UW-QOL score correlated strongly with the new single item QOL question. CONCLUSION: It remains unclear how best to incorporate importance-ratings into a single UW-QOL total score. However, for individual patients they can assist in setting priorities in treatment strategies.

Activities of Daily Living↗
PubMed2002

[The assessment of subjective distress related to hyperacusis with a self-rating questionnaire on hypersensitivity to sound].

BACKGROUND: So far there has been no adequate measure to assess or illustrate, in terms of different levels, subjective distress related to hypersensitivity to sound. METHOD AND PATIENTS: The here presented work describes and discusses the construction of a questionnaire to assess subjective distress related to hypersensitivity to sound (GUF). Between May and September 2000 226 patients that experienced suffering from hypersensitivity to sound as well as from chronic tinnitus, completed a first version of the questionnaire on admittance to the hospital. Of these patients 27.9 % were out-patients and 72.1 % were in-patients. In addition, the in-patients completed the questionnaire again during their last week of treatment. The 27 items of the GUF were interpreted by factor analysis to explore and determine the structure of the questionnaire; the number of items was reduced under the aspects of consistency and reliability. Finally, the revised version of the GUF underwent a first validation. RESULTS: The factor analysis shows three factors explaining 50.65 % variance (factor 1 [KRH], cognitive reactions to hyperacusis; factor 2 [ASV], actional/somatic behaviour; factor 3 [ERG], emotional reaction to external noises). First attempts to validate the questionnaire are promising; it appears that the GUF is also sensitive to therapy effects. CONCLUSIONS: The here presented questionnaire is suitable for identifying distinct levels of subjective distress related to hypersensitivity to sound. Thus, for the first time, there is an adequate measure for assessment available. Furthermore, results of part of the sample show that the GUF is also suitable for therapy evaluation.

Adaptation, Psychological↗
PubMedDate not supplied

[Reliability and validity of the upper limb DASH questionnaire in patients with distal radius fractures].

AIM: The purpose of the study was to verify test criteria of the upper-limb DASH questionnaire in patients with Colles' fractures. METHODS: 107 of 139 patients with Colles' fractures treated operatively were examined and asked to complete the questionnaire. To establish reliability, the item answers of all questionnaires were analysed by using Cronbach's Alpha correlation coefficient and corrected item total correlation. Construct validity was evaluated by comparing the DASH points with clinical measures according to Gartland/Werley and Castaing (Spearman correlation coefficient). Discriminant validity was assessed by comparing the DASH points of patients with AO-type A/B fractures and AO-type C fractures (Mann-Whitney U-Test). RESULTS: 2.7 percent of all questionnaires were unusuable. The time to fill out the questionnaire was on average 12 minutes. Cronbach's alpha values were high in all scales (alpha > 0.8). No items were found unsuitable (corrected item total correlation > 0.5 in 28 of 30 questions). DASH scores were correlated with ROM deficits and clinical measures of wrist function (r = 0.53; r = 0.59; r = 0.52, p < 0.01). The questionnaire could discriminate patients with different fracture types (p < 0.05). CONCLUSIONS: DASH is a workable, reliable and valid instrument for patients with Colles' fractures.

Adolescent↗
PubMed2003

[Initial status of patients and effects of rehabilitation after stroke--analysis of a patients' and a physicians' questionnaire in three neurological rehabilitation centres with a follow-up after 6 months].

