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A new, short family function assessment questionnaire for use in family medical practice in Israel: construction, validation and preliminary application.

This report describes the compilation and initial steps in the field testing of a new questionnaire intended for Israeli family physicians wishing to rapidly assess the general level of family functioning of their patients as part of everyday routine history taking in practice. The questionnaire was shown to have reasonable reliability and validity in a nonrepresentative sample of 140 married Israeli adults in three different family medicine practices. The questionnaire yielded a sum score ranging from 0 to 20. Preliminary estimates, based on a comparison of the sum score of each patient's questionnaire with the doctor's assessment of the family's functioning, suggest that patients of families with poor function score 11 or less, with satisfactory function 12 to 17, and with good function more than 17. These ranges require further refinement and standardization by testing the questionnaire among other groups of the Israeli population.

Adult↗

Maternity blues. I. Detection and measurement by questionnaire.

The studies reported had two purposes: (a) to identify psychological symptoms commonly experienced by mothers in the first few days after childbirth; (b) to use psychometric methods to develop a questionnaire for detecting and measuring these symptoms. A draft 49-item questionnaire was derived by asking 100 newly delivered mothers to volunteer suitable items. The number of items was systematically reduced to 28 while testing the questionnaire on two further samples of newly delivered mothers (n = 100 and n = 50). Cluster analysis of the 28 items yielded seven clusters, the robustness of which was established in a further sample of 87 newly delivered mothers. The validity of the 28-item questionnaire was established. The questionnaire was quick and easy to administer, suitable for repeated administration on consecutive days, and well accepted by mothers.

Female↗

Validation of a quantitative food frequency questionnaire for rapid assessment of dietary calcium intake.

This study tested the accuracy of a quantitative food frequency questionnaire (FFQ) designed to assess the amount of calcium consumed daily and to use as an educational tool in diet counseling and for prescribing calcium supplementation. The subjects were 26 perimenopausal women, aged 48 to 56 years, who were participants in a longitudinal osteoporosis study. Diets of the subjects were studied during the winter and summer of one year. Subjects filled out a food frequency questionnaire and the next week completed 4-day food intake records according to instructions from the researchers. The mean daily intake of calcium estimated from the food frequency questionnaire was 928 mg in the winter and 912 mg 6 months later. Ranges in the winter were 227 to 2,243 mg calcium and in the summer 198 to 3,063 mg calcium. The 53-item FFQ included descriptions of portion sizes and a calcium index for each item and had options for two frequency periods. The calcium level estimated from the questionnaire correlated (r = .73 in winter and r = .84 in summer) with the estimated amount from 4-day records. A seasonal difference was not found. The brief time (less than 5 minutes by a dietitian) required to calculate the amount of calcium consumed daily from the food frequency questionnaire could make it an important clinical tool.

Calcium, Dietary↗

The meaning of illness questionnaire: reliability and validity.

The reliability and validity of a recently developed Meaning of Illness Questionnaire (MIQ) is described. Questionnaire content was based on the work of Lazarus and Folkman (1984b). Three hundred twenty chronically ill subjects completed the 33-item MIQ and two open-ended questions. Subjects also completed the 45-item Psychosocial Adjustment to Illness--Self-Report Scale (PAIS-SR) described by Derogatis and Lopez (1983). Test-retest reliability for 70 subjects was, on the whole, substantial (kappa = .45 to 1.00) as was the ability of nurse clinicians to reliably categorize the qualitative component of the questionnaire into one of 12 categories (kappa = .64). The factor structure of the questionnaire supported the theoretical assumptions underlying the instrument. Three of the factors of meaning given the illness, R2 = .46, and/or three items, R2 = .60, had more power than coping behavior in explaining a person's adjustment to chronic illness. The questionnaire has accumulated reliability and validity in measuring a variety of concurrent yet divergent meanings that may be given an illness for three chronically ill populations--those with mixed cancer, rheumatological, and gastroenterological disorders.

