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PubMed2002

Australian implantable cardiac defibrillator recipients: quality-of-life issues.

Implantable cardioverter defibrillators (ICDs) have become a well-established therapy for people experiencing potentially lethal dysrhythmias. Australian recipients' quality of life and adjustment to the device over time, device-related complications, shock and associated sensations, and potential sequelae have not been widely explored. This paper reports a longitudinal prospective study of Australian ICD recipients (n = 74) to determine their responses to the device, health-related quality of life over time and shock experiences. A questionnaire designed for the study and the Medical Outcomes Trust Quality of Life Instrument, the SF36, were completed by recipients prior to and at 3 and 12 months post insertion. Results show that quality of life decreased for general health and social function between 3 and 12 months. Nearly half (49%) of the recipients received shocks within 12 months and the majority (92%) of these experienced sequelae that could make driving hazardous. Half of the population (49%) were driving at 3 months and 69% by 12 months, including 67% of those who had been shocked. Twenty-seven percent were hospitalized with device-related complications. Driving, the shock experience and rehospitalization, the shock experience and driving behaviour are significant issues for those with the implanted device. While it is a limitation of the study that partners and carers were not included, these findings will also be of interest to them.

Adaptation, Psychological↗
PubMed1990

Cognitive correlates of headache intensity and duration.

Cognitive processes and cognitive styles of persistent headache sufferers were examined in relation to indices of intensity and duration of head pain. One hundred and eight persistent headache patients, referred for cognitive-behavioral management of their disorder, completed questionnaires designed to assess: distressing thoughts and feelings experienced during headache attacks, evaluation of the experienced pain, perceived influence of stress and worry on headaches, and capacity to verbally express emotions. The results showed that the intensity of head pain correlated with measures of headache-related distress and with the proportion of headache-related distress to situation-related distress. Duration of head pain was also associated with the proportion of headache-related distress to situation-related distress, and additionally with a tendency to deny the influence of stress and worry on headaches and with difficulty in expressing emotions. These findings were taken as support of our previously stated hypothesis that head pain of increased severity is associated with a cognitive shift whereby the patient's primary concern moves from situational and interpersonal distress to distress associated with the disorder itself. In addition, these findings point to affective distress and lack of emotional expressiveness as correlating differentially with the headache dimensions of intensity and duration.

Cognition↗
PubMedDate not supplied

Satisfaction and commitment in homosexual and heterosexual relationships.

Rusbult's (1980, 1983) investment model was utilized to explore the determinants of satisfaction with and commitment to maintain romantic relationships among male and female homosexuals and male and female heterosexuals. The study employed a questionnaire designed to obtain both specific and global measures of rewards, costs, alternatives, and investments, and to obtain global measures of satisfaction and commitment. Women, both lesbians and heterosexuals, reported that they had invested more in their relationships and were more committed to maintaining their relationships than did men. Heterosexuals, male and female, reported greater costs and marginally greater investments in their relationships. In general, the investment model effectively predicted satisfaction and commitment for the sample as a whole and for all four groups of respondents. Greater satisfaction with relationships was associated with higher levels of rewards and lower levels of costs. Greater commitment was associated with greater satisfaction, greater investments, and poorer quality alternatives. Relationship costs were more strongly related to satisfaction and commitment for females than for males. Differences in the average level and the importance of a wide variety of specific predictors were also examined. In general, gender appeared to be a more important predictor of the behaviors explored in this study than was sexual preference.

Adult↗
PubMed1998

The use of artificial neural networks methodology in the assessment of "vulnerability" to heroin use among army corps soldiers: a preliminary study of 170 cases inside the Military Hospital of Legal Medicine of Verona.

This article describes a preliminary study of screening/diagnostic instruments for prediction for large-scale application in the military field at the Neuropsychiatric Department of the Military Hospital of Legal Medicine of Verona and for the prevention of self-destructive behaviors, particularly through the use of drugs. 170 subjects divided into three subsamples were examined. The first subsample was characterized by a strong tendency towards normalcy, the second by a strong tendency towards pathology, and the third by a great variety of expressions of psychological and social problems, which were not necessarily related to drug use. These subjects were administered a questionnaire designed according to Squashing Theory principles (Buscema, 1994a). Answers were processed by an Artificial Neural Network created by Semeion in Rome (Buscema, 1996) and were compared with a standard clinical psychiatric assessment report and with the results of psychodiagnostic tests. Results document ANNs' remarkable ability to recognize subjects with declared, in exordium and "at risk" pathological behaviors. Blind results on learning and trial samples show a very high predictive capacity (over 90%). A comparison with the examined subjects' clinical report and the results of the first follow-up also document very high agreements. The broad variation of answers obtained in the third subsample allows further methodological reflections on the contribution of Artificial Neural Networks and Squashing Theory to the study of deviance, for both sociologists and clinicians, and not only for those in the field of drug addiction.