Rehabilitation after stroke has to face specific problems when treating patients with more or less severe disabilities in cognition and communication. Correspondingly, stroke rehabilitation takes a special position within the larger field of rehabilitation, and relatively little is known outside the neurological scientific community about the status of patients at admission, the case mix in the centres and the short- and medium-term effects of rehabilitation. The present study describes in some detail the initial status in unselected samples of consecutive patients (n = 768) from three neurological rehabilitation centres. The description shows a very inconsistent picture in all centres, ranging from patients with no neurological deficits to patients needing intensive care. Across the centres, we found remarkable differences in case mix. In order to measure the effects of rehabilitation after stroke, an instrument was developed that combines a physicians' questionnaire aiming at an assessment of the severely disabled cases with a patients' questionnaire for the less severe cases for which the physicians' questionnaire would show "ceiling effects" so that improvements could no longer be depicted. The application of the instrument showed that about 50 % of the sample were not capable of answering the patients' questionnaire. For the patients with neurological deficits, the functional parameters of the physicians' questionnaire showed significant improvements at discharge that can be interpreted as "strong" effects (effect sizes 1.0-1.3). For the patients with less severe deficits (and usually in later stages of the rehabilitation process), the patients' questionnaire showed "strong" improvements on the somatic and psychosocial scales both at discharge and 6 months later. On the functional scales, however, only small improvements were found. Finally, predictors could be identified that explain a large amount of the variance for length of stay (R(2) =.42) as well as for the effects of rehabilitation (R(2) =.74). When comparing effects across rehabilitation units with differences of case mix, these predictors should be statistically controlled in order to assure fair comparisons.

Adult↗
PubMed2005

[Referrer satisfaction as a quality criterion: developing an questionnaire for measuring the quality of services provided by a radiology department].

PURPOSE: To develop a questionnaire for measuring referring physician satisfaction and to conduct a pilot study in which this questionnaire is given to all physicians referring patients to the authors' radiology department. MATERIALS AND METHODS: After qualitative pre-testing and adjustment of the prototype questionnaire, data were collected using the finalized standardized questionnaire comprising 29 indicators rated on a 4-point ordinal scale mailed with a personalized cover letter to the total referring physician population of a radiology department (n = 727). The replies, rated 1 - 4, were entered into a data entry mask for statistical analysis. RESULTS: The response rate was 33.8 %. The indicators with the highest satisfaction rating were the range of examinations offered ("very satisfied": 79.3 % mean 3.79), the quality of the technical equipment used for MRI and CT (79.3 %, 3.79) and mammography (82.5 %, 3.82), and the quality of the images yielded by these procedures (74.5 %, 3.73 and 82.2 %, 3.83). Dissatisfaction was relatively high with the indicators "time to receipt of the written report" (28.3 % "not very satisfied" or "not at all satisfied", mean 2.97), "time to receipt of the X-ray images" (18.2 %, 3.07) and "availability of previous findings" (20.9 %, 3.05); satisfaction was higher among external referring physicians (p < 0.05). Physicians rated the importance of these three indicators as relatively high ("very important": 62.4 %, 54.3 % and 49.6 %). Other indicators showing a similar level of dissatisfaction were "car parking availability" (24.1 %, 3.01), "patient waiting time" (27.4 %, 2.87) and "patient environment" (21.2 %, 2.99), although these factors were rated as less important ("very important": 33.0 %, 33.7 % and 40.4 %). CONCLUSION: This questionnaire constitutes a standardized validated instrument for assessing referring physician satisfaction with a radiology department. The data from this pilot study highlight areas for potential improvement. Deployment of such a questionnaire in different radiology departments could serve to establish best practice benchmarks.

Consumer Behavior↗
PubMed2005

[Referrer satisfaction as a quality criterion: developing an questionnaire for measuring the quality of services provided by a radiology department].

