Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Questionnaire Design”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,333 records · Page 74Linked to original sources
PubMed2004

Recognition of a dopamine replacement therapy dependence syndrome in Parkinson's disease: a pilot study.

Patients with Parkinson's disease may use Dopamine Replacement Therapy (DRT) in excess of therapeutic need. We investigate whether a group of 10 patients with Parkinson's disease, provisionally diagnosed with "Hedonistic Homeostatic Dysregulation" because of their excessive use of DRT, met established operational psychiatric criteria for substance dependence, compared with 10 patients with Parkinson's disease compliant with prescribed DRT. Using a semi-structured questionnaire designed to distinguish between adaptive therapeutic dependence on DRT and a maladaptive pathological pattern of DRT use, in conjunction with the SCID-1, we found that seven of the patients deemed by their treating physicians to be misusing DRT fulfilled operational criteria for maladaptive dependence in contrast to none of the compliant group. The majority experienced dysphoric "withdrawal" symptoms in the "off" state and increased their dose of DRT in an effort to control their mood. They also continued to use high doses of DRT despite disabling dyskinesias and social difficulties. This study provides preliminary evidence that some patients with Parkinson's disease may become maladaptively dependent on DRT. This finding has both clinical relevance for the treatment of PD and further implicates dopaminergic pathways in the genesis of substance dependence.

Adult↗
PubMed2006

Quality of life in patients with active sarcoidosis in Greece.

BACKGROUND: The health status of patients with sarcoidosis has rarely been studied, despite the increasing numbers of health-related quality of life publications on other respiratory diseases. The aim of this cross-sectional study was to investigate whether sarcoidosis affects quality of life (QoL), using specifically designed questionnaires for respiratory diseases as well as general health measures, and to compare these with pulmonary function indices. Our secondary aim was to determine whether these measurements are correlated with pulmonary function tests and duration of the disease. METHODS: Included in the study were 75 consecutive patients with histologically confirmed active sarcoidosis. Self-completed dyspnea scales (Borg's scale, oxygen cost diagram, modified MRC questionnaire) and health-related quality of life (HRQoL) questionnaires (St George's Respiratory Questionnaire, Quality of Well-Being, and Anxiety and Depression) were used. Pulmonary function tests, measurements of arterial blood gases at rest and after exercise, chest radiographs, and duration of disease were used for correlation. RESULTS: We found that QoL was affected in sarcoidosis patients in comparison with healthy controls. Secondly, we found that the duration of the disease was correlated with all three dyspnea scales under evaluation, as well as with the SGRQ questionnaire. Furthermore, a significant correlation was shown between lung function tests (FVC, % pred and FEV(1), % pred) and both the BORG dyspnea scale and the SGRQ questionnaire. CONCLUSION: Quality of life is affected in patients with active sarcoidosis. The SGRQ questionnaire could be a useful tool for the investigation of HRQoL in an active sarcoid population with varying degrees of lung function impairment. Future studies are needed to address the ability of these instruments to measure HRQoL in the course of this chronic disease.

Journal Article↗
PubMed2005

Use of complementary and alternative medicine in patients with cancer: a UK survey.

Over the past decade Complementary and Alternative Medicine (CAM) use in the UK has increased dramatically. However, little research appears to exist regarding its use in patients diagnosed with cancer. The study was descriptive using a survey design. Questionnaire data was collected from 127 adult patients with a diagnosis of cancer from both Scotland and England. CAM use was reported by 29% of the sample. The use of relaxation, meditation and the use of medicinal teas were the most frequently used therapies. Findings suggest that CAM use within patients diagnosed with cancer in the UK has increased which has implications for patient and health care professional education.

Adult↗
PubMed2006

Prevalence and co-occurrence of self-rated pain and perceived health in school-children: Age and gender differences.

In this nationwide study, 1975 students from grades 3, 6, and 9 (ages 9, 12, and 15 at the onset of the year), were recruited from randomly selected schools, which represented different geographical areas throughout Sweden. The main aim of the study was to assess the prevalence of self-reported pain (headache, abdominal, and musculoskeletal pain) and perceived health (problems sleeping and/or if they often felt tired, lonely and sad). A second aim was to study the co-occurrence among different pain and health variables. The students, (n = 1908 distributed by grade 3: 255 girls and 305 boys, grade 6: 347 girls and 352 boys, grade 9: 329 girls and 320 boys) answered retrospectively (three months) a specially designed questionnaire. Fifty percent (50%) of the students reported that they had experienced pain, either as headache, abdominal pain or musculoskeletal pain, within the recall period. Gender differences were especially noticeable for headaches, where twice as many girls (17%, n = 159) than boys (8%, n = 80) reported that they suffered such pain at least once a week or more often. Co-occurrence among the variables was moderate (0.3-0.5). For the total of the seven variables, the perception of pain and health complaints decreased with age for boys from grades 3 to 9, while multiple complaints increased for girls.