Adult↗
PubMedDate not supplied

A comparative study of perception of sickle cell anaemia by married Nigeria rural and urban women.

Environmental factors may influence perception of or attitude to chronic disorders. The perception of sickle cell anaemia (SCA by 165 married Nigerian rural and 507 urban women was studied to determine how living in an urban or rural environment may influence perception. None of the subjects had children with SCA. The instrument used for data collection was a structured questionnaire designed to enquire into their knowledge about the cause, precipitating factors for crises, clinical features of SCA and their opinions regarding traditional and modern treatment options for the disorder. As a group, urban women had better knowledge about SCA than rural women probably because their social environment afforded a wider scope for interaction with and information exchange among people. For most respondents, the educational institutions attended the health institutions in the locality and the electronic media were poor sources of information on SCA. The study showed a serious lack of information about important aspects of SCA among rural women. We think the training of primary health care providers as counsellors on SCA, the inclusion of instruction about SCA in the curriculum of schools and sustained outreach programmes on SCA on the electronic media would ensure early education of people in both rural and urban communities and help to improve perception of the disorder.

Adult↗
PubMed2006

Family functioning in the families of psychiatric patients: a comparison with nonclinical families.

OBJECTIVE: To examine family functioning in the families of psychiatric patients. MATERIAL AND METHOD: Families of psychiatric patients and nonclinical families were compared. There were 60 families in each group. The instrument included a semistructured interview of family functioning and the Chulalongkorn Family Inventory (CFI), a self-report questionnaire designed to assess the perception of one's family. RESULTS: From the assessment by semistructured interview, 83.3% of psychiatric families and 45.0% of nonclinical families were found to be dysfunctional in at least one dimension. The difference was statistically significant (p < 0.001). The average number of dysfunctional dimensions in the psychiatric families was significantly higher than in the nonclinical control group, 3.5 +/- 1.9 and 0.98 +/- 1.5 respectively, p < 0.0001. The CFI scores of the psychiatric families were significantly lower than the control group, reflecting poor family functioning. The dysfunctions were mostly in the following dimensions: problem-solving, communication, affective responsiveness, affective involvement, and behavior control. Psychiatric families faced more psychosocial stressors and the average number of stressors was higher than the control families, 88.3% vs. 56.7% and 4.2 +/- 2.7 vs. 1.3 +/- 1.47 stressors respectively, p < 0.0001. CONCLUSION: Family functioning of psychiatric patients was less healthy than the nonclinical control. The present study underlined the significance of family assessment and family intervention in the comprehensive care of psychiatric patients.

Case-Control Studies↗
PubMed2002

Misconceptions regarding hepatitis C in the French public.

BACKGROUND: Knowing the facts and displaying the proper attitudes and behaviors are critical in preventing the spread of infectious diseases. Hepatitis C is a common infection, but the public's understanding of it has not been studied. METHODS: A convenience sample of 431 French adults, ages 18 to 81 years, completed a questionnaire designed to assess knowledge of hepatitis C and acquired immune deficiency syndrome. A group of nine medical experts also answered the hepatitis C questions. RESULTS: The lay participants had many uncertainties about hepatitis C, and their beliefs frequently differed from medical understanding about hepatitis C. Their responses were correlated more closely with their own responses to the AIDS questions than with the experts' understanding of hepatitis C. CONCLUSIONS: Information regarding hepatitis C should emphasize the distinctions between hepatitis C and AIDS as well as between hepatitis C and hepatitis B and between seropositivity and infection. People should also be informed that blood donation is safe, that using injected drugs is the main risk factor for hepatitis C, that alcohol aggravates hepatitis C, that hepatitis C can cause cancer, that an effective treatment for hepatitis C exists, and that they are not put at risk by mere causal contact with people ill with hepatitis C.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Health care providers' opinions on intimate partner violence resources and screening in a pediatric emergency department.