PURPOSE: To develop a questionnaire for measuring referring physician satisfaction and to conduct a pilot study in which this questionnaire is given to all physicians referring patients to the authors' radiology department. MATERIALS AND METHODS: After qualitative pre-testing and adjustment of the prototype questionnaire, data were collected using the finalized standardized questionnaire comprising 29 indicators rated on a 4-point ordinal scale mailed with a personalized cover letter to the total referring physician population of a radiology department (n = 727). The replies, rated 1 - 4, were entered into a data entry mask for statistical analysis. RESULTS: The response rate was 33.8 %. The indicators with the highest satisfaction rating were the range of examinations offered ("very satisfied": 79.3 % mean 3.79), the quality of the technical equipment used for MRI and CT (79.3 %, 3.79) and mammography (82.5 %, 3.82), and the quality of the images yielded by these procedures (74.5 %, 3.73 and 82.2 %, 3.83). Dissatisfaction was relatively high with the indicators "time to receipt of the written report" (28.3 % "not very satisfied" or "not at all satisfied", mean 2.97), "time to receipt of the X-ray images" (18.2 %, 3.07) and "availability of previous findings" (20.9 %, 3.05); satisfaction was higher among external referring physicians (p < 0.05). Physicians rated the importance of these three indicators as relatively high ("very important": 62.4 %, 54.3 % and 49.6 %). Other indicators showing a similar level of dissatisfaction were "car parking availability" (24.1 %, 3.01), "patient waiting time" (27.4 %, 2.87) and "patient environment" (21.2 %, 2.99), although these factors were rated as less important ("very important": 33.0 %, 33.7 % and 40.4 %). CONCLUSION: This questionnaire constitutes a standardized validated instrument for assessing referring physician satisfaction with a radiology department. The data from this pilot study highlight areas for potential improvement. Deployment of such a questionnaire in different radiology departments could serve to establish best practice benchmarks.

Consumer Behavior↗
PubMed2002

Development and validation of a health-related quality-of-life questionnaire in patients with yellow jacket allergy.

BACKGROUND: The effects of an anaphylactic reaction after a yellow jacket sting on health-related quality of life (HRQL) have not been studied and are thus unknown. OBJECTIVE: Development of a disease-specific instrument to measure HRQL in patients with yellow jacket allergy and validation of this instrument both cross-sectionally and longitudinally. METHODS: Quality-of-life items were generated from patient interviews. Items with the highest impact were considered and correlated cross-sectionally with an independent measure (consisting of 2 questions in which patients were asked what they expected would happen if they were stung again, "Expectation of Outcome" questionnaire). Cross-sectional and longitudinal validation was achieved by administering this instrument to 69 Dutch patients. The questionnaire was also administered to 50 patients with yellow jacket allergy in Baltimore, Maryland, to establish cross-sectional validity of the English version. RESULTS: The survey showed that patients experienced impairment in quality of life especially because of emotional distress. The resultant questionnaire has 14 items. The cross-sectional validation yielded a correlation coefficient of 0.69 for the Dutch version and 0.56 for the English version. The longitudinal validation yielded a correlation coefficient of 0.71. The responsiveness of this instrument was demonstrated by the questionnaire's ability to detect changes over time. It may be completed in approximately 10 minutes by patients without assistance. CONCLUSION: Patients with yellow jacket allergy experience impairment in quality of life especially because of emotional distress. It has been possible to develop and validate a questionnaire (the Vespid Allergy Quality of Life Questionnaire) by which the HRQL of these patients can be measured. The instrument may be administered rapidly and is easy to use.

Adult↗
PubMed2003

Validation of two global impression questionnaires for incontinence.

OBJECTIVE: The purpose of this study was to assess the construct validity of two global assessment questions, the Patient Global Impression of Severity and of Improvement, in female patients with stress urinary incontinence. STUDY DESIGN: This was a secondary analysis of data from two double-blind, placebo-controlled studies that evaluated duloxetine for the treatment of predominant stress urinary incontinence in the United States (n = 1133 patients). Assessment variables included incontinence episode frequency, the Incontinence Quality of Life Questionnaire results, fixed volume (400 mL) stress pad test results, and the Patient Global Impression of Improvement and of Severity question results. RESULTS: Spearman correlation coefficients were 0.36, 0.20, and -0.50 among the Patient Global Impression of Severity question and incontinence episode frequency, stress pad test, and Incontinence Quality of Life Questionnaire results, respectively (all P <.0001). Mean incontinence episode frequency and median stress pad test results increased and mean Incontinence Quality of Life Questionnaire results decreased with increasing Patient Global Impression of Severity question severity levels. Similarly, significant (P <.0001) correlations were observed between the Patient Global Impression of Improvement question response categories and the three independent measures of improvement in stress urinary incontinence (0.49, 0.33, and -0.43 with incontinence episode frequency, stress pad test, and Incontinence Quality of Life Questionnaire results, respectively). As with the Patient Global Impression of Severity question, differences in mean changes for Incontinence Quality of Life Questionnaire and median percent changes for incontinence episode frequency and stress pad test among the Patient Global Impression of Improvement question response categories were highly significant (P <.0001). These relationships indicate appropriate and significant associations between the Patient Global Impression of Severity and of Improvement questions and the three independent measures of stress urinary incontinence severity and improvement, respectively. CONCLUSION: The Patient Global Impression of Severity and of Improvement question responses were correlated significantly with incontinence episode frequency, stress pad test, and Incontinence Quality of Life Questionnaire measures, which established the construct validity of these two global assessment questions for baseline severity and treatment response, respectively.

