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PubMed2006

Evaluation of cross-sectional and longitudinal construct validity of two vision-related quality of life questionnaires: the LVQOL and VCM1.

The Low Vision Quality of Life (LVQOL) questionnaire and the Vision-related Quality of Life Core Measure (VCM1) are two of the many vision-related quality of life (QOL) questionnaires that have been developed in recent years. Although psychometric properties of the LVQOL and VCM1 compare well with other vision-related QOL questionnaires, construct and longitudinal validity have not been assessed (adequately). The purpose of this study was to examine the cross-sectional and longitudinal construct validity of these questionnaires by testing specific pre-specified hypotheses about the relations of these questionnaires with other measures. The percentage of hypotheses regarding the cross-sectional construct validity that were refuted for the LVQOL was 22% for the basic aspects of vision subscale, 50% for the mobility subscale, 39% for the adjustment subscale and 17% for the reading and fine work subscale. For the VCM1 this percentage was 57%. For the longitudinal construct validity the percentage of hypotheses that were refuted ranged from 33 to 75% for the LVQOL subscales and was 50% for the VCM1. In conclusion, cross-sectional construct validity was satisfactory for the LVQOL subscales, but seemed poor for the VCM1. In addition, the longitudinal validity of these scales was poor to moderate.

Aged↗
PubMed2006

ISSQoL: a new questionnaire for evaluating the quality of life of people living with HIV in the HAART era.

OBJECTIVE: To design a Health-related Quality of Life (HRQoL) instrument for HIV-infected people in the era of highly active antiretroviral therapy (HAART). METHODS: The self-administered questionnaire was developed by an Italian network including researchers, physicians, people living with HIV, national institutions and community-based organizations (CBO) through several steps: (1) review of existing HRQoL literature and questionnaires for HIV-infected people; (2) selection of relevant domains measuring HRQoL in HIV-infected people, and identification of new domains related to new aspects of HRQoL concerning HAART-treated individuals; (3) conduction of two pre-test analyses in independent groups of Italian HIV-positive people (n approximately =100) distributed throughout the country. The objectives of the first pre-test were to verify the usefulness of the questionnaire, to construct a form easily understandable by everyone, to define the domains and their significance; the second pre-test aimed at evaluating and reshaping the questionnaire based on a statistical analysis of the outcomes of first pre-test; (4) validation analysis. A large cohort of people with HIV infection was recruited for the last step. RESULTS: The internal consistence reliability (Cronbach's alpha) was >or=0.70 for all domains. Most domains had Cronbach's coefficient >0.80. All domains demonstrated convergent and discriminant validity. The final version of ISSQoL includes two sections: HRQoL Core Evaluation Form (9 domains) and Additional Important Areas for HRQoL (6 domains). The ISSQoL was administered together with two additional forms: a Daily Impact of Symptoms Form and a Demographic Information Form. The Additional Important Areas for HRQoL include social support, interaction with medical staff, treatment impact, body changes, life planning, and motherhood/fatherhood. CONCLUSION: The data reported in the present paper provide preliminary evidence of the reliability and validity of the ISSQoL questionnaire for the measurement of HRQoL in HIV-infected people. The direct involvement of HIV-positive people in all the phases of the project was a key aspect of our work.

Adult↗
PubMed2003

Which questionnaires should be used in female urology practice?

The evaluation and treatment of female pelvic floor disorders is an evolving sub-specialty in urology. Recent attention has been directed toward more rigorous evaluation of treatment efficacy and durability of female urologic procedures. Throughout the past few decades, questionnaires have emerged as important subjective instruments for evaluation. Today, practitioners must choose from a burgeoning amount of questionnaires. This staggering number of questionnaires has raised two important issues: which questionnaire should be used in a female urology practice and should more refined criteria be developed for evaluating questionnaires to make the decision easier?

Fecal Incontinence↗
PubMed1993

Prosthetic profile of people with lower extremity amputation: conception and design of a follow-up questionnaire.