Abdominal Pain↗
PubMed2004

Clinical ethical dilemmas for vascular surgeons (the VASCUETHICS study): are self-interest attitudes related to professional seniority?

OBJECTIVE: To evaluate the association between professional seniority and self-interest (PSI) attitudes in the resolution of vascular ethical dilemmas (VED). DESIGN: Cross-sectional. SUBJECTS: Vascular surgeons (residents included) from the 28 vascular teaching departments of Spain. Measurements. Multidisciplinary team-designed questionnaire of 5 VED. Each VED had 3 different answers (attitudes): 2 favouring legitimate ethical attitudes (LEA) and 1 favouring PSI. The questionnaire was self-administered and all participants stated their degree of agreement with each answer on a continuous Likert scale. PSI was evaluated by: (1) adding the magnitudes of the 5 answers favouring PSI (absPSI); and (2) by comparing in each case the magnitude of the PSI answer with that of the 2 LEA (relPSI). STATISTICS: Linear regression adjusted by confounding factors. RESULTS: Two hundred and fifty-three vascular surgeons from the 26 participating teaching vascular departments of public hospitals completed the questionnaire (87.5% surgeons/department). Surgeon characteristics were: (1) median age 37 years; (2) 187 (74%) male; (3) 59 (23%) brought up with a health professional relative; (4) 94 (38%) had additional private practice; (5) 133 (65%) professed religious beliefs; and (6) 1-10 years of experience in 116 (47%), 11-20 years in 58 (24%), 21-30 years in 57 (23%), and >30 years in 15 (6%). The multivariate analysis disclosed that for every 10-years rise in professional seniority there was a 3.2% increase in absPSI (p=0.007, adjusted by variables 3 and 4), and a 3.4% increase in relPSI (p=0.002, adjusted by variable 5). CONCLUSIONS: Professional seniority is associated with a slight increase in pro-PSI attitudes in cases of vascular ethical dilemma. Both vascular surgeons and health institutions should promote the reversal of this worrying tendency.

Adult↗
PubMed2004

Sites of implantation for central venous access devices (ports): a study of the experiences and preferences of patients.

OBJECTIVE: To obtain information which might guide vascular specialists and their patients in the choice of site for implantation of central venous access devices (CVADs). DESIGN: Questionnaire study. METHODS: Questionnaires were sent to 69 patients with cystic fibrosis and 54 (78%) responded (39 females: age 5-63, median 24 years). They had received a total of 79 CVADs placed in the upper chest (60), lower chest (13), thigh (3) and arm (3). Only 46% patients had been offered a choice of site. RESULTS: Questions about 14 specific areas of disability or concern found problems most frequently with discomfort (54%), wearing a seatbelt (51%), cosmetic appearance (44%), scarring (44%), choice of clothing (42%) and lying in bed or sleeping (42%). There were no significant differences between upper and lower chest CVADs. Patients with upper chest CVADs seldom had any problems with use of their arm (12%). 81% CVADs could not be accessed by the patients, and in 39% of these cases patients would have liked to do so. CONCLUSIONS: Many patients complain of few problems with their CVADs, regardless of site, but half have some persistent discomfort. Cosmetic considerations frequently cause concern and patients should be given choice in the site of their CVADs.

Adolescent↗
PubMed2005

Venous ulcer services in the United Kingdom.

OBJECTIVES: To obtain comprehensive information about venous ulcer services throughout the United Kingdom (UK). DESIGN: Questionnaire based survey. MATERIALS: Questionnaire. METHODS: Letters about venous ulcer services were sent to consultant vascular surgeons in all areas of the UK (total 181). Questionnaires were then directed to the appropriate clinician in each area. RESULTS: Responses were received from 177 (98%) areas. Fifteen (8%) had no dedicated service. Completed questionnaires were returned for 112 (63%) areas. Fifty-six (54%) services were managed by acute hospitals, 29 (28%) by primary care (community) and 19 (18%) jointly. Doctors supervised services in 65 (64%) (vascular surgeons 49, dermatologists 12, both 4) and nurses in 31 (33%). New referrals per week were 1-50 based on audit (33%) or estimates (67%). Sixty-three (58%) services had no database. Written guidelines existed for 76% services (90% nurse-supervised and 64% doctor-supervised services--p<0.02). CONCLUSIONS: Dedicated venous ulcer services have been shown to improve healing rates and quality of life. Although now present in most areas of the UK, their organisation varies considerably and many are not based in the community, near patients homes. This survey provides a benchmark for comparison with venous ulcer services in other countries.