Body Mass Index↗
PubMed2001

Reliability of the VCM1 Questionnaire when administered by post and by telephone.

PURPOSE: To assess the reliability of different methods of administration of the VCM1 vision-related quality-of-life questionnaire by: a) comparing responses obtained by post to responses obtained in a research clinic and b) comparing responses obtained by telephone to responses obtained in a research clinic. METHOD: Questionnaire responses given in advance by post (96 subjects) or by telephone (92 subjects) were compared to those subsequently given at a visit to a research clinic. The questionnaire included the VCM1 and two other questions commonly used in surveys of visual impairment (reading small print and recognising a face across the street). RESULTS: Similar levels of vision-related quality-of-life (VR-QOL) impairment were reported by post and in the research clinic. However, the participants in the telephone test group reported less VR-QOL impairment by telephone than they subsequently reported in the clinic (P = 0.0001). The mean score difference between telephone and clinic administration was 3.2% of the VCM1 questionnaire scale. Lower social class (P = 0.002) and increasing duration of interview (P = 0.003) were associated with a tendency to under-report VR-QOL impairment by telephone. Interference with reading small print (P = 0.0001) and recognising a face across the street (P = 0.0001) were also under-reported by telephone. CONCLUSIONS: Telephone interviewing caused a general bias towards under-reporting of visual problems which was not confined to the VCM1. Care is required when planning outcome studies and questionnaire surveys to ensure that different methods of questionnaire administration produce comparable results.

Age Distribution↗
PubMed2002

Development of a short questionnaire to assess the dietary intake of heterocyclic aromatic amines.

OBJECTIVE: Development and validation of a short instrument to assess the dietary intake of heterocyclic aromatic amines (HCA). DESIGN: At first, a longer instrument asking for the consumption of 11 meat and fish items and different preparation methods was developed. The degree of browning of these foods was assessed by means of photos. This questionnaire was sent to 500 participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) in Heidelberg, Germany, in June 1999. Using 385 completed questionnaires, a short questionnaire was developed covering just seven food items, which was sent to the participants again. Of these, 344 were returned within four months. Total dietary intake of HCA as well as the intake of different HCA were calculated and compared between both versions. RESULTS: Median dietary intake of total HCA was 103 ng day-1 as assessed with the short version; the intakes of 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP), 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) and 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (DiMeIQx) were 63, 34 and 2 ng day-1, respectively. These results did not differ significantly from those obtained with the longer version. Spearman rank correlation coefficients between the long and the short version ranged from 0.46 to 0.6. In quartile cross-classification, 70-78% of the participants were assigned into the same or an adjacent quartile while categorisation into opposite quartiles was < or =3.5%. CONCLUSION: The short version of the HCA questionnaire demonstrates good validity compared with the longer version. The intake of HCA as assessed with the short questionnaire is comparable to that found in other studies using a short questionnaire.

Adult↗
PubMed2005

Reproducibility of a short semi-quantitative food group questionnaire and its performance in estimating nutrient intake compared with a 7-day diet diary in the Million Women Study.