Adaptation, Psychological↗

Validation of a semi-quantitative food frequency questionnaire: comparison with a 1-year diet record.

The validity of a self-administered semi-quantitative food frequency questionnaire was evaluated for a group of 27 men and women aged 20 to 54. Intakes of 18 nutrients computed from the questionnaire were compared with those derived from 1-year diet records completed approximately 18 months earlier. The questionnaire estimates of mean nutrient intake were within 10% of the mean diet record measurements for 11 of the 18 nutrients evaluated, and the difference was less than 25% for all but one nutrient (total vitamin A). Correlation coefficients comparing unadjusted nutrient intakes measured by the two methods ranged from 0.38 (vitamin C) to more than 0.65 (total calories, total fat, saturated fat, polyunsaturated fat, oleic acid, and cholesterol). The overall mean of correlation coefficients comparing intakes of the 18 nutrients measured by questionnaire and by diet record was 0.60. Coefficients for macronutrients decreased somewhat after adjustment for age and gender or caloric intake. The data provide further evidence that a simple and relatively inexpensive questionnaire can provide useful information on dietary intake over an extended period.

Adult↗

[Questionnaire method of evaluating the effectiveness of the treatment of pain].

A Polish version of pain questionnaire for pain intensity definition has been prepared after an inquiry study on the "pain glossary" which showed that in the Polish language a large number of words are used for characterization of pain. These words contain information about pain intensity understandable for the studied population. The authors describe this questionnaire and discuss a preliminary evaluation of its usefulness for assessing the effectiveness of pain management. The presented questionnaire makes possible evaluation of pain intensity in several indices whose values correlate significantly with each other. In comparative investigations a significant correlation has been found also between the indices of pain intensity in the questionnaire and the index in the 24-hour observation card. The mean differences of pain intensity scores calculated before and after the treatment differed significantly in definite categories of verbal evaluation of treatment effectiveness. This justifies the conclusion that the questionnaire may be useful for evaluating treatment effectiveness by a method not depending on the utterances of the patients.

Acupuncture Therapy↗

[Value of the health questionnaire in family medicine and hospital consultation].

Questionnaires calling for answers of yes or no were tested in the field of family medicine (125 questions) and in a hospital outpatient clinic (164 questions). In the hospital, results were not given to physicians before evaluation of the patient. In family medicine, 3 328 positive answers were given by 200 patients (average 17), against 3 439 and 115 (average 30) respectively in the hospital. As compared with questionnaires, conventional case-reports missed two out of three symptoms or antecedents, many of which were important. Examples are given. Such omissions were more frequent in males, and in some, specialties. They were not less frequent in common diseases. Unexpectedly, omissions were all the more numerous that patients already had more diagnoses. Filling the questionnaire took an average of 3.5 seconds per question. The opinion of patients was usually favorable. The duration of consultations was slightly increased when using the questionnaires. Questionnaires were useful: to patients, by reducing risks of omissions, fatigue of physicians and disparities between physicians; to physicians, by reducing risks of lawsuits. Economic results are complex. Acceptability is discussed. The initial reluctance of physicians can be overcome. From this experience, the number of questions can be brought down to 89.

Evaluation Studies as Topic↗

A questionnaire technique for assessing the stress at work.

Subjective perception of the stress at work is a phenomenon reflecting the experience-mediated relationship between the sum of objective conditions of work and the sum of individual's traits available to cope with demands of the work environment. This relationship is mirrored in the function of the whole organism and can be described using the formula S = f (E, D), where S = the state of the organism, E = exposure (i.e. the sum of all stressors the organism is exposed to), and D = disposition (i.e. the sum of traits the organism has available to cope with these stressors). Based on these theoretical considerations, a questionnaire has been developed as a tool for assessing the work stress in different groups of occupations. This "Work Stress Assessment" (WSA) questionnaire was used in a group of 4800 female employees from various branches of the printing industry. Of a total of 160 questionnaire items, 98 items were selected and used to assess the workload in these employees, using a 5-point rating scale of evaluation. The responses were processed statistically, separately for 3531 blue-collar and 1269 white-collar respondents. The use of the factor analysis method revealed that the two groups of jobs had 16 factors in common, 3 factors were specific for blue-collar and 2 factors for white-collar jobs. Judged by factor components, the responses of subjects were well structured and the perceived stress at work turned out to well reflect the reality of conditions of work, which confirms the construct validity of this methodical approach based on the subjective perception of occupational stress. High coefficients of consistency (0.959 for blue-collar and 0.946 for white-collar occupations) point to the reliability of this questionnaire technique. Thus, the WSA questionnaire appears to suitably complement the other methodical approaches aimed at assessing the stress at work in different groups of occupations.

