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PubMed1998

A plastic surgery literature review to assist in the management of patients seeking elective esthetic dental treatments.

This article reviews plastic surgery literature to help identify and manage the risk presented by patients interested in elective esthetic dentistry whose physiologic profile would compromise the success of the procedure. A questionnaire, designed to help identify patients with problematic physiologic profiles, is presented. In addition, risk management techniques adapted from the plastic surgery literature are reviewed.

Attitude↗
PubMedDate not supplied

Religious beliefs and practices in family medicine.

OBJECTIVES: To determine whether the religious beliefs and behaviors of family medicine outpatients differed from those of their physicians and whether patients' religiousness affects their expectations of their physicians regarding religious matters. DESIGN: A survey study was performed on a consecutive sample of 380 family medicine clinic outpatients and 31 family medicine faculty and residents in 2 family medicine residency programs. SETTING AND SUBJECTS: Outpatients were recruited from an outpatient clinic of a family medicine residency program in North Carolina. Family medicine physicians and residents were recruited from this program and another in Texas. MAIN OUTCOME MEASURES: Scores were obtained from the Springfield Religiosity Scale, the Hoge Intrinsic Religiosity Scale, and a religious beliefs questionnaire designed for this study. RESULTS: Absence of religious affiliation was more common for physicians than patients. Physicians were less likely than patients to pray privately and less likely to hold intrinsic religious attitudes. Patients were more likely than physicians to be interested in their own physician's religious beliefs, more likely to feel that they should know their physician's religious beliefs, and more likely to want their physician to pray with them under certain circumstances. When sex and age were controlled, some of these differences disappeared. When compared with patients, physicians tended to be younger and male--characteristics inversely associated with religious belief and practice. Regardless of sex or age, however, the more religious the patients, the more likely the desire to know their physician's religious beliefs and share their own religious beliefs. CONCLUSIONS: Patients are more involved in religious beliefs and practices than physicians, a finding partially explained by age and sex. The more religious the patients, the more important it is for them to know their physician's beliefs, share their beliefs with their physician, and want their physicians to pray with them.

Adult↗
PubMed1995

A brief, telephone-administered food frequency questionnaire can be useful for surveillance of dietary fat intakes.

A 13-item questionnaire designed for quick telephone administration was evaluated for use in surveillance of fat intake in the United States. Study populations included 560 middle-aged and older adults from Beaver Dam, WI, 252 middle-aged and older women from Wisconsin, 73 young, low income Hispanic women from Chicago, IL, 52 older adults from Arizona and 135 younger adults from Augusta, GA. Correlations between fat scores and fat intakes measured by multiple food records or recalls or by more extensive food frequency questionnaires ranged from 0.33 to 0.60, similar to results from other published questionnaire validation studies. Correlations with percentage of energy from fat were lower (0.26 to 0.42), except for the Chicago population, for which there was no correlation (-0.02). There was no systematic variation in correlations among other subgroups defined by demographic and health-related characteristics, including race (black vs. white). Most, but not all, of the substantial differences in fat intakes among subgroups were identified by the questionnaire. The questionnaire will not capture small differences in intakes among groups and is inappropriate when the sample size is limited or for populations with diets substantially different from the typical U.S. diets, such as the Chicago population. However, with attention to its limitations, the questionnaire is useful for surveillance.

Adolescent↗
PubMedDate not supplied

Strengthening patient-provider relationships.