OBJECTIVES: To assess the short- and long-term reproducibility of a short food group questionnaire, and to compare its performance for estimating nutrient intakes in comparison with a 7-day diet diary. DESIGN: Participants for the reproducibility study completed the food group questionnaire at two time points, up to 2 years apart. Participants for the performance study completed both the food group questionnaire and a 7-day diet diary a few months apart. Reproducibility was assessed by kappa statistics and percentage change between the two questionnaires; performance was assessed by kappa statistics, rank correlations and percentages of participants classified into the same and opposite thirds of intake. SETTING: A random sample of participants in the Million Women Study, a population-based prospective study in the UK. SUBJECTS: In total, 12 221 women aged 50-64 years. RESULTS: In the reproducibility study, 75% of the food group items showed at least moderate agreement for all four time-point comparisons. Items showing fair agreement or worse tended to be those where few respondents reported eating them more than once a week, those consumed in small amounts and those relating to types of fat consumed. Compared with the diet diary, the food group questionnaire showed consistently reasonable performance for the nutrients carbohydrate, saturated fat, cholesterol, total sugars, alcohol, fibre, calcium, riboflavin, folate and vitamin C. CONCLUSIONS: The short food group questionnaire used in this study has been shown to be reproducible over time and to perform reasonably well for the assessment of a number of dietary nutrients.

Cross-Sectional Studies↗
PubMed1999

Validity of a questionnaire survey: the role of non-response and incorrect answers.

Errors in questionnaire surveys are usually of one of two sources: non-responses or incorrect answers. The aim was to investigate the validity of a questionnaire survey and to estimate the respective bias of these answers. Of 9,283 subjects selected to receive a questionnaire by post, 3,949 (43%) responded, and, of these, 3,400 correctly reported their Swedish social security number. Answers in the questionnaire survey were given as proportions of the claims registered at local insurance offices. In the group of respondents who had correctly reported their social security number, the answers were compared individually with the registrations in dental insurance claims. In Sweden, these claims are labeled with the patient's social security number and it is thereby possible to make such comparisons. It was shown that errors were caused by non-response and also by respondents giving incorrect answers. Incorrect answers accounted for approximately one-third of the total bias. The remaining bias was caused by a non-response error. It is concluded that questionnaire studies have a bias caused by both non-response and incorrect answers and that together these can be substantial. Scientific reports that include questionnaire surveys must describe the procedure carefully. If possible, other sources of information should be considered.

Bias↗
PubMed1992

Getting the story straight: evaluating the test-retest reliability of a university health history questionnaire.

This study was designed to establish the reliability of a health history questionnaire used as a screening tool for incoming university students. The authors used a test-retest design, with a test interval of 6 months, on a sample of medical and nursing students. The analysis focused on overall reliability of the questionnaire and reproducibility of specific items, based on question format. Questionnaire items of specific interest were those with dichotomous yes/no response options versus open-ended format questions, those using the words frequently or recently, or those that asked multiple questions. Demographic characteristics of the subjects were considered in the evaluation of reliability. Overall reliability of the questionnaire (93.6%) was above the anticipated level of 90%, and subject sex or program of study did not show any significant differences in reproducibility of responses. Although wording of questions did not affect item reliability, dichotomous format questions demonstrated a higher degree of reliability (96.4%) than the overall reliability of the questionnaire. Recommendations for enhancing the reliability of the questionnaire are based on item analysis and information gathered from interviews with subjects.

Adult↗
PubMed2004

Likert and Guttman scaling of visual function rating scale questionnaires.

PURPOSE: To test the assumptions underlying Likert scoring of visual function questionnaires. METHODS: Questionnaires were administered to 284 low-vision subjects by telephone. Each subject was administered two of four questionnaires: ADVS, NEI VFQ-25 plus supplement, expanded VAQ, and VF-14. RESULTS: Z-scores for cumulative frequency of using each rating category across subjects are not linear with rating category rank and items are not the same difficulty for any of the questionnaires. Guttmann coefficients of reproducibility ranged from 57% for the ADVS to 51% for the NEI VFQ-25. Cronbach alphas ranged from 0.92 for the VF-14 to 0.96 for the NEI VFQ; however, inter-item consistency coefficients ranged from 0.24 for the VAQ to 0.45 for the NEI VFQ. Likert scores were significantly correlated between instruments, ranging from 0.66 for NEI VFQ vs ADVS to 0.90 for the VF-14 vs. ADVS. CONCLUSIONS: The rating scales of all four questionnaires fail to satisfy Likert's assumptions. Also, ratings are probabilistic, rather than deterministic, which means that the Likert model is not valid for these questionnaires. However, Likert scores for all four instruments are intercorrelated, suggesting that they are monotonic with the latent subject trait distributed in the low vision sample.

