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PubMedDate not supplied

Physicians' use of medical knowledge resources: preliminary theoretical framework and findings.

The recurring decision of selecting among potential knowledge resources was modeled as a cost-benefit tradeoff, with associated observable features. Internal medicine and community family practice physicians (n = 228) completed a self-administered questionnaire designed to elicit reported use and cost-benefit features of nine knowledge resources. The subjects reported most frequent use of clinical colleagues, intermediate use of textbooks and journals, and least use of indexing systems. Resources' benefit-related qualities (extensiveness and credibility) were not related to reported use. In contrast, the model's access cost variables (availability, searchability, understandability, and clinical applicability) were significantly related to use. Results were generally favorable to the model's framework of knowledge resource selection. Multiple linear regression analysis suggested that physicians' use of clinical knowledge resources could be described by the physician's level of training, availability, applicability, and the resource medium (colleague, index, or text/journal).

Cost-Benefit Analysis↗
PubMed1996

Survey of infection in hospitals: use of an automated data entry system.

This paper describes an automated approach to data entry which substantially reduced time and effort involved in infection control surveillance within a large teaching hospital. As part of our involvement in the Second National Prevalence Survey of infection in hospitals, a hospital-wide prevalence survey of infection was carried out during January and February 1994. We simultaneously entered the results manually into an "in-house' database to enable analysis of data within the hospital. The prevalence survey was repeated during January and February 1995 using a paper questionnaire designed "in-house' and read automatically using a sheet-fed optical scanner. There was a substantial 17-fold decrease in data entry time using this method compared with manual entry. The new approach enabled more rapid analysis of surveillance data and feedback to hospital staff. If hospital clinical data is collected routinely in a format suitable for scanning, then potentially useful data could be rendered accessible. Automated data entry systems are invaluable in reducing time spent on data input and should be considered by all those involved in surveillance and audit. There would appear to be little hope in the near future of having all patient clinical data in an electronic format so that the prospects for scanning initiatives are excellent.

Cross Infection↗
PubMed2001

Mother and child perceptions of child functioning: relationship to maternal distress.

The relationship between maternal distress and mother's reports of psychosocial problems in their children has been well-documented. However, relatively little research has investigated the relationship between maternal and family distress and young children's perception of their own functioning. Using a brief questionnaire designed for use with children, data were collected from 166 mothers and their children aged 5-12 years. Children provided information about their own daily functioning, and mothers provided information about their own, their child's, and their family's psychosocial functioning. Findings indicated that while children generally agreed with the reports of their mothers, children of distressed mothers self-reported better daily functioning than their mothers did. Distressed mothers tended globally to report negatively about themselves, their child, and their family. The present findings suggest that when assessing mothers or children, the reports of children should be considered as well as the reports of mothers.

Adult↗
PubMed2002

Quality of life (Spain and France): validation of the chronic venous insufficiency questionnaire (CIVIQ).

A health-related quality of life (HRQOL) assessment is particularly necessary for patients with chronic venous insufficiency (CVI), as is an assessment of the objective signs (edema, dilated veins, ulceration and other lesions). A comprehensive 3-year research program was undertaken in France to construct and validate the Chronic Venous Insufficiency Questionnaire (CIVIQ), a questionnaire designed specifically to evaluate the quality of life for CVI sufferers. The next step was to implement a program of cross-cultural validation in several countries. Translation into Spanish was undertaken following international guidelines. Face validity was verified with a pilot test among 12 Spanish patients. Psychometric validation was performed in Spain (n = 476 patients with CVI). The Spanish CIVIQ demonstrated very good internal consistency, high reproducibility and responsiveness, as well as longitudinal clinical validity. It appears to be a valuable instrument for assessing improvement in patient quality of life in response to both therapy in clinical practice and clinical trials.

Chronic Disease↗
PubMed2001

Behaviour problems in children with dyslexia.

The association between behaviour problems and dyslexia was assessed in a population sample of 10- to 12-year-old children. Twenty-five dyslexic children and a matched control group were recruited through a screening in primary schools in the city of Bergen, Norway. For the assessment of behaviour problems the Child Behavior Checklist (CBCL), Teacher Self Report (TRF), and Youth Self Report (YSR) were filled out by parents, teachers, and children, respectively. Information on health and developmental factors were obtained from parents on a separate questionnaire designed for the study. The dyslexic group had significantly more behaviour problems than the control group according to both the CBCL and the TRF. On the YSR there was no significant difference between the groups. Dyslexic children had higher CBCL and TRF scores on the Total Behaviour Problem scale, the Internalizing and Externalizing subdomains, and the Attention problem subscale. The groups differed in social background, prenatal risk factors, birth weight, preschool language problems, and IQ, but these variables showed no relationship to the level of behaviour problems in the present sample. We conclude that pre-adolescent dyslexic children show a wide range of behaviour problems that cannot be attributed to social or developmental background variables.

