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Interviews or medical records, which type of data yields the best information on elderly people's health status?

BACKGROUND AND AIMS: Self-reported data and/or medical records are often used to assess the prevalence of illness and impairment in epidemiological studies. However, these two data sources do not always provide the same information. The aim was to compare data from interviews and medical records regarding illness, symptoms and impairment in the elderly, and to analyze the agreement between a consensus from both data sources and data from interviews and medical records, respectively. METHODS: We interviewed 130 persons (age range 67-99) regarding socio-demographic background data and physical and mental health. Medical records were reviewed. Illness burden was rated according to the Cumulative Illness Rating Scale for Geriatrics, and was rated in three ways based on: (1) interview data; (2) medical records; (3) information from both interviews and medical records considered to be consensus. Agreement was measured by the Kappa coefficient and the Svensson Paired Rank Measurement. A permutation test tested whether the ratings from interviews and medical records had the same agreement when compared with consensus. RESULTS: Statistically significant differences in agreement were found between interview versus consensus and medical records versus consensus for the vascular system (medical records best), eyes/ears/nose/throat/larynx and musculoskeletal/integument (interview best). Medical records gave better in formation concerning specific diseases and diagnoses, whereas interview data provided a better measure of illness, functional impairment and health in a broader sense. CONCLUSIONS: Both medical records and interviews yield good information of elderly people's health status, but they focus on different aspects of health.

Adult↗

Time and cost analysis of a computer-assisted telephone interview system to collect dietary recalls.

This study, conducted in 1991, examined the time requirements and costs of obtaining 24-hour dietary recalls via telephone interviews using the University of Minnesota's microcomputer Nutrient Data System to conduct the interviews and compute the nutrient composition of the diets. The subjects were 156 hypercholesterolemic children (aged 4-10 years) and 102 hypercholesterolemic adults (aged 21-65 years), who were participating in ongoing cholesterol education programs. A total of 391 recalls were completed with the children and 278 with the adults. For each completed interview, 3.5 and 2.8 attempts were required, respectively. Evenings were the most productive time for completing interviews. All tasks associated with completing the interviews (attempts to call, interviews per se, and postinterview procedures) required an average of 39.7 and 35.5 minutes per completed interview with the children and adults, respectively. About half of these total times were actually devoted to conducting the interview. The costs per completed interview were $9.22 for the children versus $6.99 for the adults. This difference reflects the greater number of attempts required to reach the children, the longer duration of their interviews, and the higher intrastate toll rates for calls to them as compared with the interstate rates for calls to the adults.

Adult↗

An investigation of tasks and techniques associated with dynamic interview adequacy.

We examined the hypotheses that adequately conducted dynamic interviews would be associated with performance on five interview tasks, which, in turn, would be associated with specific clinical techniques. Ten subjects provided two dynamic interviews each, one rated higher and one lower in overall dynamic adequacy. Interviews were independently rated for completion of five interviewer tasks. Another rater independently categorized each therapist intervention as one of 10 therapeutic interventions. Dynamic interview adequacy was associated with four of five interview tasks, attributable to the interviewer's contribution, after controlling for the subject's contribution. Four tasks-frame setting, exploration of affect, interpretation, and synthesis-were associated with specific clinical interventions, whereas offering support was not. The overall thoroughness of completing the interview tasks was highly associated with dynamic adequacy and the ratio of exploratory to supportive interventions. The adequately conducted dynamic interview is associated with identifiable tasks and techniques that should facilitate teaching it for research or clinical use.

Adult↗

Comparability of telephone and face-to-face interviews in assessing axis I and II disorders.

OBJECTIVE: The present study examined the comparability of data obtained by telephone and face-to-face interviews for diagnosing axis I and II disorders. METHOD: Sixty young adults from the community were interviewed face-to-face and over the telephone regarding axis I disorders; another 60 subjects were interviewed twice regarding axis II disorders. The order of interviews was counterbalanced, and subjects with a history of disorder were oversampled. Agreement between telephone and face-to-face interviews was contrasted with interrater values, which were obtained by having a second interviewer rate a recording of the original interview. RESULTS: Interrater reliability was excellent. Agreement between telephone and face-to-face assessment was excellent for anxiety disorders and very good for major depressive disorder and alcohol and substance use disorders; agreement was problematic, however, for adjustment disorder with depressed mood. Strong support was shown for the validity of the axis II telephone assessment format. Small but consistent trends were noted for lower rates of psychopathology reported in the second interview. CONCLUSIONS: This is the first study in which telephone and face-to-face assessments of axis I and II psychopathology were conducted with the same subjects assigned to conditions in a counterbalanced manner. The present findings provide qualified justification for the use of telephone interviews to collect axis I and II data. The apparent concerns do not appear sufficient to override the economic and logistic advantages of telephone interviewing.

