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PubMed2001

Validation of the inflammatory bowel disease questionnaire in Swedish patients with ulcerative colitis.

BACKGROUND: The Inflammatory Bowel Disease Questionnaire (IBDQ) is a disease-specific health-related quality of life (HRQOL) questionnaire including four dimensions and a sum score. The aim of this study was to assess the internal and external validity, reliability, and sensitivity of a Swedish version of the IBDQ. METHODS: Three hundred consecutive patients with ulcerative colitis completed the IBDQ and three other health-related quality of life questionnaires (the Rating Form of IBD Patient Concerns (RFIPC), the Short Form-36 (SF-36) and the Psychological General Well-Being (PGWB) index). Disease activity was evaluated using a 1-week symptom diary, blood tests and rigid sigmoidoscopy. One hundred and fourteen patients filled in the questionnaire a second time, of whom 75 had been in stable remission for over 6 months and 39 had a significant clinical change in disease activity. RESULTS: Factor analysis of the 32 IBDQ items did not support the four dimensional scores. The dimensional scores had sufficient convergent validity, but low discriminative validity and homogeneity. The homogeneity was also low for the sum score. The inter-dimensional correlations were high. The concurrent validity was supported by correlations between the dimensional scores and other measures of disease activity and HRQOL. Patients in relapse scored significantly less on the sum score and the four dimensions compared to patients in remission. The test-retest correlations for the dimensional scores were 0.40-0.76. Patients with a change in disease activity during the 6-month follow-up period had a significant change in IBDQ scores not found in those who remained in remission. CONCLUSIONS: The Swedish version of the IBDQ had external validity and was shown to be a reliable and sensitive measure of HRQOL in ulcerative colitis, though there are some concerns regarding the internal validity. The use of a sum score was not supported and the questionnaire may benefit from a redivision of items into dimensions with better homogeneity and discriminative validity.

Colitis, Ulcerative↗
PubMed2006

Digestive symptoms and their psychosocial impact: validation of a questionnaire.

OBJECTIVE: Questionnaires evaluating digestive symptoms and their psychosocial impact have not been extensively validated in Norwegian populations. In this study a self-administered questionnaire developed in Norway is evaluated for this purpose. MATERIAL AND METHODS: The questionnaire, the Digestive Symptoms and Impact Questionnaire, DSIQ, was developed by a cooperative group of general practitioners and gastroenterologists. The DSIQ contains 18 similarly structured global-type questions focusing on the patient's own judgement. The validation was based on 567 patients with dyspeptic symptoms or reflux symptoms referred to gastroscopy from general practice. RESULTS: Eighty percent of the patients responded to all the questions. All response categories were used for all questions. Factor analysis revealed 4 subscales: abdominal pain and bowel symptoms; gastric dysfunction; health impairment and impairment of everyday life. A question about reflux symptoms was retained as a subscale on its own. Overall score was established by calculating the mean of all question responses. Test-retest reliability in stable patients (intraclass correlation coefficient, range 0.80- 0.91) and internal consistency reliability (Cronbach's alpha, range 0.65-0.91) were satisfactory. Criterion validity was supported by significant correlations to patients' globally estimated quality of life and the General Health Questionnaire (GHQ-30). Responsiveness in spontaneously improved patients or patients given effective treatment ranged from moderate to highly responsive (responsiveness statistic range from 0.54 to 2.83). CONCLUSIONS: The DSIQ is a self-administered, simple and well-validated method for evaluating digestive symptoms and their psychosocial impact. The DSIQ shows satisfactory internal consistency reliability, test-retest reliability, responsiveness and criterion validity.

Adult↗
PubMed1998

The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease.