A questionnaire, the Prosthetic Profile of the Amputee (PPA), is described both in terms of its conceptualization and design. The objectives of the questionnaire (mail and telephone versions) were to evaluate and to determine the factors potentially related to prosthetic use by a person with a lower extremity amputation after discharge from rehabilitation. The PRECEDE theoretical model (Predisposing Reinforcing and Enabling Causes in Educational Diagnosis and Evaluation) was adapted to the present study and served as a guide for the conceptual basis of the instrument. A multidisciplinary group of 13 experts and another group of eight persons with lower limb amputation were involved in the identification, classification, and priority rating of the factors related to prosthetic use. The design of the questionnaire was structured according to Dillman's Total Design Method. To ensure the content validity of the instrument, the pertinence of each question with regard to the questionnaire's objectives was assessed by the group of experts. Pretesting of the questionnaire was then conducted with a random sample of 26 people with lower extremity amputations. The preliminary version of the instrument has already demonstrated the potential for clinical and research use.

Activities of Daily Living↗
PubMed1995

Questionnaire based exposure assessment methods.

In environmental epidemiological studies, questionnaires may be the method of choice for assessing exposure because no other source of information is available, or because they provide the most efficient study design, allowing a larger study size and greater statistical power than would be possible with other more accurate measurement techniques. Problems may arise from a lack of content validity (the questionnaire does not cover all sources of exposure to the hazard of interest) or criterion validity (e.g., through inaccurate recall or misunderstanding of questions). Methods for validating questionnaires are described. The usefulness of validated 'standard' questionnaires is discussed, particularly in regard to comparison of exposure patterns in various populations studied separately. It is stressed that the validity of standard questionnaires should not be automatically assumed when they are applied to populations other than those in which they have been tested.

Environmental Exposure↗
PubMed1994

Assessment of quality of life in adolescents with allergic rhinoconjunctivitis: development and testing of a questionnaire for clinical trials.

BACKGROUND: The objectives of the study were to evaluate impairment in quality of life in 12- to 17-year-old patients with seasonal allergic rhinoconjunctivitis and to develop and test a questionnaire suitable for evaluating change in quality of life during clinical trials. METHODS: Patients were asked to identify physical and emotional impairments associated with allergic rhinoconjunctivitis. The resultant questionnaire was tested for responsiveness and validity in a clinical trial in which fluticasone nasal spray and loratadine were compared for treatment of ragweed pollen-induced rhinoconjunctivitis. Eighty-three patients, 12 to 17 years of age, with grass- or ragweed-induced hayfever participated in the instrument development phase. They were recruited for the study from an allergy clinic and local schools and recreational organizations. Two hundred forty patients with ragweed hayfever participated in the clinical trial and provided quality of life data. RESULTS: The survey showed that in addition to local symptoms, patients experienced impairment of quality of life because of systemic symptoms, activity limitations, and emotional and practical problems. The resultant questionnaire has 25 items in six domains. In the clinical trial responsiveness was demonstrated by the questionnaire's ability to detect change over time and differences between treatments. Construct validity was demonstrated by moderate to strong relationships between changes in diary symptom scores and quality of life. CONCLUSIONS: The items identified by 12- to 17-year-old patients were not identical to those previously identified by adults. This suggests that impairment of quality of life may not be the same in the two groups and that it is appropriate to have a questionnaire specifically designed for adolescent rhinoconjunctivitis clinical trials.

Activities of Daily Living↗
PubMed1991

A simple score and questionnaire to measure group changes in dietary fat intake.

BACKGROUND: A short 12-term questionnaire was designed to measure changes in the dietary intake of saturated and total fat among groups of people attending health promotion events. A simple score (the fat-habits score) derived from the questionnaire was compared with estimates of saturated and total fat intake (% total energy) estimated from a standard 180-item food frequency questionnaire of 105 children (less than 18 years) and 202 adults (greater than 18 years). RESULTS: The correlation coefficients for saturated fat intake and the fat-habits score were 0.60 (95% CI = 0.50 to 0.68) in adults and 0.54 (95% CI = 0.39 to 0.66) in children, and those for total fat and the fat-habits score were 0.46 (95% CI = 0.41 to 0.56) in adults and 0.40 (95% CI = 0.22 to 0.55) in children. Linear regression equations relating the fat-habits score to saturated and total fat were used to predict changes in fat intake in 12 children and 27 adults who completed both questionnaires 6 months apart. The differences between the predicted changes in saturated and total fat and the observed changes measured by the food frequency questionnaires were not significant (saturated fat: adults -0.3%, 95% CI = -1.3 to 0.7%; children -0.2%, 95% CI = -1.7 to 1.3%; total fat: adults -0.6%, 95% CI = -2.9 to 1.7%; children -0.4%, 95% CI = -2.8 to 2.0%). The study had a 90% power of detecting a difference between the predicted and the observed changes for saturated fat of greater than +/- 1.7% (adults) and +/- 2.5% (children), and for total fat of greater than +/- 3.9% (adults) and +/- 4.0% (children). Conclusion. Thus simple scores can be used to evaluate group changes in fat intake.