Community Health Services↗
PubMed2006

Ultrasound based measurement of 'carotid stenosis >70%': an audit of UK practice.

OBJECTIVES: To determine velocity thresholds for diagnosing 'carotid stenosis >70%' and whether Vascular Studies Units in the United Kingdom used ECST or NASCET measurement methods. DESIGN: Questionnaire to 102 members of the Society of Vascular Technology of Great Britain and Ireland. RESULTS: One quarter (26%) of respondents reported that their unit used the NASCET measurement method, 31% used the ECST method, while 43% did not know. When all velocity criteria were pooled and compared, an almost equal proportion of ECST, NASCET and 'do not know' respondents used a peak systolic velocity threshold of >230 cm/s as being diagnostic of a 'stenosis >70%'. Interestingly, this velocity is now the threshold proposed by a North American consensus group for diagnosing a NASCET stenosis of >70%. CONCLUSIONS: This audit suggests that there is considerable confusion about what constitutes an ultrasound based diagnosis of 'stenosis >70% in the United Kingdom.

Blood Flow Velocity↗
PubMed2005

Respiratory effects of inhalation exposure among workers during the clean-up effort at the World Trade Center disaster site.

During December 2001 we conducted a field study of 183 clean-up and recovery workers at the World Trade Center (WTC) disaster site to assess respiratory health effects potentially resulting from their work at the site. On site, we administered a respiratory health questionnaire designed to assess upper respiratory symptoms and lower respiratory symptoms, including cough, phlegm, and wheeze, as well as indices of exposure, including number of days worked at the site and job category. Spirometry was conducted for 175 workers. Sixty-five percent of the workers surveyed arrived at the site without lower respiratory symptoms. Of this group, 34% developed cough, 24% developed phlegm, and 19% developed wheeze. Prevalence rates of these symptoms were related to the number of days spent working at the WTC, but not job category. The mean percentage predicted FEV(1) and FVC were 6% and 5% lower, respectively, for workers who developed new lower respiratory symptoms compared to those who remained symptom free. While the development of new wheeze suggested the presence of airway obstruction, the near-normal distribution of age-adjusted FEV(1)/FVC ratios suggested that the degree of obstruction was mild. The prevalence rates of upper airway symptoms (nasal congestion, sore throat, hoarse throat) exceeded those of lower respiratory symptoms, however, it was not determined whether symptoms pre-dated arrival at the WTC site.

Adult↗
PubMed2004

Paroxysmal atrial fibrillation in male endurance athletes. A 9-year follow up.

AIMS: To study the course and circumstances of atrial fibrillation in endurance sports. BACKGROUND: Atrial fibrillation is the main cause of symptoms in athletes and frequently disturbs the performance during the practising of sport. The course of the arrhythmia is seldom reported in this population. METHODS: In 1993 and 2002 symptoms and clinical presentation of atrial fibrillation were evaluated in 30 well-trained athletes with a specially designed questionnaire. RESULTS: In 1993 paroxysmal atrial fibrillation was present in 30 male athletes at the mean age of 48.1 +/- 7.8, 3 (10%) of them also had paroxysmal atrial flutter. Three (10%) of the athletes died before 2002. In 2002 paroxysmal atrial fibrillation continued in 15 (50%) athletes, permanent atrial fibrillation emerged in 5 (17%) athletes and 7 (23%) of them showed no further atrial fibrillation. In 1993 paroxysms of atrial fibrillation started at a relatively low level of training intensity compared with the mean maximal training intensity of 11 +/- 7 versus 8 +/- 4 h/week (p < 0.05). The first attack of adrenergically induced paroxysmal atrial fibrillation was more often present in younger athletes (p < 0.005) and vagally induced paroxysmal atrial fibrillation was more apparent in older athletes (p < 0.05). In 10 (38%) of the athletes a familiar form of paroxysmal atrial fibrillation was present. CONCLUSION: A small proportion of the athletes (26%) was asymptomatic. Paroxysmal atrial fibrillation remained stable in half of the athletes whereas the arrhythmia changed into permanent atrial fibrillation in a minority of this population.