BACKGROUND: The diagnosis of gastroesophageal reflux disease (GERD) rests primarily on recognition of symptom patterns that are classical for reflux disease, but little attention has been paid to the use of a formal questionnaire for identifying such symptom patterns. METHODS: A self-administered questionnaire was developed which has seven items that focus on the nature of the symptoms and the precipitating, exacerbating, and relieving factors. The diagnostic validity of the questionnaire was tested against endoscopy and 24-h pH monitoring. A further evaluation was undertaken in patients with symptoms suggestive of GERD and in patients with non-ulcer dyspepsia, to identify factors that might predict symptom relief during treatment with omeprazole. RESULTS: When endoscopic esophageal mucosal breaks and 24-h pH data were used as criteria for the diagnosis of GERD, the questionnaire had a sensitivity of 92% but a very low specificity of 19%. Symptom relief during treatment with omeprazole was predicted by the presence of heartburn, described as 'a burning feeling rising from the stomach or lower chest up towards the neck' (P = 0.004), and 'relief from antacids' (P = 0.02). In non-ulcer dyspepsia a positive response to omeprazole was confined to the subgroup of patients who identified their main discomfort as heartburn as described above. CONCLUSION: The present questionnaire using descriptive language usefully identified heartburn in patients presenting with upper abdominal symptoms, and this symptom predicted symptom resolution during treatment with omeprazole.

Anti-Ulcer Agents↗
PubMed2005

Development and validation of a questionnaire to identify learning-oriented group interactions in PBL.

Collaborative learning attracts attention because of its potential as a powerful learning strategy. This also holds for PBL. However, group work in PBL sometimes encounters problems and the quality of interaction is not always at the desired level. The aim of the present study was to develop and validate a questionnaire to assess the quality of learning-oriented group interactions in PBL in an uncomplicated way. The questionnaire, to be completed by students involved in PBL, contained items on three group-interaction dimensions: exploratory questions, cumulative reasoning and handling conflicts. It was validated by means of confirmatory factor analysis and regression analysis, the latter to investigate the relation between the three-dimension model and the tutorial group's productivity. The factors underlying the questionnaire were confirmed by the data in a linear structural analysis of the data. The regression analysis showed that the 'exploratory questions' and 'cumulative reasoning' factors explained together 26% of the variance of the tutorial group's productivity. This study provided evidence for the validity of the questionnaire. The instrument contains tips for students and tutors to stimulate deep processing interactions in the tutorial group. Nevertheless, it seems useful to investigate the external validity of the questionnaire.

Cooperative Behavior↗
PubMed1989

Development and relative validity of a food frequency questionnaire for the estimation of intake of retinol and beta-carotene.

The aim of this study was to develop and validate a semiquantitative food frequency questionnaire to classify individuals according to their intakes of retinol and beta-carotene. Food items for the questionnaire were selected both on the basis of their contribution to total population intake of retinol and beta-carotene and on the proportion of between-person variation explained, which was as calculated from data of two study populations in the Netherlands. Thus, 15 products containing retinol and 15 products containing beta-carotene were selected. These contributed over 90% to the total intake and explained 99% of the variation of retinol and beta-carotene, respectively. The questionnaire was validated against a dietary history in a population of 82 women (aged 30-49 years). The time elapsed between the two interviews was (on average) 25 days. Spearman rank-order correlation coefficients comparing the questionnaire with the dietary history were 0.54, 0.59, and 0.64 for retinol, beta-carotene, and total vitamin A, respectively. The proportion of exact agreement in the two extreme categories of vitamin A intake, based on quintiles, was 56%. The corresponding gross misclassification (from 1 extreme category into the opposite) was 3%. These data indicate that a very short questionnaire can classify subjects into categories according to their vitamin A intake.

Adult↗
PubMed2005

Significant others of persons with mental health problems: the testing of a questionnaire on the burden of significant others.

The importance of family and friends for patients with mental health problems has been recognized over the past few years. Significant others (SO) of patients admitted to a psychiatric ward specializing in affective disorders and suicide prevention filled in a self-rating questionnaire concerning their burden as SOs, the Involvement Evaluation Questionnaire (IEQ). The aims of this study were twofold: first, to test whether the questionnaire IEQ was applicable in psychiatric services in Sweden and second, to relate the IEQ results to socio-demographic data and diagnosis of the patients, and also to the situation of the SOs. We found the questionnaire useful. Nearly half of the SOs had difficulties in accepting and handling the patient's psychiatric problems. More than half had been worried that the patient was going to harm him/herself and because of this had kept close watch on the patient. Almost all SOs worried about the patient's general health and future. Most of them felt obliged to intervene in the patient's activities of daily living. More than half worried about the kind of medical and psychological treatment the patient was receiving. Most SOs concluded that they were burdened by their engagement in the patient. Our results were compared with a European study of schizophrenic patients also investigated with the IEQ. The comparison indicated that the perceived burden on SOs of these different kinds of psychiatric patients can be equally burdensome. SOs need information, help and support in their difficult support role. This questionnaire could be useful in finding new routines for increasing the involvement by SOs in the treatment of patients with mental health problems.