Case-Control Studies↗
PubMed1984

Current tuberculosis screening practices.

Health department officials in all 50 states and 14 major cities responded to a survey questionnaire designed to obtain information about current tuberculosis screening practices. Persons being screened fell into the groups designated as high risk by the American Thoracic Society (ATS) and the Centers for Disease Control (CDC). The methods used for screening were generally those advocated by ATS, CDC, and the Food and Drug Administration (FDA), although chest radiographs continue to be overused. Screening in about one-half of the groups is mandated by law or regulation. There appears to be some confusion about the circumstances in which "two-step" tuberculin testing should be used. Data on the productivity and costs of screening activities were very limited. We encourage those responsible for tuberculosis screening programs to evaluate them, discontinue those which are unproductive, and intensify those which are productive.

Female↗
PubMed2005

Development and preliminary evaluation of a measure of support provided to a smoker among young adults.

Most studies indicate a positive association between social support and smoking cessation. However, clinic-based interventions to increase support for stopping smoking have had limited success. Prior research has emphasized the smoker's perceptions of support received for smoking cessation while less attention has focused on support persons' reports of supportive behaviors provided to a smoker. This study examined select psychometric properties of the Support Provided Measure (SPM), a self-report questionnaire designed by the investigative team to assess supportive behaviors provided to a smoker. The SPM was administered to a college sample (N=771; 67% female) of young adults, aged 18 to 24 years, who reported knowing a smoker whom they thought should quit smoking. Results indicate that, in this sample, the SPM has a two-factor structure with good internal consistency reliability (Cronbach's alpha=0.77) and appears to assess a wide range of individual differences in the provision of support. Demographic correlates associated with SPM scores are described and suggestions for future research are offered.

Adolescent↗
PubMed1998

Patient attitudes to glove use by orthodontists.

The aim of this study was to evaluate the awareness of orthodontic patients of the importance of glove wearing by orthodontists, and consisted of a patient completed questionnaire carried out at an orthodontic clinic in Ireland. The subjects were 194 consecutive patients [122 (63 per cent) female, 72 (37 per cent) male; mean +/- SD age: 15.5 +/- 2.2 years] attending an orthodontic clinic. They completed a questionnaire designed to determine their attitudes to the wearing of gloves by orthodontists. Most patients (97 per cent; n = 188) considered that orthodontists should routinely wear gloves. However, approximately 15 per cent of patients (n = 30) would attend an orthodontist who did not wear gloves. Ninety-four per cent (n = 182) of patients considered that gloves were worn to protect both the orthodontist and the patient. A total of 86.5 per cent (n = 168) of patients thought that the orthodontist should change gloves between patients. The overwhelming majority of patients surveyed demonstrated a strong awareness of the importance of glove wearing by orthodontists. The results suggest that many patients will not attend an orthodontist who does not wear gloves during treatment.

Adolescent↗
PubMed1984

Young diabetics: memories, current lifestyles and attitudes.

Eighty-six subjects aged 22.3 +/- 2.3 years (mean +/- S.D.), who attended one clinic as diabetic children, filled in a questionnaire designed to evaluate their present health and lifestyles, as well as discover their childhood memories. About two-thirds (66.3%) had unhappy recollections particularly of such irritating routines as urine testing, injections, and special food programmes. Only 6% complained that future complications were not discussed with the child at the appropriate time, but with the exception of blindness, childhood knowledge of diabetic complications was poor. Around two-thirds (66.4%) left school with some examination result; 44.2% went into further education, while 19.8% entered into a trade. These attainments were comparable to those of local school leavers. As young diabetic adults, 62.8% were employed; 22.1% were students or housewives with no other occupations.

Adolescent↗
PubMed1997

Endicott Work Productivity Scale (EWPS): a new measure to assess treatment effects.

The Endicott Work Productivity Scale (EWPS) is a brief self-report questionnaire designed to enable investigators to obtain a sensitive measure of work productivity. The total score is based on the degree to which behaviors and subjective feelings or attitudes that are likely to reduce productivity and efficiency in work activities characterize the subject during the week before evaluation. The total score was found to be reliable and valid within a group of depressed outpatients and a group of nonpatients in the community. The EWPS score is related to, but not redundant with, measures of overall severity of illness and severity of depression in these samples. The EWPS shows considerable promise as an easily used, brief, and sensitive measure for assessing the effects on work performance of various disorders and the efficacy of different therapeutic interventions.

Dysthymic Disorder↗
PubMed1986

Trends in activity-limiting chronic conditions among children.