Adolescent↗
PubMed1988

Some methodological aspects of using postal questionnaires with the elderly.

Postal questionnaires are not usually recommended for use with the elderly. This paper describes a methodological study of the use of a postal questionnaire as a method of data collection with older subjects. In particular the problems of generating an adequate response rate, of non-response bias and response quality are addressed. It is shown that postal questionnaires can generate response rates in excess of 80% with older subjects. Questionnaire length was not associated with response rate. Non-response was highest amongst the older age groups suggesting that this method of data collection is subject to non-response bias, thereby understanding the effects of age. The format of question presentation was associated with both response rate and response quality. It is concluded that postal questionnaires are a useful and cost-effective way of collecting survey data from older subjects. In particular such techniques may be effectively employed as a method of routinely screening older people living in the community.

Aged↗
PubMed1975

The McGill Pain Questionnaire: major properties and scoring methods.

The McGill Pain Questionnaire consists primarily of 3 major classes of word descriptors--sensory, affective and evaluative--that are used by patients to specify subjective pain experience. It also contains an intensity scale and other items to determine the properties of pain experience. The questionnaire was designed to provide quantitative measures of clinical pain that can be treated statistically. This paper describes the procedures for administration of the questionnaire and the various measures that can be derived from it. The 3 major measures are: (1) the pain rating index, based on two types of numerical values that can be assigned to each word descriptor, (2) the number of words chosen; and (3) the present pain intensity based on a 1-5 intensity scale. Correlation coefficients among these measures, based on data obtained with 297 patients suffering several kinds of pain, are presented. In addition, an experimental study which utilized the questionnaire is analyzed in order to describe the nature of the information that is obtained. The data, taken together, indicate that the McGill Pain Questionnaire provides quantitative information that can be treated statistically, and is sufficiently sensitive to detect differences among different methods to relieve pain.

Adult↗
PubMed1994

Comprehensive evaluation of the Minnesota Leisure Time Physical Activity Questionnaire.

The accuracy of the Minnesota Leisure Time Physical Activity (LTPA) Questionnaire (a 1-year survey of non-occupational activity used in MRFIT) was studied in 78 men and women, age 20-59 years, by comparing survey results to the following measures obtained over a year's duration: six 48-hour physical activity records; fourteen 48-hour Caltrac accelerometer readings (Caltrac); 14 administrations of a 4-week version of the LTPA Questionnaire (FWH); 3 VO2peak determinations and percent body fat (% BF). The LTPA Questionnaire demonstrated: weak to moderate associations with % BF (r = -0.24) and with VO2peak (r = 0.47); a weak association with Caltrac readings expressed as MET.minutes.day-1 (r = 0.23); strong associations with corresponding activities reported on the FWH; and moderate associations with total and heavy activities reported in the physical activity record, but no associations with moderate and light activities. Furthermore, several types of LTPA were found to be either under-represented or not currently included in the Minnesota LTPA Questionnaire. It is concluded that although validation results were found to be quite good, several possible refinements were identified, which should improve the accuracy of the Minnesota LTPA Questionnaire in assessing habitual physical activity.

Adipose Tissue↗
PubMed1995

A semiquantitative food frequency questionnaire for use in epidemiologic research among the elderly: validation by comparison with dietary history.