Adolescent↗

Use of trained mothers to teach interviewing skills to first-year medical students: a follow-up study.

This report describes an attempt to evaluate the effectiveness of "trained mother" interviews early in the medical school curriculum. As an adjunct to a first-year course that teaches interviewing techniques, half of the students were exposed to an interview with one of three trained mothers early in the course. This treatment interview was immediately followed by a feedback session which concentrated on the content and process of interviewing. At the end of the course, all students had an evaluative interview. Those students who had an initial interview and feedback session with a trained mother scored significantly higher on both the content and process of their interviews than the control group. This technique is an effective and efficient way to teach interviewing skills to medical students prior to entering any of their clinical clerkships. A follow-up assessment conducted one year later indicated that one interview with a trained mother is sufficient for optimal learning and that the skills learned are retained over at least that period of time.

Adult↗

Postpartum interviews: factors affecting patients' learning and satisfaction.

BACKGROUND: Interview setting and technique presumably alter efficacy of the postpartum interview. It is commonly believed that interviews are most effective when both parties are positioned at the same physical level. OBJECTIVE: To test the hypothesis that women's satisfaction and learning are improved when postpartum visits are conducted by pediatricians sitting in a chair rather than standing and are further improved when female pediatricians sit on the mother's bed. DESIGN: Randomized double-blind study. SETTING: University hospital newborn nursery. SUBJECTS: Seventy-five mothers on their first postpartum day. Patients' postpartum interviews were conducted by physicians assigned randomly to (1) sitting on the edge of the bed near the mother's feet, (2) sitting in a chair near the side of the bed, or (3) standing at the foot of the bed. MAIN OUTCOME MEASURES: Within 60 minutes of completing the interview, an investigator (B.S.W.), blinded to physician position, asked each mother questions related to her satisfaction with the interview and the information that she was given. Differences among position groups were compared by means of 1-way analysis of variance or Kruskal-Wallis, chi2, or Fisher exact tests; P<.05 was considered statistically significant. RESULTS: Potential confounding factors were similar among patients assigned to each of the 3 interview positions. The estimated duration of the interviews, the degree of satisfaction, and information retention were similar in each group. CONCLUSION: Physicians need not make special efforts to conduct postpartum interviews in a seated position.

Analysis of Variance↗

Admission interviews: questions of utility and cost in masters of physical therapy programs in the United States.

PURPOSE: The purpose of this research was twofold. The first purpose was to assess the predictive validity of the interview process in student completion of entry level Masters of Physical Therapy programs on the conventional schedule for the university. The second was to provide a descriptive study of interview formats currently used by these institutions and the cost to the institution, estimated by hours of labor used exclusively for the interview process. METHOD: A questionnaire was mailed to the Director of Admissions of 63 accredited Masters of Physical Therapy programs in the United States. Forty-three responded to the questionnaire for a response rate of 68.3%. Twenty-eight programs (65.1%) performed interviews and fifteen (34.9%) programs did not. RESULTS: A two-tailed t-test revealed that no significant difference existed between programs that interview and those that did not with regards to the attrition rate of students. There was great diversity between the programs in interview content and structure. The cost to the institutions in terms of hours averaged 261 hours per school for faculty and support staff combined. CONCLUSION: The schools of physical therapy that award the Masters of Physical Therapy degree vary markedly in the interview content and format both between schools and with recommendations known to enhance validity and reliability. Since, no difference exists in attrition of students between schools that interview and those that do not, the expense and time invested by both the institution and the students are important considerations. The findings of this study indicate the need for continued investigation of the effectiveness of the interview process and alternative methods of valid and reliable student selection.

Costs and Cost Analysis↗

The vernacular term interview: eliciting social knowledge related to sex among adolescents.

This article demonstrates a method for collecting data on adolescents' social knowledge related to sex by conducting an interview which elicits the meanings of vernacular terms. The purpose of the interview is to determine how behavior related to sex is planned and interpreted. Short answer questions at the outset of each interview are used to elicit vernacular terms. The interviewer starts by identifying a term and asking its meaning. The interviewer then seeks to determine how the term is used in colloquial speech. As the interview progresses, the interviewers develops a provisional model of concepts and assumptions which underlie the term. Techniques such as paraphrasing and eliciting criteria and exceptions are used to test hypotheses related to the model. A key dimension of the inquiry has to do with the identification of models of persons and behaviors encompassed by the meaning of the term. The interview is capable of determining expectancies and values linked to a target behavior. Interviews with an African-American male and a White female, both focused on the vernacular term "clean", are used to illustrate the method.

Adolescent↗

Do we believe what patients say about their neoplastic symptoms? An analysis of factors that influence the interviewer's judgement.