In support of the Veterans Health Administration commitment to the promotion of shared decision-making between providers and patients, this study investigated the relationship between the provision of a patient appointment guidebook, designed to promote and support patient participation in the health care visit, and patient perceptions of primary care visit effectiveness. This study compared perceptions among 277 randomly selected patients randomly assigned to one of two groups. Patients assigned to an intervention group received a patient appointment guidebook along with the standard appointment reminder letter prior to the scheduled routine visit. Patients assigned to a control group received only the standard appointment reminder letter. Patient perceptions were assessed with a follow-up questionnaire designed to measure patient agreement with six statements pertaining to primary care visit effectiveness. No significant differences were noted in the proportion of patients in the two groups that agreed with any of the six statements pertaining to primary care visit effectiveness. Significant differences were noted, however, in the proportion of patients in the groups who received preventive health care interventions of influenza vaccination, pneumococcal vaccination, and gender-specific cancer screening. Approximately 37% of the patients in the intervention group provided positive comments about the patient appointment guidebook, while only 7% provided negative comments. Although statistically inconclusive, the narrative comments indicate that a patient appointment guidebook may assist veterans in preparing for primary care appointments. The lack of significant difference between the two groups on the measures of primary care visit effectiveness may be due, in part, to positive perceptions among the sample in general, as reflected by high levels of agreement and predominantly positive comments for both control and intervention groups.

Appointments and Schedules↗
PubMed2003

Relevance and speed of message delivery trade-offs in augmentative and alternative communication.

This report is the first in a series of investigations designed to test a theory identifying the effects of conversational trade-offs between selected maxims on public attitudes toward augmentative and alternative communication (AAC) system users and their communication. In the current study, the trade-offs between the relevance of a prestored message and its speed of delivery were examined. Participating were 96 sales clerks. Twelve scripted videotaped conversational conditions, involving an AAC customer and a clerk at a checkout counter, were used to manipulate message relevance, speed of message delivery, and participant/AAC user gender. Following each assigned viewing, participants completed a questionnaire designed to assess their attitudes toward the AAC user and his or her communication. Significantly higher mean ratings were found for the conditions involving the slowly delivered relevant messages (both preceded by a conversational floorholder and without a floorholder) when compared to the quickly delivered partly relevant message condition. In addition, the condition involving the slowly delivered relevant message with a floorholder yielded significantly higher mean ratings than that without the floorholder. There was no effect for participant/user gender. Modifications of the theory and technological implications are discussed.

Adolescent↗
PubMed2005

[Method and design of the Telephone Health Survey 2003].

Telephone surveys are increasingly being used in public health research, also in Germany. In 2003 the Robert Koch Institute completed the first nationwide telephone survey predominantly on conditions and prevalence of selected chronic diseases (GSTel03). Its findings are presented in this publication. The tasks of planning, implementation and realization of procedures used in telephone surveys differ in many aspects from other modes of data collection. This article deals with the most important methodological aspects that were implemented and used in the course of the GSTel03 to ensure a high level of data quality. These include sample design, questionnaire development and the process of data collection (including the recruitment and training of the staff). Finally steps of data preparation for analysis including weighting procedures are described and calculation of contact and cooperation rates are reported.

Data Interpretation, Statistical↗
PubMed1996

Survey of patient satisfaction in a community hospital.

To assess the satisfaction with the department and hospital services provided by a medium-size community hospital during a 2 month period (April-May 1995), 118 randomly chosen patients were asked to complete a questionnaire designed to reflect their opinions during hospitalization. The principal points of the survey concerned the general perception regarding the services in the department and the hospital, the admission and discharge procedures, the quality of food and sanitary conditions, an evaluation of the physicians' and nurses' skill and attitude, as well as their compliance to patients' needs. Overall satisfaction with the medical care was very high, the physicians' attitude and nurses' compliance being the two most important determinants. The role of this type of questionnaire as an instrument for improving health services is emphasized.

Adult↗
PubMed2005

Use of bio-resorbable implants for stabilisation of distal radius fractures: the United Kingdom patients' perspective.

Bio-resorbable implants have been, recently, introduced in the United Kingdom. To our knowledge there have been no randomised studies to assess perception of today's well-informed patients about this new method of fracture stabilisation. In order to assess the patients' perception a prospective study was performed on 100 consecutive adult patients with distal radius fractures. Following detailed verbal and written information about both resorbable and metal implants, the patients were asked to complete a specifically designed questionnaire. Ninety-five percent of the patients appreciated the 'resorbable' feature and responded that they would prefer to have their fracture stabilised with a resorbable implant. Conversely, 91% of the participants considered removal as the most negative aspect of the metal implant (p<0.0001). While 56% of the patients felt that it was relatively a new and evolving technology, 29% of them had apprehension about the relative strength of the resorbable implant. Eighty percent of the patients stated that they would be happy to participate in clinical trials to compare the use of bio-resorbable implants versus metal ones (p=0.0001). This study sets the foundation for the implementation of prospective randomised trials to assess the efficacy of the new generation of bio-resorbable implants.