Adult↗
PubMed2007

Patients with Barrett's esophagus perceive their risk of developing esophageal adenocarcinoma as low.

BACKGROUND: The risk of developing esophageal adenocarcinoma (EAC) for patients with Barrett's esophagus (BE) is approximately 0.5% per year. OBJECTIVE: To investigate how patients with BE estimate and perceive their risk of developing EAC. DESIGN: Questionnaire study. SETTING: Patients with BE who were undergoing surveillance endoscopy based on histologic and flow cytometric results. PATIENTS: A total of 192 patients with BE were included. MAIN OUTCOME MEASUREMENTS: Individual patients were asked to estimate the numerical risk to develop EAC for patients with BE in general and for themselves. How patients perceived their own risk was measured on a scale from "very small" to "very large." RESULTS: At least 1 question was filled out by 169 patients (88% response). Sixty percent of respondents underestimated the numerical risk for patients with BE, in general, to develop EAC, while even more patients (69%) underestimated their own risk. Most respondents perceived their own risk as very small or small (63%). LIMITATIONS: Risk estimations may depend on the response scale used. CONCLUSIONS: Most patients with BE underestimated the numerical risk and perceived their risk of developing EAC as (very) low. Despite a low perceived risk, all patients in this group adhered to endoscopic surveillance.

Adenocarcinoma↗
PubMed2005

When being 'tired of living' plays an important role in a request for euthanasia or physician-assisted suicide: patient characteristics and the physician's decision.

BACKGROUND: In the Netherlands physicians are allowed to grant requests for euthanasia or physician-assisted suicide (EAS) if they meet several requirements of due care. According to jurisprudence, a physician is not allowed to end the life of a patient whose request for EAS is based on being 'tired of living', because such a request falls outside the medical domain. Our previous studies have shown that in spite of this, such requests are made approximately 400 times a year. OBJECTIVES: To learn more about patients who request EAS because they are tired of living, and about factors that influence the decision of the physician. DESIGN: Questionnaires (n=4842) completed by general practitioners (n=3994). RESULTS: According to the physicians, 17% of patients who requested EAS were 'tired of living'. Of 139 patients in whose request for EAS being tired of living played a major role, 47% suffered from cancer, 25% suffered from another severe disease and 28% had no severe disease. In all three groups the same three symptoms occurred most frequently, 'feeling bad', 'tired', and 'not active'. Each of these symptoms occurred in more than half of the patients in each group. Most of the requests from patients with cancer were granted, but those from patients who had some other severe disease, or no severe disease at all, were refused. Factors that were related to granting a request were: the presence of unbearable and hopeless suffering, the absence of alternatives, and the absence of depressive symptoms. CONCLUSIONS: Being tired of living can play a major role in requests for EAS, both in the absence and the presence of a severe disease. The high occurrence of symptoms in the absence of a classifiable severe disease implies that physical symptoms are prevalent in this group of patients, leaving the legal requirement for EAS of 'a medical cause' open to interpretation in the more complex medical practice.

Adult↗
PubMed2005

Nurses' and physicians' sedation practices in Danish ICUs in 2003 A national survey.

OBJECTIVE: The aim of the study was to describe and compare physicians' and nurses' estimated use of sedatives and analgesics in patients requiring mechanical ventilation in Danish Intensive Care Units (ICUs) in 2003. DESIGN: Questionnaires were mailed in January 2003 to all Danish ICUs providing mechanical ventilation (n = 48). One physician and one nurse at each site were included in the study. RESULTS: Thirty-nine questionnaires were returned by physicians (response rate 81%) and 43 by the nurses (response rate 90%). Physicians and nurses agreed that sedation related decisions are predominately made during rounds and that most decisions are made by physicians and nurses collaboratively. Only 9% of the nurses and 23% of the physicians reported using a written protocol for sedation, while 30% of the nurses and 44% of the physicians reported the use of sedation scoring systems. The study generally supported the hypothesis, that nurses' and physicians' would respond similarly, but there were, however, significant variations, regarding formal sedation practices. CONCLUSIONS: Sedation decisions are made collaboratively by nurses and physicians, while sedation protocols and scoring systems are still not systematically implemented in Danish ICUs. The most common drugs for sedation of the mechanically ventilated patient are propofol and fentanyl by continuous infusion. It is recommended that the ICUs collaborate on developing evidence-based standards for sedation and that clinical databases are introduced, which may be used to assess the efficacy of such standards.