Adult↗
PubMed1999

Parallel accounts? Discrepancies between self-report (diary) and recall (questionnaire) measures of the same sexual behaviour.

Questionnaires and diaries have complementary biases and advantages for obtaining information on sexual behaviour but self-completed sexual diaries have the advantage of reducing retrospective bias. In a validation study of homosexual behaviour, sexual diary counts and subsequent questionnaire estimates (together with ratings of the certainty of the estimates) referring to the same month are compared and the discrepancies analyzed. Main findings include: questionnaire data yield consistently higher average estimates than diary counts, but have the same ordinal profile; individual difference (diary-questionnaire) scores show that 55% of questionnaire estimates of acts are higher than diary counts, 20% are identical and 25% are under-estimates; discrepancies are differentially located in different sexual acts. Masturbation and fellatio are systematically over-estimated in questionnaires and anal intercourse without a condom is the major source of inaccuracies, but in different directions: active partners under-estimate and passive partners over-estimate the amount of highest-risk sex. A strategy of joint use is discussed.

Homosexuality, Male↗
PubMed2001

Assessment of total energy expenditure in a Chinese population by a physical activity questionnaire: examination of validity.

A physical activity questionnaire from which total daily energy expenditure (TEE) could be estimated was developed for adult Hong Kong Chinese subjects, and its reliability and validity examined. The questionnaire was based on questionnaires used in Caucasians, and adapted for local lifestyle after focus group meetings involving subjects of all age groups. The questionnaire was administered to 94 subjects, consisting of healthy adults, the elderly, and two patient groups (those with renal disease on continuous ambulatory peritoneal dialysis and those with cancer). Seventy-one subjects were reinterviewed within 14 days to test reliability. Validity was examined in 31 normal subjects by measuring the basal metabolic rate (BMR) by indirect calorimetry and multiplying by the physical activity level (PAL) obtained from published studies using the doubly labelled water method and also from FAO/WHO/UNU to obtain the TEE. The intraclass correlation coefficient of reliability rages from 0.7 to 0.8 for all subject groups. The mean estimated TEE from the questionnaire was not significantly different from the mean value derived from measured BMR x PAL. The mean bias ranged from an underestimation of 27 kcal to overestimation of 215 kcal. However, the limits of variability were wide. Age was inversely related to the energy expended for occupational activities, but was positively associated with energy expended in leisure activities. Women spent less energy on occupational and exercise activities, and more on caretaking activities. Those with disease were also less likely to participate in caretaking activities. We conclude that this questionnaire may be a useful tool for future studies where energy expenditure needs to be estimated in various settings in the Hong Kong Chinese population.

Aged↗
PubMed2002

A qualitative evaluation of questions and responses from five occupational questionnaires developed to assess exposures.

Questionnaires are increasingly being used in the workplace to assess exposures to chemicals and other agents. Although the literature contains much information on questionnaire design in general, little information is available on the challenges related to questionnaires applied to the occupational setting. Questionnaires on dry cleaning workers, nurses, farmers, car mechanics, and truck drivers were administered to a total of 25 people currently performing one of these jobs. After asking each question, the interviewer probed to identify the difficulties the respondents had in answering the questions. Overall, the respondents were able to answer the questions. Problems were found, however, with particular questions that reduced the effectiveness of the questionnaire. These included the use of unclear terms, questions open to multiple interpretations, difficult computational requirements (e.g., asking for averages for highly variable tasks), ineffective transitions between topics, and overlapping response categories. This type of testing is a crucial part of questionnaire development and can be used to effectively identify potential problems with questions and, therefore, improve them to enhance collection of higher-quality data for assessments of occupational exposures.

Humans↗