Absorbable Implants↗
PubMed2006

A questionnaire study for 128 patients with Gaucher disease.

Gaucher disease is an uncommon autosomal recessive disorder characterized by lysosomal storage of glucosyl ceramide, a material released during cell degradation. Patients with Gaucher disease often have significant hematologic, bone structural, and visceral problems which sometimes greatly affect their health and life style. Based on some extraordinary scientific discoveries over the past 45 years, a treatment system has evolved which consists of administration of an enzyme, which destroys the lysosome-stored material and to some extent restores the patients to good health. There are still some problems for these patients; however, and the purpose of the study is to define some of the clinical, sociologic, and psychologic problems with a specially designed questionnaire. Questionnaire data was collected for 128 patients from two institutions with complete anonymity, and the information compared against data from a National Health Interview Survey. The results show that many of the patients still have fairly extensive problems, which could possibly be helped by some alterations in treatment protocols.

Adolescent↗
PubMed1976

Development and application of an index of social function.

Brief indexes of social function were constructed in a project to develop a health index questionnaire designed to measure the social, emotional, and physical function of free-living populations. The social function items have been found to be generally applicable, capable of application by lay interviewers, and acceptable to interviewees. Initial evaluations to form composite scores for social function items have demonstrated their validity against concurrent assessments of a health professional. These social function indexes have been successfully applied in two randomized trials of innovative primary care services. The criteria for inclusion of items in the social function index questionnaire, the generation of the instrument, and the evaluation of questionnaire responses for their validity are summarized here.

Attitude to Health↗
PubMed2003

[Gastro-oesophageal reflux disease presenting as laryngeal pathology--epidemiology, symptoms, diagnosis. Preliminary report].

UNLABELLED: Symptoms from the ears, throat, nose and larynx--the laryngeal mask's manifestations of gastroesophageal reflux disease (GERD) are important clinical problem of significant occurrence. AIM: (1) Determination of GERD's frequency of occurrence, especially within the group of patients with the pathology of the posterior laryngeal commissure. (2) Evaluation of the effective algorithms for detecting and management of patients demonstrating symptoms of laryngeal mask, which develop on the ground of gastroesophageal reflux disease. The investigation included 9 patients who were hospitalized in the Department of Otolaryngology of Karol Marcinkowski University of Medical Sciences in Poznań. Every patient was carefully interviewed by means of 3 questionnaires: the first one being Karlsson's general questionnaire, the second one--author's questionnaire designed in the Department of Otolaryngology of Medical Academy in Poznań which emphasises laryngeal symptoms; and the third one being the inquiry including serious past diseases, regularly taken medications, and stimulants. The objective condition of the hypopharynx and larynx was estimated on the basis of indirect laryngoscopy, followed by manometric examination of the oesophagus and 24-hour pH-metry carried out in Motility Laboratory of Surgical Department. 8 patients (88.9%) out of 9 were diagnosed as having GERD on the ground of the questionnaires as well as on the base of the results from the 24-hour pH-metry, and among 7 patients (87.5%) out of the 8 motility disfunction of the oesophagus was detected. Within the group of 8 patients with diagnosed GERD on the ground of additional tests 3 patients (37.5%) were diagnosed as having posterior laryngitis, 2 patients (25%) were diagnosed as having chronic laryngitis and the last 1 (12.5%) suffering from dysphagia. Among 3 patients (37.5%) with tumors of the larynx of rare location within the posterior laryngeal commissure coexistence of gastroesophageal reflux disease (GERD) was proved. The remaining 1 patient (11.1%) with the larynx cancer had no confirmation of GERD. The connection between chronic laryngitis and gastroesophageal reflux disease and/or motility disfunction of the oesophagus described in the literature was confirmed within the group of examined patients. Awareness of GERD and diagnostics carried out in that direction is needed in the group of patients with typical symptoms of the laryngeal mask. Significant frequency of coexistence of gastroesophageal reflux disease and pathology of the posterior laryngeal commissure requires effective algorithms for management of these patients.