A self-administered semiquantitative food frequency questionnaire including 75 food items and providing information on the habitual intake of 31 nutritional parameters, based on the intake of protein, fat, carbohydrate, fiber and 11 vitamins and minerals, was developed for use in epidemiologic research on chronic disease among the elderly, such as diabetes and cardiovascular disease. By means of detailed frequency and quantity questions, specifications of types of food, preparation methods and seasonal variation, the questionnaire was expected to be an improvement on existing instruments. The relative validity of the questionnaire was examined in 74 men and women, aged 50-75, by comparison with a modified dietary history. Systematic differences were absent or negligible for all nutrients, except vitamin C. Bias depending on the level of intake could be ruled out for all but seven nutrients. Pearson correlation coefficients for estimates from the questionnaire and dietary history were on average 0.71 (range: 0.65-0.78) and 0.66 (range: 0.36-0.81) for macronutrients, and vitamins and minerals, respectively. Classifying individual intake estimates into tertiles of the distribution for both methods, on average 62.4 and 54.7% of the intakes were categorized into the same tertile and 3.9 and 5.9% into the opposite tertile for macronutrients, vitamins and minerals, respectively. These results demonstrate an acceptable relative validity for this newly developed questionnaire, as compared to the dietary history method.

Aged↗
PubMed1995

The EORTC core quality of life questionnaire (QLQ-C30): validity and reliability when analysed with patients treated with palliative radiotherapy.

The EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) is designed to measure cancer patients' physical, psychological and social functions. The questionnaire is composed of multi-item scales and single items. 247 patients completed the EORTC QLQ-C30 before palliative radiotherapy and 181 after palliative radiotherapy. The questionnaire was well accepted with a high completion rate in the present patient population consisting of advanced cancer patients with short life expectancy. In addition, the questionnaire was found to be useful to detect the effect of palliative radiotherapy over time. The scale reliability was excellent for all scales except the role functioning scale. Excellent criterion validity was found for the emotional functioning scale where it was correlated with GHQ-20. Performance of the questionnaire was improved after the second evaluation as compared with the first. The present study shows that the EORTC QLQ-C30 is found to be practical and valid in measuring quality of life in patients with advanced disease.

Adult↗
PubMed1994

Simulated validation of a brief food frequency questionnaire.

Nutrient assessment by the brief 45-item food frequency questionnaire used in the New York State Cohort was simulated by reducing the food list and frequency-of-use categories of the extensive 131-food item semiquantitative questionnaire used in the Health Professionals Follow-up Study. As a validation of the brief questionnaire, daily nutrient intakes were calculated following simulation procedures for 127 men who completed the extensive questionnaire, and the values were compared with those from two 1-week diet records in the same population. Deattenuated correlation coefficients for 25 energy-adjusted nutrient values ranged from 0.12 for iron to 0.76 for vitamin C (mean, 0.26). The brief questionnaire appears reasonably effective in assessing relative dietary intakes of total fat, saturated fat, monounsaturated fat, carbohydrate, dietary fiber, carotene, vitamin C, calcium, potassium, and magnesium. Modest improvements in the correlations for most nutrients were seen when the number of frequency-of-use categories was increased. Correlations decreased when nutrient intakes were calculated using regression coefficients instead of a conventional nutrient database.

Adult↗
PubMed2004

Mothers misunderstand questions on a feeding questionnaire.

Feeding questionnaires have not consistently identified mothers' beliefs or behaviors associated with preschool children becoming overweight. One reason may be that mothers do not understand the constructs in the questions in the way intended by the developers of the questionnaire. This study assessed items on the Preschooler Feeding Questionnaire (PFQ)--a maternal questionnaire about feeding practices and beliefs relating to the weight status of preschoolers. Seven audio-taped interviews were conducted with African American mothers of 24-59 month-old children in Chicago enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children. Questions in the PFQ were interpreted by respondents to mean something other than what was intended. In particular, the constructs difficulty in child feeding, pushing the child to eat more, and using food to calm the child were present among the mothers but not captured by items on the questionnaire. Thus, qualitative interviewing could help to match the intention in asking a question with its interpretation by respondents. A mismatch may contribute to our low level of understanding about the causes of early obesity.

Adult↗
PubMed2006

Complementary medicine for alcohol dependence in Italian services: a mail questionnaire.