Adaptation, Psychological↗
PubMed2004

The development and assessment of a self-perceived quality of vision questionnaire to test pseudophakic patients.

PURPOSE: To develop and test a questionnaire to assess quality of vision in pseudophakic patients. METHODS: The problems with existing health measurement scales and the need for a new questionnaire are first discussed. Development of the new questionnaire from concept to completion is presented and all stages discussed. The questionnaire is then tested for internal consistency, reliability and validity. RESULTS: The Cronbach Alpha for internal consistency was 0.92. British Standards Institution repeatability coefficient was satisfactory at 6.6. Discriminant construct validity testing by extreme groups demonstrated excellent discrimination between patients with functionally significant posterior capsule opacification (PCO) and no significant PCO (Mann-Whitney U test, p = 0.001). CONCLUSION: The questionnaire is validated as a robust, stable measure of pseudophakic visual symptoms with a high degree of clinical utility. It should be invaluable for the many studies that compare outcomes from different forms of modern cataract surgery with implantation of different intraocular lenses.

Activities of Daily Living↗
PubMed2005

Application of stochastic measurement models to visual function rating scale questionnaires.

PURPOSE: To test hypotheses that low vision patient responses to visual function rating scale questionnaires conform to an additive conjoint structure and that the Likert score is a sufficient statistic for the latent patient trait; to compare results for two competing stochastic measurement models; and to determine if different questionnaires measure the same construct in low vision patients. METHODS: Visual function rating scale questionnaires were administered to 284 low vision subjects by telephone. Each subject was administered two of four questionnaires: ADVS, NEI VFQ-25 plus supplement, expanded VAQ, and VF-14. RESULTS: Data were analyzed with the Muraki item response model and the Andrich measurement model. The estimates of latent person, item, and response threshold measures from the two models are linearly related. The Muraki model produced a better overall fit to the item response data, the Andrich model produced a better fit to the average ratings for each person and item. Fit statistics for the Andrich model were proportional to the item-dependent discrimination parameter in the Muraki model. The ADVS was the most accurate measure and the NEI VFQ was the least. Reliability was similar for all four instruments. Person measures for each pair of instruments were linearly related indicating that all four instruments measured the same construct. The person measure estimate from the Andrich model is monotonic with the average rating. That relationship suggests a transformation of the Likert score that can correct the floor and ceiling effects in rating scale data. CONCLUSIONS: Patient responses to all four questionnaires conform to varying degrees to an additive conjoint structure. The Likert score is a sufficient statistic for the ADVS and the VAQ, but not for the NEI VFQ or VF-14. All four instruments measure the same construct in the low vision population, but they differ in measurement accuracy and precision.

Adult↗
PubMed1999

Patient satisfaction with HIV service provision in NPMS hospitals: the development of a standard satisfaction questionnaire. NPMS Steering Group.

A self-completion satisfaction questionnaire evaluating the standard of care of HIV outpatient services was developed as part of the National Prospective Monitoring System on the Use, Cost and Outcome of HIV Service Provision in English Hospitals (NPMS). The questionnaire was designed in conjunction with service users and health care professionals, and piloted in three London and three non-London HIV clinics. In addition to testing alternative methods of administering the questionnaire, the pilot provided satisfaction scores on a variety of aspects of service provision for participating clinics. The questionnaire was completed by 548 respondents and was most effectively collected using a sealed box in the clinic waiting area. Mean satisfaction scores for the attitude and skills of staff members was 4.7 (95% CI 4.6-4.7) but satisfaction scores were significantly lower for the clinic environment with a mean of 4.1 (95% CI 4.1-4.2). Satisfaction scores did not differ significantly by gender, age, sexual orientation, ethnic group, employment status or severity of symptoms. London respondents were more satisfied with the clinic environment and seeing preferred members of staff than their non-London counterparts, however there were no other differences between clinics. The questionnaire functioned well in practice and provided meaningful and useful information for individual clinics as well as at aggregate level.