Chronic Disease↗
PubMed2004

Preference for insulin delivery systems among current insulin users and nonusers.

BACKGROUND: It is not known whether preferences for the vial and syringe (VS) or the insulin injection pen device (IIPD) differ between current insulin users and nonusers. Additional benefits in treatment might be realized if preference were considered when discussing insulin use with patients initiating or changing insulin treatment. OBJECTIVE: The objective of this study was to examine respondent preferences for the VS and the IIPD between current insulin users and nonusers. METHODS: US residents with type 1 or 2 diabetes mellitus who responded to a year-2001 mail survey completed a 19-item self-administered questionnaire designed to assess respondents' expectations of attributes related to the VS and IIPD. Items were analyzed on a 5-point Likert-type scale with higher scores indicating greater agreement that attributes met expectations. Composite scores for ease of use, activity interference, and social acceptability were used to further examine differences between insulin users and nonusers regarding their preferences for the VS or IIPD. Observed differences in preferences were evaluated statistically using the chi-square test, paired Student t test, and regression analysis. RESULTS: Questionnaires were received from 302 respondents, producing an adjusted response rate of 20.8%. Respondents ranged in age from 18 to 83 years (mean [SD], 52.4 [13.2] years), with 62% reporting annual income above 25,000 US dollars. Of the 242 usable responses, 99 respondents were insulin users and 143 were not. Statistical evaluation using analysis of variance revealed significant regression coefficients (P < or = 0.001) for both insulin users and nonusers for each of the 3 dimensions (ease of use, activity interference, and social acceptability with respect to preference). CONCLUSIONS: Based on this survey analysis, overall preference for the IIPD appeared to be higher compared with the VS among both insulin users and nonusers. Social acceptability was the strongest predictor of preference for the IIPD. For current insulin users, social acceptability and ease of use were significant predictors of preference for the VS. For insulin nonusers, these results suggested that patient discussions about VS should emphasize activity interference and ease of use.

Adolescent↗
PubMed2005

Validation of a questionnaire for the detection of cluster headache.

BACKGROUND: In the absence of biological markers, the diagnosis of cluster headache (CH) rests on clinical evidence as reported through ad-hoc interviews. OBJECTIVE: The aim of this study was to validate a 16-item self-administered questionnaire designed to screen CH cases. METHODS: The questions were based on the second edition of the International Headache Society classification (ICHD-II) criteria for CH (n = 12) and on specific disease features (n = 3). Answers to each question were either "Yes,""No," or "Don't know." The validity of this screening tool was assessed using a two-step procedure. In Step 1, the 16 questions were submitted to 30 healthy subjects with different cultural backgrounds to verify content clarity. In Step 2, the questionnaire was given to 71 patients (32 women and 39 men) aged 15 to 78 years (mean 37.5 years), who were seen at the University of Parma Headache Center with a diagnosis of CH (episodic, 17; chronic, 13), migraine (without aura, 18; with aura, 3), and tension-type headache (episodic, 16; chronic, 4) according to the ICHD-II criteria. Sensitivity, specificity, and the positive and negative predictive values were calculated for each question as measures of validity. RESULTS: Severity, unilaterality, and location of pain had the highest sensitivity (100%), but low (34.1%) or fairly low specificity (61.0% and 58.5%, respectively). In contrast, a positive response to lithium or verapamil had a 66.7% sensitivity and a 97.6% specificity. Sensitivity and specificity were 100% and 90.2% for duration of attacks (<180 to 240 minutes), and 90.0% and 92.7% for compulsory movements, respectively. The best discriminatory pattern for symptom detection was unilaterality of pain and the presence of at least five of the following seven features: pain severity and location, duration, frequency and daily recurrence of attacks, rhinorrhea and restlessness as accompanying symptoms. CONCLUSIONS: Our findings confirm that this questionnaire is a useful method for CH screening in epidemiological studies.