Anesthetics, Intravenous↗
PubMed2005

A comparison of recovered bipolar patients, healthy relatives of bipolar probands, and normal controls using the short TEMPS-A.

OBJECTIVE: To investigate the presence of temperament dysregulation in healthy relatives of bipolar probands (RBP), a population at high risk for developing mood disorders, by comparing them with clinically recovered bipolar patients (BP) and normal controls (NC). METHOD: 52 RBP and 23 BP were originally recruited for a multicenter genetic study in bipolar disorders. NC (n=102) were also recruited by newspaper advertisement, radio and television announcements, flyers, newsletters, or word of mouth. All volunteers were asked to complete the TEMPS-A Scale, a self-report questionnaire designed to measure temperamental variations in psychiatric patients and healthy volunteers. In scoring temperaments, we relied upon the short validated version of the TEMPS-A [J. Affect. Disord. (2004)], from which traits with loadings <0.035 had been deleted. RESULTS: To examine differences in temperament dimensions among the three groups, a MANCOVA model was constructed using diagnostic group as the fixed factor (BP vs. RBP vs. NC); effects of age and gender were adjusted as covariates. MANCOVA showed overall group effect on the dependent variables (Hotelling's F5,175=6.64, p<0.001). Four dependent variables (dysthymic, cyclothymic, irritable, and anxious temperaments) showed significant between-group differences. RBP showed lower cyclothymic temperament scores than BP, but higher scores than NC. BP and RBP showed higher anxious temperament scores than NC. Hyperthymic scores were significantly highest in the NC. LIMITATION: In view of the small cell sizes, bipolar I vs. bipolar II subanalyses could not be conducted. CONCLUSIONS: Methodologic strengths of the present analyses is that the BP group had clinically recovered, and we used the validated short version of the TEMPS-A for the present analyses. Our findings suggest that some clinically healthy relatives of bipolar probands exhibit a subclinical cyclothymic instability in mood, interest, self-confidence, sleep, and/or energy as well as anxiety proneness that is not observed among normal controls. These traits may represent vulnerability markers and could presumably be used to identify individuals at high risk for developing bipolar spectrum disorders, or specific clinical subtypes (e.g., bipolar I, bipolar II) within this spectrum. This is a conceptual perspective with many unanswered questions. Resolution of these questions will require innovative definitions of phenotypes to be included in the analyses of the temperament subscales in different populations. The temperament subscales themselves need to be calibrated properly, to find out which traits or specific combinations of trains are most promising. More extensive and complex quantitative trait analyses of these temperaments in a much expanded sample are reported elsewhere in this issue [J. Affect. Disord. (2004)].

Adaptation, Psychological↗
PubMed2005

Dietitian involvement in the neonatal intensive care unit: more is better.

OBJECTIVE: Describe the level of registered dietitian (RD) involvement in neonatal intensive care units (NICUs) and associations with NICU nutrition practices. DESIGN: Questionnaires were mailed to 820 NICUs in the United States with two follow-up mailings to nonresponders. Abbreviated phone surveys were conducted with a random sample of 10% of nonresponders. A nutrition care score was devised based on a sum of 10 survey questions (range 0 to 10) to summarize the intensity of reported practices. SUBJECTS/SETTING: Directors of NICUs in the United States and RDs associated with them. STATISTICAL ANALYSES: Chi2, analysis of variance, Bonferroni and Duncan multiple range tests, regression. RESULTS: Respondents from 417 (54%) of the 772 NICUs eligible for the study provided completed questionnaires. Among NICUs responding, 76% involved RDs in care (41% employed full- or part-time RDs, 35% employed consult RDs), and 24% had no RD. NICUs with full- or part-time RDs provided fewer kilocalories and more protein parenterally, and more kilocalories and protein enterally. NICUs with less RD involvement were more likely to provide full-term infant feedings (eg, unfortified breast milk, full-term formula) to very-low-birth-weight infants. Mean nutrition care score varied with RD involvement from 4.6+/-1.7 (mean+/-standard deviation) for NICUs with a consult RD and 4.7+/-1.4 for NICUs employing no RD to 5.6+/-1.7 for NICUs with a full- or part-time RD (overall P<.001). CONCLUSIONS: More involvement of RDs in NICUs increased the intensity of important aspects of nutrition care that may improve outcomes of very-low-birth-weight infants in NICUs. These findings highlight the importance of RDs as NICU team members.