Acquired Immunodeficiency Syndrome↗
PubMed2000

The Radboud skills questionnaire: construction and reliability in patients with reflex sympathetic dystrophy of one upper extremity.

PURPOSE: To construct a questionnaire to measure skills in which notably both hands are active, which is suitable for patients with a disease of one or both hands and to research its response stability and possible improvements. METHOD: Using the Dutch elaboration of the ICIDH and then experts in a Delphi round, the questionnaire was constructed. Thereafter, test-retest and inter-observer reliability was examined. Fifty-four patients with RSD in one upper extremity and a normal contralateral extremity participated in the study, the first twenty to evaluate the construction of the questionnaire and the others to test reliability. RESULTS: The constructed Radboud skills questionnaire was reliable in terms of response stability (median coefficients of variation 2.2% to 6.6%). Correlation's between categories of items were fair to good. CONCLUSIONS: A useful questionnaire was constructed to map alterations in the level of disability in patients with a disease of one hand or both hands.

Adult↗
PubMed2005

Development and reliability of the Motivation for Change Questionnaire.

PURPOSE: The purpose of this study was to describe the development of the Motivation for Change Questionnaire (MCQ) and to test its intra-patient reliability on musculoskeletal pain patients in interdisciplinary rehabilitation as a basis for use in rehabilitation planning. METHOD: The MCQ questionnaire was developed from a literature search in the Medline, Cinahl and Psychlit databases concerning motivating factors for change in the life and work situation. Questions covering these factors were developed (item generation). Factor analysis of the questions implied a reduction of the number of questions (item reduction). Inter-item correlation was assessed on the baseline administration of the questionnaire by calculating Cronbach's alpha. When testing the structure of the scales, it was shown that the MCQ questionnaire could be described in two scales, one scale relating to motivation for change in the life situation and the other focusing on motivation for change in the work situation and in total 49 questions. RESULTS: The test -- retest reliability was calculated using the intra-class correlation coefficient (ICC) and 95% confidence intervals were calculated. One question was excluded due to the threshold limit of > 0.5. Seven scales relating to the life situation were accepted by the analysis: social support, mastery in life, challenges in life, control in life, values, self-efficacy and self-confidence. Six scales relating to the work situation were also accepted: co-worker support, supervisory support, challenges in work, job control, interaction and job-satisfaction. CONCLUSIONS: The MCQ questionnaire with 48 questions is reliable for use on musculoskeletal pain patients in interdisciplinary rehabilitation. It can be used to identify each individual's motivating factors for change in life and work situation as a basis for motivational work within rehabilitation and/or to measure within-subject changes in motivation over time. The validity and the responsiveness of the MCQ, need to be studied.

Adult↗
PubMed2006

Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: reliability and functionality of the Turkish version of the Boston Questionnaire.

OBJECTIVES: The aim of this study was to develop a Turkish version of the Boston Questionnaire and assess its reliability and validity. METHODS: Sixty-seven patients with idiopathic carpal tunnel syndrome were included in the study. The Turkish version of Boston Questionnaire was obtained after translation process, and was then administered to subjects twice within seven days. Reliability was assessed by internal consistency (Cronbach's alpha and item-total correlation), and reproducibility. Validity was examined by correlating the Boston Questionnaire scores to general health status (Short Form-36), pain severity (Visual Analogue Scale) and pinch and grip strength measures. RESULTS: Reliability of the Turkish version was very good, with high internal consistency (Cronbach's alpha 0.82 for symptom severity scale, and 0.88 for functional status scale), and reproducibility (Pearson correlation coefficient 0.60 for symptom severity scale, and 0.77 for functional status scale). The Boston Questionnaire scores were correlated with Visual Analogue Scale, physical functioning, physical role, bodily pain and emotional role subscales of Short Form-36, pinch and grip strength scores to obtain coefficients for external construct validity. CONCLUSION: Adaptation of the Boston Questionnaire for use in Turkey was successful. Our results seem to support previous finding of the English version, indicating that it is valid and reliable.