Adolescent↗
PubMedDate not supplied

Family satisfaction and affect of men and their wives after myocardial infarction.

OBJECTIVE: To describe (1) the affect of patients who have had a myocardial infarction and their spouses during hospitalization, (2) the correlation between patient and spouse on affect and satisfaction with family function, and (3) the relationship between satisfaction with family function and affect for both patient and spouse. DESIGN: Descriptive, correlational, cross-sectional. SETTING: Five hospitals in the Delaware Valley: four were community based and one was a university medical center. PATIENTS: Thirty-five couples who were married and living together. Patients were men with a diagnosis of myocardial infarction without renal, vascular, cerebral, or pulmonary complications who had been transferred from the cardiac care unit before being discharged. MEASURES: The patient completed the medical and demographic data form. Both patient and spouse completed the Family APGAR, a five-item questionnaire designed to give a rapid overview of satisfaction with the functional status of either a nuclear or alternative lifestyle family, and the Affects Balance Scale, a 40-item adjective mood scale that measures positive affect states, negative affect states, and the balance between them. RESULTS: Both patients and spouses experienced considerable negative affect and reduced positive affect during hospitalization when compared with the norms for nonclinical subjects. Patients and spouses were highly correlated on both measures, particularly for satisfaction with family function and positive affect (p < 0.01). Positive affect and satisfaction with family function were significantly positively correlated for spouses (p < 0.05). Additionally, it was found that both patients (p = 0.001) and spouses (p = 0.032) who were married longer were more satisfied with family function and that older patients reported more positive affect (p = 0.023). CONCLUSIONS: Both male patients who have had a myocardial infarction and their spouses experienced considerable emotional distress during hospitalization, with the implications that assessment should focus on the family unit as well as the individual and that interventions be directed toward emotional as well as physical symptomatology. The results of this study also suggest that female spouses with lower satisfaction with family function and younger male patients may be at greater risk for higher levels of negative affect.

Affect↗
PubMed1989

Development and initial validation of a dual-language English-Spanish format for the Arthritis Impact Measurement Scales.

Language, cultural, and educational barriers complicate efforts to validate health status questionnaires that have been translated into Spanish. To overcome these problems, a prototype dual-language format was developed for the Arthritis Impact Measurement Scales. Validity testing with 72 patients diagnosed as having rheumatoid arthritis indicated high levels of test-retest reliability, item-to-scale internal consistency, and construct validity for both Anglo and Hispanic subjects. A technique for developing and pilot-testing a questionnaire written in a regional Spanish dialect is described. Linguistic considerations, questionnaire design, and other applications are discussed in light of the results obtained.

Arthritis↗
PubMed2001

Changes in public attitudes toward epilepsy in Hungary: results of surveys conducted in 1994 and 2000.

Our study investigated public attitudes toward epilepsy, and knowledge and understanding of epilepsy in Hungary. We compared changes of public attitudes in the last six years, hypothesizing a trend of positive changes because of recent national initiatives for acceptance and integration of people with epilepsy (e.g., participation of Hungary in the "Out of the Shadows" world campaign). We also studied how the demographic background of the respondents affects awareness, understanding, and attitudes toward epilepsy. Using a questionnaire design, we conducted a public opinion poll with a representative sample of 1,000 people in 1994 and 6 years later, in 2000. Hungarian respondents were most prejudiced regarding employment of people with epilepsy. In recent years, significant decreases in prejudice rates were found regarding all attitude aspects (marriage, children associating, work). Significant background effects of demographic variables were also apparent: differences by age, education, residence, and family status were found. Some culture-specific characteristics of understanding epilepsy could be observed. Significant positive attitude changes from 1994 to 2000 confirm the need for and potentialities of education of the public and informational initiatives. Demographic influences and culture-specific characteristics could be of relevance in designing public education for different target groups.

Adolescent↗
PubMed2006

Differences in characteristics of nocturnal enuresis between children and adolescents: a critical appraisal from a large epidemiological study.