Adult↗

[Questionnaire method in conducting prophylactic oncological examinations of the population of a rural locality].

The authors describe the method of conducting mass prophylactic oncological examinations by means of questionnaires at the first stage, which was developed at the N. N. Petrov Research Institute of Oncology of the USSR Ministry of Health. Questionnaires were aimed at the recognition of somatic pretumor and tumor lesions of the main localizations and the increase of oncological vigilance of general practitioners. The method has been tested on 11386 inhabitants of rural district of Leningrad and Novgorod Provinces. As a result of mass prophylactic oncological examinations 738 different pathologies were revealed (in 6.6% of all questionnaires), pretumor lesions making 2.05% malignant neoplasms--0.06%. The use of the questionnaire method in conducting prophylactic examinations made it possible: to enhance their medical efficacy, to reduce the number of individuals subject to medical control, to employ instrumental-laboratory tests on more proper grounds, and on the basis of a questionnaire to make a registry of the primary account of persons undergoing prophylactic examinations.

Epidemiologic Methods↗

Validity and reliability of a high school drug use questionnaire among Mexican students.

This study was carried out to ascertain the validity and reliability of data generated through an internationally developed self-administered questionnaire. Data were collected from two student populations in which prevalence of drug use was known (high and low prevalence rates) and information obtained from the questionnaire checked through personal interview. The questionnaire covered both demographic characteristics and drug use items. A total of 474 students were tested and 335 students (70.7 per cent) retested. Although percentages of missing data and inconsistent responses were high, the questionnaire appeared valid and reliable when analysed on a group basis. It was less reliable on an individual basis. In conclusion, it is considered that with minor modifications the questionnaire can be used in the populations studied with enough confidence in validity and reliability to allow comparisons.

Adolescent↗

Data collection techniques: mail questionnaires.

Questionnaire use, construction, content, wording, administration and pretesting are reviewed. Mail questionnaires gather large amounts of information at relatively low costs, but their design and administration affect the usefulness of the results. Many different aspects of a questionnaire survey will influence its effectiveness, including pre-contact and follow-up, cover letters, question sequence, and questionnaire appearance and length. The type of question to use depends on the level of measurement desired, suitability of the response form to the issue surveyed, and the ability of respondents to use and understand the response form. A small sample group should be used to pretest the questionnaire.

Methods↗

[Postpartum "blues" questionnaire. French version of "Maternity blues" of H. Kennerley and D. Gath].

The "maternity blues questionnaire", of Kennerley and Gath, has been translated, following the usual procedures: first, preparation of a preliminary translation in French, then, evaluation of the translation by experts of the subject matter and language. The French questionnaire has been tested, with French women from different socioeconomic levels, and with bilingual women. A back-translation has confirmed the translation. This 28 items questionnaire is presented in two steps to women: for each item first, they have to decide whether the item applies to them to-day by answering yes or no; then, to decide how much change there is from their usual self, by ticking one choice out of five, from "much less than usal" to "much more than usal". The instructions for questionnaire administration and scoring are described in the paper. We also describe the limits and difficulties of use and we discuss the possible applications of this questionnaire.

Depressive Disorder↗

[The Spanish version of the SF-36 Health Survey (the SF-36 health questionnaire): an instrument for measuring clinical results].