It is well known that Complementary Medicine (CM) is extensively used in western countries for the treatment of many afflictions. CM has been recently promoted in addiction treatment. To evaluate CM use in alcohol dependence we planned a mail questionnaire for Italian alcohol services. We sent out 612 questionnaires. Health services that were unable to respond to the questionnaire within a 20-day limit period were contacted by phone and if we obtained agreement to participate in the study the questionnaire was sent by fax. We obtained 312 (51.82%) completed questionnaires. Only 16.50% of Italian services use CM for alcohol dependence treatment and acupuncture is utilized more frequently than other methods (phytotherapy, homeopathy, etc.). In Italian alcohol services CM is identified as an instrument incorporated into traditional alcohol treatments (self-help groups, drug treatment, etc.) and not an alternative method. In fact, health services that use it as a principal method of treatment were a rare event in our study (1%). CM plays an integrated role with traditional forms of alcohol treatment in Italian alcohol services and this utilization could be useful to reduce drop-outs and improve alcohol treatment compliance.

Alcohol-Related Disorders↗
PubMed2004

Validation of a questionnaire measure of the relative reinforcing value of food.

The traditional method of measuring the relative reinforcing value of food provides subjects a choice of food and non-food alternatives, and defines the relative reinforcing value of food based on the allocation of responses for the two alternatives as the schedules of reinforcement for the alternatives change. Greater allocation of responses for one alternative versus another reflects the relative reinforcing value of the alternatives. This method was designed for laboratory use, but methods are needed to extend measurement of reinforcing value to applied research environments. Two experiments were conducted to assess the validity of a questionnaire measure of the relative reinforcing value of food in normal weight university samples. Study 1 (n=39) assessed the relationship between the relative reinforcing value of snack food versus fruits and vegetables (condition 1) or enjoyable sedentary behaviors (condition 2) as measured by the questionnaire and standardized computerized concurrent schedules criterion. A significant relationship (Pearson r=0.49, p<0.01; Guttman's MU2=0.69) across the two conditions between the two methods of measuring food reinforcement was observed. Experiment 2 (n=10) utilized a within-subject counterbalanced design to manipulate food deprivation and hunger levels to determine if food deprivation increased the reinforcing value of snack food as measured by the questionnaire to provide an index of validity of the questionnaire. Results showed that food deprivation increased the relative reinforcing value of snack food. Results from both studies suggest that the questionnaire has good validity, and may represent an efficient and reliable method of assessing the relative reinforcing value of food.

Adolescent↗
PubMed2005

The development of the EORTC QLQ-C15-PAL: a shortened questionnaire for cancer patients in palliative care.

This study aimed at developing a shortened version of the EORTC QLQ-C30, one of the most widely used health-related quality of life questionnaires in oncology, for palliative care research. The study included interviews with 41 patients and 66 health care professionals in palliative care to determine the appropriateness, relevance and importance of the various domains of the QLQ-C30. Item response theory methods were used to shorten scales. Patients and health care professionals rated pain, physical function, emotional function, fatigue, global health status/quality of life, nausea/vomiting, appetite, dyspnoea, constipation, and sleep as most important. Therefore, these scales/items were retained in the questionnaire. Four scales were shortened without reducing measurement precision. Important dimensions not covered by the questionnaire were identified. The resulting 15-item EORTC QLQ-C15-PAL is a 'core questionnaire' for palliative care. Depending on the research questions, it may be supplemented by additional items, modules or questionnaires.

Activities of Daily Living↗
PubMed2006

Development of a disease-specific Quality of Life questionnaire module for patients with gastrointestinal neuroendocrine tumours.

Quality of life (QoL) measurements are increasingly being used as an end point in cancer clinical trials. Standard generic QoL questionnaires may not assess symptoms produced by neuroendocrine tumours. Here we report the development of a disease-specific quality of life score questionnaire for patients with neuroendocrine tumours of the gut to supplement the EORTC core cancer questionnaire, the QLQ-C30. Phases 1-3 of the EORTC quality of life group guidelines for module development were used to design the new questionnaire. Forty-one relevant issues (questions) were generated after an extensive literature search. Following interviews of 15 health care workers and 35 patients, a 35 question provisional questionnaire was constructed. This was translated into seven European languages and pre-tested in 180 patients resulting in a 21-item module that will be validated in an international clinical trial. The EORTC QLQ-NET21 provides a site-specific module to supplement the QLQ-C30 for patients with neuroendocrine tumours.

Adolescent↗