Adult↗
PubMed2004

The role perception questionnaire (RPQ): a tool for assessing undergraduate students' perceptions of the role of other professions.

A systematic review of interprofessional education (Freeth et al., 2002) revealed that there were many weaknesses in the current body of knowledge of interprofessional education outcomes. One reason for this was the lack of good quality study designs for evaluating the outcomes of interprofessional education. This paper discusses the range of tools that were found in the literature and describes the production and validation of two questionnaires that can be used as part of an interprofessional evaluation strategy. Firstly, a Generic Role Perception Questionnaire which can be used for measuring the perception of the role of a range of professions and a Nursing Role Perception Questionnaire used specifically for measuring the perception of the role of a nurse. Repertory grid technique was selected to elicit constructs from a multiprofessional group of final year undergraduate students. This pool was then used to develop the two questionnaires. Factor analysis, internal consistency and test re-test measures are used along with evidence of validity. The questionnaires were found to have acceptable validity and reliability and could be used as part of an IPE evaluation strategy to measure changes in professional role perception in an undergraduate population.

Attitude of Health Personnel↗
PubMed2003

General or disease specific questionnaire? A comparative study in hemodialysis patients.

OBJECTIVE: Today questionnaires developed to assess important outcome measures such as health-related quality of life are widely used. In this study we evaluated the construct validity of the Nottingham Health Profile (NHP) and the reliability of its Turkish version in hemodialysis patients. METHODS: In a sample of patients on renal dialysis (n = 94) the quality of life is measured by the NHP. The validity of this questionnaire is evaluated by using the Kidney Disease Questionnaire (KDQ) in the same patient group. The NHP is administered twice to each patient, at dialysis intervals two weeks apart. RESULTS: NHP scores at both administrations are similar in both assessments. Pearson's correlation coefficients range from 0.61 to 0.84. Cronbach's alpha coefficients for the NHP sections range between 0.64 and 0.79. The alpha coefficients for three of the NHP scales (energy, sleep and social isolation) are well below 0.7. In the KDQ the mean values obtained for the five dimensions are: 4.2 +/- 1.5 for physical symptoms, 4.8 +/- 1.7 for fatigue, 4.9 +/- 1.9 for depression, 4.2 +/- 1.2 for relationship with others, and 4.8 +/- 1.5 for frustration. In general the correlation between the dimensions of the NHP and KDQ is good and the correlation coefficients varies from 0.18 to 0.73. Clinical validity is assessed by examining the correlation between the results obtained for the two questionnaires (components of the NHP and KDQ) and hemoglobin level, number of the co-morbid conditions and educational level. CONCLUSIONS: The NHP is shown to have construct validity when used in patients with end-stage renal disease (ESRD) in Turkey. The application of the NHP in patients with ESRD is easy, fast and the questions are not difficult to understand. The multiple-degree scoring in the KDQ causes a complexity in answering. The correlation between the dimensions of the NHP and KDQ is good. Our results show better correlations between disease specific questionnaires and clinical parameters.

Adult↗
PubMed2003

Validation of a self-reported questionnaire assessing adherence to antiretroviral medication.

The aim of this study was to verify the validity of a new self-reported questionnaire designed to assess nonadherence to antiretroviral medication among patients with HIV. Two hundred fifty-six patients from four clinics participated in a prospective longitudinal study. The questionnaire was designed to measure if patients with HIV were taking less than the total number of antiretroviral pills prescribed by their physician. Change in viral load was used as the criterion for validity analyses. Self-reported adherence, viral load and CD4 cell count were assessed at T0 (baseline), T3 (3-month), and T6 (6-month). The findings indicated that the questionnaire had adequate validity (sensitivity, 71%; specificity, 72%; correct classification, 72%; odd ratio, 6.15). These best values were obtained when the analyses excluded individuals with an unstable viral load and a CD4 cell count of less than 200 copies per milliliter over the 6-month follow-up period. This study has shown that this questionnaire has satisfactory psychometric qualities to assess nonadherence to antiretroviral medication among patients with HIV. The questionnaire is brief, simple, and can be used in both clinical or research settings regardless of the patients' antiretroviral regimens.