BACKGROUND: The present study, performed within the International Quality of Life Assessment project (including researchers from 15 countries) presents preliminary results of the process of adaptation of the SF-36 to be used in Spain. METHODS: The adaptation was based on the translation/back-translation methodology. Meetings of translators, researchers and patients were organized in order to produce successive versions. A study involving 47 individuals was carried out to assess the relative value (through a visual analogue scale) of each response choice of the questionnaire items. Finally, internal consistency and reproducibility of the Spanish version of the SF-36 was assessed by administering the questionnaire to 46 patients with stable coronary heart disease in two different occasions 2 weeks apart. RESULTS: The average ratings of equivalence of the translated version with the original were high regardless of the difficulty of translation. The rank ordering of mean scores for each responses choice agreed with the ranking assigned in the questionnaire in all cases. Cronbach's Alpha was higher than 0.7 for all dimensions (range: 0.71-0.94) except for Social Functioning scale (alpha = 0.45). Intraclass correlation coefficients between both administrations of the questionnaire ranged from 0.58 to 0.99. CONCLUSIONS: The adaptation process of the SF-36 has concluded with an instrument apparently equivalent to the original and with an acceptable level of reliability. Nevertheless, other basic characteristics of the adapted questionnaire (i.e. validity and sensitivity to changes) should be also assessed.

Adult↗

[Comparison of 2 methods of evaluation of food and nutrient intake: 24-hour recall and semiquantitative frequency questionnaire].

BACKGROUND: Methods of dietary collection at an individual level include various procedures with different estimates of food, energy and nutrients intakes. The aim of this study was to compare two dietary methods widely used in nutritional epidemiology: a 24-hour recall and a semiquantitative food frequency questionnaire. METHODS: One hundred and fifty-five people selected at random from the population of the Valle de Arán (Lérida, Spain) were surveyed. Nutritional intake information was obtained from both methods. RESULTS: The frequency method overestimated all the nutrient intakes only before adjustment by energy intake, except for cholesterol. After adjustment by energy intake estimations from both questionnaires were very similar; the percentages of energy supplied by proteins, fatty acids and carbohydrates were very similar, too; the polyunsaturated/monounsaturated fatty acid ratios, were almost the same. Results show a level of correlation between the questionnaires that ranges from 0.81 to 0.23. Nutrients that showed the highest crude correlation between both questionnaires were alcohol, energy, carbohydrates, sodium and iodine (R > or = 0.7) while vitamins C, B1, B6, B12, and A, niacine, folic acid, iron, phosphorus and potassium showed the lowest (R < or = 0.5). Energy adjusted correlations were quite different to unadjusted ones particularly for lipids, monounsaturated fatty acids, carbohydrates, fiber, cholesterol, zinc and sodium, for which a lower coefficient was calculated after adjustment, and vitamins B2, B6, C, D and potassium, for which a higher coefficient was estimated after energy adjustment. CONCLUSIONS: Both methods make similar assessments when adjusting for caloric intake, but food frequency questionnaire tends to overestimate food consumption.

Adolescent↗

[Reduction modality of a dietary questionnaire].

The data relative to the average daily intake of 7 nutrients and total energy obtained through the answers to a dietary questionnaire, consisting of 152 items and administered to 200 patients (admitted for acute pathologies) has been analysed. The aim has been to elaborate a questionnaire consisting of a more limited number of items but maintaining a great part of the informative contents from the original questionnaire. For this aim, a multiple regression model with a selection procedure for independent variables, of the stepwise type, has been used, where the dependent variable is the daily average intake of the nutrient and the independent variables are the consumption of each food included in the complete questionnaire (QC). By combining the results of the model with the 7 nutrients and total energy, 3 reduced questionnaires have been produced (QR): the first two are based on the sole criteria of the inter-individual variance of the intake of the nutrient, explained by the consumption of the foods included in the QR, the third by adding the foods that offer an adequate contribution in order to explain the supply of the nutrient under examination. The application potentials of the 3 QRs have been analysed both by evaluating the inter-class correlation coefficient, deduced by an concordance/discordance matrix relative to the quintilis values of the nutrient deduced by the QC and by each QR, and by simulating their use in a case-control study; for this aim, the attenuation of the odds ratio trend and the increase of the sample dimension has been calculated following the use of a QR instead of a complete one.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Measurement of quality of life in intermittent claudication. Clinical validation of a questionnaire].