OBJECTIVE: To evaluate any differences in the characteristics of primary nocturnal enuresis (PNE) between younger enuretic children and adolescents. SUBJECTS AND METHODS: In all, 21 000 questionnaires designed to determine the presence or absence of bed-wetting, diurnal incontinence, frequency of wetting, systemic illness, and family history, were sent to children aged 5-19 years from 67 kindergartens, primary schools and secondary schools randomly selected by a computer from different areas in Hong Kong. In addition, questions were asked to evaluate when and how the parents became aware that bed-wetting is a significant medical problem deserving attention in children after the age of 5 years. RESULTS: Of the 21,000 questionnaires distributed, 16 512 (78.6%) were completed. Among the respondents, 512 children (302 boys, 210 girls) had PNE; of these, 106 (20.7%) also had daytime incontinence. There was a marked reduction in the overall prevalence of PNE with advancing age. At 5 years old, 16.1% of children had PNE (20.7% boys, 10.8% girls; at age 9 and 19 years, 3.14% and 2.2% of children had PNE, respectively. However, this reduction was significantly more apparent among those with mild enuretic symptoms (wet <3 nights/week) than in those with more frequent bed-wetting. Furthermore, younger enuretic children behaved very differently from adolescents and older patients. As age increased there was a significant tendency towards more severe enuretic symptoms. At age 5 years, 14.3% of enuretic children wet 7 nights/week, compared with 48.3% at age 19 years (P < 0.001). In addition, significantly more adolescent boys aged >10 years had daytime urinary incontinence than had enuretic children aged < or = 10 years (32% vs 14.6%, respectively, P < 0.001). Most (89%) parents only became aware that bed-wetting was a significant medical problem deserving attention through material in the mass media over the past 3-4 years. CONCLUSIONS: The present finding suggesting that PNE spontaneously resolves with increasing age probably applies only to those with mild enuretic symptoms. There are significant differences in characteristics between younger enuretic children and older subjects. As age increases there is an increasing proportion of enuretic patients with more severe bed-wetting. Enuretic children aged >10 years and adolescents have significantly more daytime urinary symptoms and incontinence. The previously reported low prevalence of PNE in Hong Kong was probably due to parental indifference to the problem.

Adolescent↗
PubMed2006

Willingness to pay for drug abuse treatment: results from a contingent valuation study in Taiwan.

OBJECTIVE: In this study, we attempted to describe and justify the use of a contingent valuation (CV) method to elicit the willingness to pay (WTP) for a drug abuse treatment program by the general public in Taiwan. METHOD: In total, 1817 CV survey questionnaires were conducted through telephone interviews from randomly dialed numbers. Subjects were members of the general public aged between 20 and 65 years, with full-time jobs, and residing in the three major Taiwanese cities of Taipei, Taichung, and Kaohsiung. Respondents' WTP for drug treatment programs was elicited for two different financing mechanisms: payment through 'compulsory' payroll tax/health insurance premiums, and through 'voluntary' donations. The WTP was modeled as a function of scenarios and policies of the treatment program, respondents' socio-demographic information, and their responses to knowledge and attitudes questions. RESULTS: The general public in Taiwan was estimated to be willing to pay between NT$81.00 and NT$95.00 per month for a drug abuse treatment program, while the benefits of drug abuse treatment were estimated to range between NT$12.8 billion and NT$15.0 billion in 2004 (US$1=NT$31.9 in 2004), which was equal to around 0.15% of Taiwan's GDP for that year. The general public in Taiwan was more willing to pay for drug abuse treatment via increases in NHI premiums than via donations. Preferences for the drug abuse treatment program were also found to be sensitive to the target treated population as well as the sequence in which the WTP questions were asked. CONCLUSIONS: Results of this study provide policymakers with important evidence on the monetary value of a substance abuse treatment program, allocation of healthcare resources, and a possible financing mechanism of the treatment program, which may be justified by knowledge of the WTP of the general public. This study has also advanced the knowledge of the methodological issues with regard to CV questionnaire design, and it provides a base case for further studies on drug abuse in Taiwan.

Adult↗