Adult↗
PubMed2004

Identifying workers at risk for high health care expenditures: a short questionnaire.

The objective of this study was to create and measure the predictive accuracy of a brief questionnaire for screening new workers to identify those at increased risk for generating high health care insurance expenditures during the following year. Such an instrument could help health plans and providers intervene to mitigate the health risks of identified high-risk workers. We mailed a 53-item questionnaire to members of a "derivation cohort" (adult food processing workers, n = 15496) and obtained records of the eligible respondents' health insurance expenditures during the following year. Using multiple linear regression, we identified eight of the questions that predicted future expenditures most accurately, and created a formula to predict total expenditures from answers to these questions. To validate the formula's predictive accuracy, we used the eight-item questionnaire to survey two "validation cohorts" (transportation workers, n = 7445; and their dependents, n = 5562), inserted responses into the scoring formula, classified respondents into high-risk (top 10%) or low-risk (lower 90%) groupings, and then compared health insurance expenditures generated by the high- and low-risk groups during the following year. In the derivation cohort, age, sex, regular use of medications, frequent visits to physicians, and having arthritis, diabetes, cancer, or high cholesterol predicted future health care expenditures. In the worker and dependent validation cohorts, the respondents classified by the formula as high-risk generated insurance expenditures during the following year that were 2.4 and 1.8 times greater than those generated by the members of the low-risk groups (p < 0.001). An eight-item questionnaire and its scoring formula can identify high-risk groups of workers that will generate high health care expenditures during the following year. Healthcare organizations could use this questionnaire to help target new workers for care management and disease management interventions.

Adult↗
PubMed1994

Comparison of energy intake by semiquantitative food-frequency questionnaire with total energy expenditure by the doubly labeled water method in young children.

We assessed the validity of a semiquantitative food-frequency questionnaire to estimate energy intake in young children by comparison with total energy expenditure (TEE). TEE was measured in 45 children (22 males and 23 females; 4.2-6.9 y of age) by the doubly labeled water method and body composition was estimated from bioelectrical resistance (20.2 +/- 4.0 kg body weight, 4.6 +/- 2.1 kg fat mass, and 15.6 +/- 3.1 kg fat-free mass). The sample included 36 white children and 9 Mohawk Native American children. The children's mothers completed one Willett food-frequency questionnaire to reflect the child's usual dietary intake over the last year. Total energy intake by food-frequency questionnaire (9.12 +/- 2.28 MJ/d) was significantly higher than TEE (5.74 +/- 1.13 MJ/d; P < 0.001). Misreporting of intake by food-frequency questionnaire ranged from 9.57 MJ/d overestimation to 1.58 MJ/d underestimation and was not significantly influenced by sex or body composition of the children. We conclude that use of the food-frequency questionnaire significantly overestimates energy intake in children.

Adult↗
PubMed2000

Self-administered questionnaire compared with a personal diary for assessment of current use of hormone therapy: an analysis of 16,060 women.

A personal diary may be more appropriate than a questionnaire for assessing self-reported current use of hormone therapy (estrogens, progestagens, or their combination); however, use of a questionnaire is more feasible and less expensive. The authors compared both methods for 16,060 Swedish women aged 45-73 years from the Malmo Diet and Cancer Study (baseline, 1991-1996). In a reliability analysis, the authors investigated the agreement (kappa value) between the questionnaire and the diary regarding current hormone therapy use (yes vs. no), studying the ability to replicate results whether or not they were correct. They also explored associations between discrepancy and individual characteristics. A validity analysis was conducted to determine whether use of the questionnaire achieved an outcome without systematic error (i.e., high specificity and sensitivity); the personal diary was considered the "gold standard." Agreement between both methods was high: 95.5% (kappa = 0.840). The sensitivity was 84.9% and the specificity 97.7%. Higher body mass index and being a widow were associated with agreement, whereas age (50-59 years), use of anxiolytics/hypnotics or opiates, high alcohol consumption, past smoking, and higher educational level were associated with discrepancy. Compared with a personal diary, a simple self-administered questionnaire is a valid method for assessing current use of hormone therapy.

Aged↗