OBJECTIVES: Functional limitation in patients with intermittent claudication impairs their quality of life. In order to measure this new evaluation parameter, we developed a self-administered questionnaire: Artemis. METHODS: The questionnaire was composed of a general instrument (SF-36) and a specific one. A cross sectional study was performed in 177 patients with intermittent claudication (mean age 68 +/- 10 years, 77% males) who stated their walking distance was limited within 50 to + 2000 meters. The acceptability, reliability and sensitivity of the questionnaire were tested. RESULTS: In patients who had a walking distance greater than 500 m (n = 96), the scores obtained were significantly higher (better quality of life) than in patients whose walking distance was limited to less than 500 m (n = 81) (p < 0.05). Intermittent claudication had a global effect on the different parameters of the quality of life evaluated by the questionnaire including physical performance and psychological and social aspects. CONCLUSION: The Artemis questionnaire as shown its ability to describe patients with intermittent claudication. It can be used in clinical trials as a tool for measuring quality of life.

Activities of Daily Living↗

Prosthetic profile of the amputee questionnaire: validity and reliability.

The Prosthetic Profile of the Amputee (PPA) is a clinical follow-up questionnaire that measures the factors potentially related to prosthetic use and the actual use of the prosthesis by people with a lower extremity amputation. This profile is a report on the psychometric properties of the questionnaire. The PPA was administered, on two occasions, to 89 adults with lower extremity amputations. Test-retest data analysis demonstrated that the questionnaire was reliable in terms of repeatability. Strong test-retest agreements were obtained. When the PPA was assessed against the Reintegration to Normal Living (RNL) index, results supported the presence of construct validity. Data confirmed convergence of analogous constructs of the PPA questionnaire and the RNL index and showed evidence of discrimination between the more distantly related constructs. Based on the results of this study, we conclude that the PPA questionnaire is reliable and valid for clinical and research use.

Adult↗

Validation of a short dietary questionnaire and a qualitative fat index for the assessment of fat intake.

In connection with a population-based study on familial and non-familial determinants of serum total cholesterol an interviewer-administered short questionnaire, including 21 food items, and a qualitative fat index based on four questions were developed. Subjects for the validation study, 51 women and 31 men, aged 16-71 years, were selected from the population-based study (n = 892). The short questionnaire and the qualitative fat index were validated with a 3 day food record as the reference method. The short questionnaire captured 90-97% of the mean intakes of total fat, saturated, monounsaturated and polyunsaturated fatty acids and cholesterol. The Pearson correlation coefficients between the fat intakes based on the questionnaire and the diet records were strongest for the intake of total fat (r = 0.80). The qualitative fat index was based on four questions concerning type of fat: the higher the scores the higher the intakes of polyunsaturated fatty acids. The Spearman correlation coefficients between the qualitative fat index and the intakes based on the diet records were -0.55 for saturated, 0.34 for monounsaturated and 0.52 for polyunsaturated fatty acids. The respective correlation for the P/S ratio (total amounts of polyunsaturated fatty acids/saturated fatty acids) and the PM/S ratio (total amounts of polyunsaturated and monounsaturated fatty acids/saturated fatty acids) were 0.50 and 0.53. An inverse association between serum total cholesterol and the qualitative fat index was found in the whole study population, suggesting the impact of dietary fat on serum cholesterol in this study population. In conclusion, the short questionnaire proved to be accurate in measuring the intake of different fatty acids at the group level, whereas the simpler fat index measured the quality of fat quite well.

Adolescent↗