Data from the National Health Interview Survey indicate that the prevalence of activity-limiting chronic conditions among children under age 17 years doubled between 1960 and 1981, from 1.8 to 3.8 per cent. Approximately 40 per cent of the overall rise in prevalence occurred before 1970. Most of the increase in prevalence during this early period can be attributed to changes in questionnaire design and aging of the child population following the "baby boom" years. The factors responsible for increases in reported cases of activity limitation following 1970 are more difficult to specify and evaluate. During this later period, the increase in prevalence was restricted to less severe levels of limitations. While prevalence levels rose for a variety of conditions during this period, respiratory conditions and mental and nervous system disorders demonstrated the largest changes. It appears that much of the increase in reported cases of activity limitations during the 1970s can be attributed to shifting perceptions on the part of parents, educators, and physicians.

Activities of Daily Living↗
PubMed1990

What dental phobics say about their dental experiences.

Previous surveys have indicated that there is a substantial proportion of dentally anxious individuals in the general population. Many of these individuals avoid contact with dentistry as much as possible, while fearful individuals who present themselves for treatment are probably too uncomfortable or too afraid to make their views known. Consequently, a study of the feelings and attitudes of a group of dental phobics was carried out as part of a larger study of the efficacy of psychological treatments for excessive dental anxiety. The subjects were recruited by means of a newspaper advertisement and asked to complete a questionnaire designed to obtain information regarding their dental experiences and attitudes. Twenty-three individuals provided enough data for analysis. They were distributed widely in terms of age, education, income levels, and general fearfulness. They reported less satisfaction with the level of understanding or acceptance found in the last dentist they had seen than with the dentist's level of technical competence and the diagnostic information they received. Dental phobics who had been to a dentist in the past year were generally more satisfied with their dentist than those who had not. It is suggested that a good dentist-patient relationship based on understanding and acceptance is an important factor in overcoming the avoidance of fearful patients.

Adult↗
PubMed2003

Job satisfaction among mental health professionals in Rome, Italy.

Although various surveys on job satisfaction have been performed in mental health care settings, no studies have investigated in-depth the level of satisfaction with the various aspects of work in Italian mental health services. In the present study, all clinical mental health staff working in a large psychiatric catchment area in Rome were invited to anonymously complete a previously validated questionnaire designed to measure job satisfaction among mental health professionals. Of the total 236 health professionals, 196 (83%) agreed to participate. Most participants were not completely satisfied with many aspects of their job, and many were not even moderately satisfied. The level of satisfaction increased with age, and it was significantly lower among hospital-ward staff compared to the staff of outpatient clinics or residential facilities, even after adjusting for age, gender, profession, work setting, and time in current job, using a multiple logistic regression model. Our findings suggest that interventions aimed at increasing job satisfaction among Italian mental health professionals might be warranted, particularly among hospital-ward staff.

Adult↗
PubMed1986

Patient education before discharge from the hospital.

Hospitalized patients' perception of their physician's effectiveness as a patient educator was surveyed, using three basic areas of doctor-patient communication: diagnoses, medications, and follow-up plans. The survey instrument, a questionnaire designed and administered by medical students, was designed to ascertain (1) the patients' satisfaction with their hospital stay, (2) satisfaction with their physician as a patient educator, (3) any correlation between (1) and (2), and finally (4) specific data about the amount and kind of information that patients perceived had been transferred from their physician. Satisfaction with their doctor as a patient educator was not a good predictor of satisfaction with the hospital stay. Results are compared with those of a similar survey published in the British medical literature. The effectiveness of the resident physicians as patient educators increased as they were given more information about the exact content of the survey. Their increased effectiveness did not clearly persist during a later follow-up period.

Consumer Behavior↗
PubMed2002

The Guy's Neurological Disability Scale in patients with multiple sclerosis: a clinical evaluation of its reliability and validity.

OBJECTIVE: To establish reliability and validity of the Guy's Neurological Disability Scale (GNDS) for the assessment of patients with multiple sclerosis (MS) and to investigate whether it can be used by postal questionnaire. DESIGN: An observational study assessing one group of 22 patients using the GNDS face-to-face, repeating the assessment two or three weeks later with other tests; and assessing a second group of 21 patients first using a postal version of the GNDS and then seeing them face-to-face. SETTING: Patients in the community attending a day centre or a voluntary support group. SUBJECTS: Patients with multiple sclerosis. MEASURES: The GNDS was the primary measure, and was compared with the Barthel Index, the Expanded Disability Status Scale (EDSS), the Short Orientation Concentration and Memory Test, the Nine-hole Peg Test, the Rivermead Mobility Index, the Hospital Anxiety and Depression Scale, the Fatigue Severity Scale, visual acuity assessment, swallowing 50 ml of water, and a clinical assessment of dysarthria. RESULTS: The test-retest reliability of the GNDS total score (r= 0.972) and each of its components (r varied from 0.685 to 0.987) was good. When compared with the EDSS or the Barthel, the GNDS had good validity (respectively r = 0.636 and r = -0.757). The validity was also measured for the different areas of the GNDS by comparison with corresponding indices or test. The results varied from good to excellent (r from -0.557 to 0.910). The results were only a little less reliable when a postal questionnaire was used. CONCLUSION: The GNDS is a valid and reliable tool for the assessment of MS patients. The test-retest correlation varies from good to excellent. It can be used as postal questionnaire even if, as expected, the interviewer-administered method shows slightly better results.