OBJECTIVES: The American Academy of Pediatrics has called upon pediatricians to routinely screen for intimate partner violence (IPV) as an active means by which to prevent child abuse. The pediatric emergency department (ED) is one potentially important site to screen and to provide women with IPV resources. This cross-sectional questionnaire investigated pediatric health care providers' (HCPs') opinions about displaying IPV posters and performing IPV screening in a pediatric ED. METHODS: This cross-sectional survey was conducted in the ED of an urban, academic, tertiary care children's hospital that serves approximately 70,000 children each year. A convenience sample of 151 HCPs, defined as any person who provided medical care, including physicians, nurses, paramedics, and respiratory therapists, in the pediatric ED was surveyed using a 4-item questionnaire, designed by investigators, about their views regarding newly displayed IPV posters and resource cards, their opinions about universal IPV screening, and their personal use of the IPV materials. Between June and August 2004, surveys were distributed, along with return envelopes to be placed in a sealed box, to HCPs during their shifts in the ED. RESULTS: Of the 158 distributed surveys, 151 (96%) were returned. Of the sample, 30% were physicians, 53% were RNs, 10% were paramedics/emergency medical technicians, and 7% were other HCPs. Pediatric ED providers supported both IPV resource information and routine screening. Female providers were more likely than men to support the IPV posters. Five percent of the sample took IPV resource information for themselves or for later use with patients. CONCLUSIONS: Our pediatric ED's providers' endorsement of IPV screening and of the presence of IPV posters demonstrates support for and recognition of the problem of IPV in their patients' families.

Adult↗
PubMed2002

Parental enabling attitudes and locus of control of at-risk and honors students.

Parental enabling attitudes and behavior interfere with the child's ability to take responsibility for his or her behavior. Enabling is expressed in overprotectiveness and manipulation in which parents insulate their children from unpleasant circumstances and from making mistakes. Unfortunately, these are the very situations in which most children learn self-control, independence, and strategies to correct aberrant behavior. Children of enabling parents often fail to learn that their actions have consequences. The Lynch Enabling Survey for Parents (LESP), a forty-item questionnaire designed to assess the enabling behavior of parents, was evaluated to establish its psychometric properties. In Experiment 1, 416 parents responded to the LESP. The instrument was determined to be reliable (rs = .84 and .92 for split-half and test-retest reliability, respectively) and valid. Factor analysis established four factors, assessing Direct Enabling Parent Involvement, Indirect Nonenabling Parent Involvement, Direct Nonenabling Parent Involvement, and Indirect Enabling Parent Involvement. In Experiment 2, the LESP and the Nowicki-Strickland Locus of Control Scale were used to assess the differences between ninth-grade at-risk and honors students and their parents. The responses of parents of at-risk students on the LESP were significantly more enabling than were the responses of the parents of honors students. At-risk and honors students were also significantly different in their locus of control. Lastly, there was a significant relationship between parents' LESP scores and their children's locus of control scores.

Achievement↗
PubMedDate not supplied

The reliability and validity of the Maternal Social Support Index for primiparous mothers: a brief report.

The Maternal Social Support Index (MSSI) is an 18-item questionnaire designed to quickly assess qualitative and quantitative aspects of a mother's social support. This study examines a sample of primiparous mothers during the first nine months following delivery. Mothers were interviewed within 72 hours after delivery and again at six weeks and nine months. Using Spearman coefficients, the correlation for total MSSI scores between birth and nine months was .75. The correlations for individual items between birth and nine months ranged from .22 to .76. The MSSI at birth was strongly correlated with the Dyadic Adjustment Scale at nine months (r = .41, P = .001). Scores on the Center for Epidemiologic Studies Depression Scale at birth were inversely and significantly associated with the MSSI at six weeks postpartum (r = .50, P = .004). The MSSI assesses important elements of a new mother's environment which are related to her satisfaction with an intimate other, as well as depressive symptoms. These findings are similar to those in earlier reports.

Activities of Daily Living↗
PubMed2006

Patterns of response to sensory stimuli encountered in daily activities: A comparison between 3-10-year-old Israeli and American children without disabilities.

The purpose of this study was to examine the extent to which patterns of response of typical children aged 3 to 10 in Israel, as reported in the Sensory Profile (Dunn, 1999), were similar to typical children in the United States. The Sensory Profile is a caregiver questionnaire designed to assess sensory processing abilities. A translated Hebrew version of the Sensory Profile was completed by parents of 714 typically developing children who were recruited from across Israel. The mean scores of the Israeli children were compared to the published mean scores of the American children at the section and factor level to determine whether the scoring system of the Sensory Profile would be applicable for Israeli children. The findings revealed that, in some sections and factor clusters, the scores of Israeli children were lower than the scores of the American children across all ages. Although the Israeli children scored lower, overall, their scores were within the established range of typical performance. Initial support for the application of the scoring system of the Sensory Profile in Israel is suggested. Due to the nature of the sample of Israeli children, future studies are recommended with a national representative sample and with specific disability groups to further validate the clinical use of the Sensory Profile in Israel.