Analysis of Variance↗
PubMed2006

Facilities for complainants of sexual assault throughout the United Kingdom.

BACKGROUND: A sexual assault referral centre (SARC) is a model of service established to address the forensic and therapeutic needs arising following sexual assault. As yet, only a minority of urban areas in England are served by one, the rest of the United Kingdom (UK) being served by police victim examination suites. OBJECTIVE: To examine variations in service offered to complainants of sexual assault within the United Kingdom in 2005. METHODS: A purpose designed questionnaire sent to all areas of the United Kingdom. Data were received and analysed from 12 of 13 SARCs and 54 of 58 non SARC services. RESULTS: Very wide disparities in service, most marked between SARC and non SARC services. SARCs see a proportion of complainants from non-police sources. The non SARC services do not usually offer a forensic examination without police involvement, and a significant minority have so few doctors that they cannot provide a 24h rota for examinations. Inadequate numbers of forensic physicians are available for child examinations, and a robust service for 'acute child sexual assault' is virtually absent. Photodocumentation with appropriate safe storage is available in all SARCs, while 45% of non SARCs have no facility for photodocumentation. DNA contamination issues were perceived to be significant in many of non SARC services. Most non SARC services for adults do not provide baseline screening for sexually transmitted infection (STI) or offer prophylaxis against STIs. Follow up is by referral to local clinics which complainants may have to arrange themselves. Funded counselling is rare in the non SARCs with the exception of Yorkshire. CONCLUSION: In the non SARC services, lack of co-operative working with local health services, lack of equipment, and lack of 'in house' medical follow up arrangements is the norm. Many areas rely on the good will of a small number of doctors to provide a service without a rota.

Ambulatory Care Facilities↗
PubMed2005

Adolescents' experience with the combined estrogen and progestin transdermal contraceptive method Ortho Evra.

BACKGROUND: The new combined estrogen & progestin contraceptive patch Ortho Evra was approved by the FDA in December 2001. To date, there is a paucity of data regarding its use in the adolescent age group. We examined adolescents' experience with this new contraceptive method. METHODS: Using a questionnaire designed by the authors, care providers in a hospital based adolescent clinic interviewed and reviewed the charts of adolescent girls who had initiated Ortho Evra in 2002-2003. RESULTS: Twenty-eight adolescent girls (age 18 +/- 1 years, gyn age 6 +/- 1 years, onset of sexual intercourse at 14 +/- 1 years, body mass index (BMI) 27.6 +/- 1.2, 57% Hispanic, 21% Caucasian, 11% African American, 7% biracial, 4% Indian American) who had used Ortho Evra for 7 +/- 1 months were enrolled. Half (50%) were adolescent mothers, and 57% had a history of irregular menstrual periods. All (100%) girls reported regular menstrual periods while using Ortho Evra, with only 14% experiencing occasional breakthrough bleeding. Half reported a shorter duration and 36% reported a lighter flow of their periods. About a third (39%) reported a decrease and 11% reported an increase in dysmenorrhea symptoms. About a third (29%) of those with a history of recurrent headaches at initiation reported decrease in headaches, and about a third (33%) of those with acne at initiation reported decrease in facial acne while on Ortho Evra. There were no significant BMI changes during Ortho Evra use. Although condom use while on Ortho Evra was poor (only 15% reporting consistent condom use), there were no pregnancies reported. A majority (93%) reported that they remembered to apply the patches on time, and 40% stated that Ortho Evra was easier than previous contraceptive methods. Two thirds (68%) were very satisfied and 29% were somewhat satisfied with the method, and 93% stated that they would recommend the method to a friend/relative. The preferred application site was the buttock (40%) followed by the lower abdomen (32%). About a fifth (21%) experienced at least one episode of complete patch detachment and 32% reported partial peeling of the patch corners. About a third (32%) would prefer another patch color, and 25% would like a fourth week placebo patch. The most common side effects were mild temporary application site reactions (64%), some discomfort on patch removal (32%), nausea (18%), and breast tenderness (18%). Eleven girls (39%) discontinued Ortho Evra (three lost health insurance, three because of application site reactions, two found patch application schedule difficult to remember, two desired pregnancy, two because of nausea, one because of perceived weight gain). CONCLUSIONS: Ortho Evra provides excellent cycle control in adolescents. Most adolescents are satisfied with this method. Intensive efforts should be made to increase condom use by adolescents on Ortho Evra.

Abdomen↗