Adult↗
PubMed1999

Perceived control, autonomy, and self-regulated learning strategies among Japanese high school students.

This study investigated relations among measures of perceived control, autonomy, and self-regulated learning strategies for 228 junior high school (90 in Grade 7 and 138 in Grade 8) and 306 senior high school (184 in Grade 11 and 122 in Grade 12) students. Participants completed three self-report questionnaires designed to measure control beliefs, strategy beliefs, capacity beliefs, seven types of motivation, and two types of self-regulated strategies. Confirmatory factor analysis identified the structure of perceived control modeled by Skinner, Chapman, and Baltes (1988), the seven-factor structure of autonomy by Vallerand, Pelletier, Blais, Briere, Senecal, and Vallieres (1992, 1993), and the two types of self-regulated learning strategies by Pintrich and De Groot (1990). Significant "grade" differences were obtained in several measures. Canonical correlation was used to investigate the relations between perceived control and autonomy measures. Finally, multiple regression analysis was used to investigate the relations between perceived control and self-regulated learning strategies and between autonomy and self-regulated learning strategies. Implications of the results are presented.

Adolescent↗
PubMed1999

Current followup strategies after radical prostatectomy: a survey of American Urological Association urologists.

PURPOSE: Followup care of men who have undergone potentially curative surgical treatment for prostate cancer varies widely among clinicians. To determine current practice patterns we mailed a custom designed questionnaire to American and nonAmerican urologists who were American Urological Association (AUA) members. MATERIALS AND METHODS: Surveys were mailed to a random sample of the approximately 12,000 AUA members, comprising 3,205 Americans and 1,262 nonAmericans. Evaluable surveys were returned by 760 American (24%) and 290 nonAmerican (23%) urologists. Our analysis is based on these 1,050 responses. RESULTS: In generally healthy patients after radical prostatectomy for stages T1 to 2NOMO and T3a to cNOMO prostate cancer the most frequently recommended followup diagnostic tests included office visit with digital rectal examination, serum prostate specific antigen (PSA) and urinalysis. Although there is appreciable variation in the frequency of use of these methods, respondents generally recommended office visit with digital rectal examination, serum PSA and urinalysis every 3 months in year 1, every 6 months in years 2 to 5 and annually thereafter. Other tests, such as serum prostatic acid phosphatase, bone scan, and abdominal and pelvic computerized tomography and magnetic resonance imaging, are rarely recommended. CONCLUSIONS: Our survey provides information regarding current followup strategies recommended by AUA urologists after radical prostatectomy for stages T1 to 2NOMO and T3a to cNOMO disease. Office visits and digital rectal examination, urinalysis and PSA measurement are the main tools that urologists currently use. Although optimal strategy remains unknown, these data permit the rational design of clinical trials of alternate followup strategies based on actual current practice to answer this important question.

Adult↗
PubMed2004

Evidence-based medicine teaching in the Mexican Army Medical School.

Training of medical students must include the skills necessary to use advances in scientific research. Evidence-based medicine (EBM) has been incorporated in undergraduate programs in several countries, a process that has not been well studied in developing countries' medical schools. An EBM course was incorporated into the curriculum of the Mexican Army Medical School. In the first year of its implementation it was given to half the fifth- and sixth-year groups. At the end of the semester, a previously validated questionnaire designed to evaluate the effectiveness of EBM teaching was administered. In total, 67 students took the course and 64 did not. A significant increase in the self-assessment of critical appraisal skills and the self-reported use of the Cochrane Library were found. There was a significant increase in the attitudes score, 22.9 +/- 5.9 (mean +/- SD) in the non-EBM group vs. 28.8 +/- 3.2 in the EBM group (p < 0.001), and a trend towards higher scores in the knowledge domain, 1.89 +/- 3.3 in the non-EBM group vs. 2.56 +/- 3.6 in the EBM group (p > 0.05). EBM concepts can be taught in a developing country medical school, with a short-term gain in attitude and probably in knowledge.

Competency-Based Education↗