Activities of Daily Living↗
PubMed2004

Delivering information about cancer genetics via letter to patients at low and moderate risk of familial cancer: a pilot study in Wales.

Increasing demands upon specialist cancer genetics services have resulted in a need to explore alternative means of delivering genetic risk information to individuals at low-risk of familial cancer. This pilot study investigates patient satisfaction with a letter to low and moderate risk individuals notifying them of their risk. Sixty-six people completed a questionnaire designed to measure satisfaction with the way they had been notified of their cancer risk. Two key findings emerge from the data: first of all, whilst many respondents indicated overall satisfaction with the risk letter, a substantial number wanted more information about their risk; and secondly, low-risk individuals in this study are less reassured by and less satisfied with the risk letter than those at moderate risk. The optimal service provision for delivery of genetic risk information is likely to be one which can best respond to individual differences in information-seeking, distress and risk comprehension. There is a need therefore, for a randomised control trial to compare the effectiveness of a risk notification letter with more traditional telephone risk counselling and the implications of each mode of delivery upon the resources of specialist cancer genetics services.

Adult↗
PubMed2004

Validation of the cancer needs questionnaire (CNQ) short-form version in an ambulatory cancer setting.

The short-form Cancer Needs Questionnaire (CNQ) is a self-administered cancer-specific questionnaire designed to assess patients' needs across several domains. The purpose of this study is to further evaluate its internal consistency and construct validity, in a group of ambulatory patients with cancer. Four hundred and fifty patients with a variety of cancer types participated. Factor analysis reproduced five domains: psychological; health information; physical and daily living; patient care and support; and interpersonal communication needs. Cronbach's alpha coefficients ranged from 0.94 to 0.77, indicating substantial consistency across items grouped in the five domains. A priori predictions regarding convergent and contrasting groups construct validity were explored using bivariate relationships between domains of the short-form CNQ, the EORTC QLQC-30 and Beck Depression Inventory (short-form), with support provided for most of the predictions. The current study provides supportive evidence that the short-form CNQ is a reliable and valid instrument for assessing the needs of patients with cancer in an ambulatory care setting.

Adolescent↗
PubMed2006

Surveillance of infection control procedures in dialysis units in Japan: a preliminary study.

As there is a high risk of indirect and direct transmission of infectious agents in chronic hemodialysis, infection control procedures should be established in dialysis units. This paper presents the findings of a questionnaire designed to survey the current status of infection control procedures in hemodialysis settings. Two hundred and forty-three hemodialysis units in Japan were surveyed. Nearly 90% of hemodialysis units reported compliance with each procedure recommended by the Center for Disease Control and Prevention in the United States, including use of disposable gloves, handling of non-disposable or non-single-use items, and routine serological testing of blood-borne viruses. However, more than 50% of units reported that they did not comply with recommendations concerning some procedures, such as places for preparing medications and their delivery, clean areas in the units, vaccination for hepatitis B, and additional measures for hepatitis B surface antigen (HBs-Ag) positive patients. Especially, the concept of universal precautions seemed to be misunderstood in units with a high prevalence of anti-hepatitis C antibody-positive (anti-HCV Ab-positive) patients. In conclusion, further intensive education and training will be necessary to establish infection control procedures.

Disposable Equipment↗
PubMed1991

Determinants of acceptance of routine voluntary human immunodeficiency virus testing in an inner-city prenatal population.

Routine voluntary prenatal human immunodeficiency virus (HIV) counseling and testing offer the opportunity to encourage reduction of high-risk behaviors among uninfected women and to identify those women with asymptomatic HIV infection. To characterize the determinants of acceptance of routinely offered and encouraged HIV testing in inner-city parturients in Atlanta, we identified two groups of women, one that declined HIV testing and another that accepted testing. Each group was asked to complete a questionnaire designed to assess the effectiveness of pre-test counseling. During the 7-month study period, 4731 women registered for prenatal care and 4574 (97%) consented to HIV testing. Nearly all women stated that they were not pressured into having HIV testing performed. Women who accepted HIV testing were more likely to be young, black, and single (P less than .001) and less likely to have received education beyond high school (P less than .05). More accepters than decliners thought the HIV counseling session was valuable (97 versus 91%; P = .04); 55% of accepters agreed to antibody testing because of concern about the risk of transmitting HIV infection to their fetus or infant. More accepters than decliners indicated a willingness to have HIV testing in a future pregnancy (74 versus 33%; P less than .001). These data suggest that most inner-city parturients in our institution view routine voluntary HIV counseling as a valuable component of their prenatal care.

Adolescent↗
PubMed1985

The McGill Pain Questionnaire reconsidered: confirming the factor structure and examining appropriate uses.

A major problem in the understanding and psychological treatment of chronic pain patients is the inadequacy of available assessment procedures. Currently, the most frequently used instrument is the Pain Rating Index (PRI) of the McGill Pain Questionnaire, designed to assess 3 components of pain (i.e., sensory, affective, and evaluative) postulated by the Gate Control Theory. The PRI has been used in many studies to make differential diagnoses, to describe different groups of pain patients, and to identify the factor composition of the instrument itself. To date, however, no study has appropriately tested the a priori structure of the PRI or cross-validated it. Confirmatory factor analytic procedures employed in the present study supported Melzack's postulated tri-component structure of the PRI in 2 diverse samples of pain patients from different hospitals. However, the 3 components were found to be highly intercorrelated. Subsequent analyses revealed that the 3 components of the PRI do not display adequate discriminant validity. The current use of 3 subscales to establish differential diagnoses or patterns of different pain syndromes may lead to inappropriate classification and treatment decisions. The major conclusion of these findings is that use of only the total score of the PRI is appropriate for pain assessment.

Chronic Disease↗
PubMed1997

Prevalence of human seminal plasma hypersensitivity among symptomatic women.

BACKGROUND: Experience with human seminal plasma hypersensitivity in the last decade has led to increased physician awareness of symptoms consistent with human seminal plasma sensitization in women. Incidence and prevalence of human seminal plasma hypersensitivity in women are unknown. OBJECTIVE: A questionnaire survey was distributed to determine the prevalence of human seminal plasma hypersensitivity among a population of women suspected of having this disorder. METHODS: A questionnaire designed to elicit age, symptoms, duration of symptoms, number of sexual partners, time to onset of symptoms after first human seminal plasma exposure, onset of symptoms after first intercourse, recent gynecologic procedures, history of atopy, vaginitis, food or drug allergy and family history of atopy was distributed to 1,073 women who suspected they had symptoms consistent with human seminal plasma hypersensitivity. Women were considered "possible" for human seminal plasma hypersensitivity if they reported two or more symptoms consistent with localized or systemic human seminal plasma hypersensitivity. Women were considered "probable" for disease if they fulfilled the "ultimate criterion" defined as complete prevention of symptoms with a condom. Women with "possible" localized or systemic human seminal plasma hypersensitivity who had persistent symptoms despite use of a condom served as cohort control groups. RESULTS: Two-hundred sixty-six women reported symptoms "possible" for human seminal plasma hypersensitivity (88 localized and 178 systemic). When the "ultimate criterion" was applied, 130 (46 localized and 84 systemic) of the 266 women were identified as having "probable" human seminal plasma hypersensitivity. The responses to most of the questions from each group were very similar. A significantly shorter time interval to symptom onset after initial human seminal plasma exposure was more common for women with "probable" localized human seminal plasma hypersensitivity compared with their cohort control group (49 months versus 108 months; P < .02) whereas a significantly increased number of women with "probable" systemic human seminal hypersensitivity gave positive food allergy histories compared with their cohort control group (31 versus 20; P < .05). Atopy did not appear to be a risk factor for human seminal plasma hypersensitivity. CONCLUSIONS: Evaluation of women with symptoms suggestive of human seminal plasma hypersensitivity using a validated questionnaire indicates that this disorder is more common than previously recognized.

Adult↗
PubMed2006

A comparative assessment of the factor structures and psychometric properties of the GHQ-12 and the GHQ-20 based on data from a Finnish population-based sample.

The General Health Questionnaire (GHQ) is a self-report questionnaire designed to identify psychological distress. Psychometric properties of two versions of GHQ-12 and GHQ-20 were assessed in a large population-based sample of Finnish twins, ages 22 to 27 (n= 4580). Participants were randomized into two subgroups, namely Twin1 (n= 2294) and Twin2 (n= 2286). The GHQ-12 data were assessed using Confirmatory Factor Analysis (CFA). The factor structure of the GHQ-20 was first assessed with Exploratory Factor Analysis (EFA) in the Twin1 dataset, and the results obtained were then subjected to CFA in Twin1 and Twin2 datasets. The CFA of the GHQ-12 indicated that the best fit and the simplest solution were provided by the three-factor solution in both subpopulations. Analyses of the GHQ-20 suggested that the four-factor structure was superior to the three-factor model. This result is also theoretically justifiable. Compared to the 12-item version, GHQ-20 provides additional fourth factor of anhedonia, suggesting some discriminative power.

Adult↗