In order to analyze factors that influence an interviewer's judgement of the validity of responses given by patients on the duration of their neoplastic signs and symptoms, 183 consecutive symptomatic patients hospitalized for a digestive tract neoplasm were personally interviewed. The validity of the answers was judged by the interviewers to be high in 156 cases (85%), and low in 27 (15%). The subjective validity of the interview (SVI) was inversely related to the time elapsed from first medical symptom to interview (TFMSI), even after adjusting for the duration of the interview (p < 0.05). SVI was not influenced by whether patient and interviewer agreed on the first symptom. SVI was inversely related to educational level (p < 0.01) and to occupational class (p = 0.04). Patients whose Karnofsky's Index (KI) was > or = 80 were over twice as likely to yield valid responses (TFMSI-adjusted odds ratio [OR] = 2.82, p = 0.037). Multivariate analyses selected education, TFMSI and KI as independent predictors of the interviewer assessment. The SVI of patients admitted to the hospital through the Emergency Department was lower than that of subjects whose admission was planned (OR = 6.49, p = 0.005). In this study SVI related in a logical manner to the characteristics of the interview, of the subjects and of their clinical course. It hence appeared to reasonably estimate the validity of data collected. Identifying factors that affect the reliability of patients' responses would help increase the validity of studies on the duration of cancer symptoms.

Aged↗

House officer interviewing techniques: impact on data elicitation and patient perceptions.

The relationships among physicians' interviewing techniques, the amount and type of data gathered, and patients' perceptions of the interviewing process were studied. Thirty-one Internal Medicine house officers each interviewed one of three standardized patients. The house officers' thoroughness of data collection was assessed by the patients and by a trained evaluator. A videotape of each interview was analyzed at the National Board of Medical Examiners using the interaction analysis system for interview evaluation, ISIE-81, to define house officers' interviewing techniques. From the physicians' problem-solving perspective, data elicitation was positively related to the length of the interview, asking psychosocial questions, the use of narrow questions, and the amount of time the patient talked. The patients' assessments of house officers' data-gathering thoroughness were also positively influenced by interview length, the use of narrow questions, and inquiries about their psychosocial histories. The use of broad questions by the house officer was positively related to the patient's feelings about and reaction to the interaction. This study potentially explains some of the differences that appear to exist between patients' and physicians' judgments about and perceptions of the medical interviewing process.

Aged↗

The research status of Clayman and Heritage's (2002) "The news interview".

The databases of three books with almost identical titles are examined in order to throw light on the theory of neutralistic professionalism of news interviewers and on the empirical logic of the most recent of the three: "The news interview" by Steven Clayman and John Heritage (2002). Instead of a theory of neutralism, a theory of perspectivity that applies to both interviewer and interviewee is presented. The logic of Clayman and Heritage's arguments is found wanting in a number of respects: (a) their treatment of TV and radio interviews as if they were identical; (b) their treatment of news interviews in the United States and Great Britain as essentially the same in practices and ground rules; (c) their inferences from isolated excerpts to the structure of the news interview itself; (d) their very concept of the news interview as "an interactional encounter between a journalist and one or more newsworthy public figures" (p. 1). Inaccuracies in their database make it unsatisfactory as support for a theory of neutralistic professionalism. Despite these limitations, Clayman and Heritage provide an excellent overview of the recent history of the news interview in the United States and Britain and a wealth of information about the local organization of news interviews.

Humans↗

Development and validation of the interview version of the Hong Kong Chinese WHOQOL-BREF.

INTRODUCTION: The Hong Kong Chinese version of the WHOQOL-BREF was designed as a self-administered questionnaire and has limitations in clinical application on subjects who have limitations in reading or writing. An interview version is therefore needed to avoid sampling biases in clinical studies. Since there are significant differences in the written Chinese and spoken Cantonese, which is a dialect commonly spoken among people in Hong Kong, and adaptation process for converting the written Chinese into spoken Cantonese was necessary. The interview version was designed to allow administration in both face-to-face interview and telephone interview mode. METHODS: Three members of the research team translated the formal written Chinese in the self-administered version of the WHOQOL-BREF(HK) into colloquial Cantonese separately. Brief notes extracted from the facet definitions of the WHOQOL-100 were added in brackets after some questions to further explain the intention of the questions. Two series of focus groups were conducted and subsequently the field test version was produced. 329 subjects were recruited by convenient sampling method for the field test. RESULTS: The interview version and the self-administered version was found equivalent. The ICC values of the domain scores ranged from 0.73 in the environment domain to 0.83 in the psychological domain. The face-to-face interview and telephone interview mode of administration were also found equivalent. The ICC for the domain scores ranged from 0.76 in the social interaction domain to 0.84 in the psychological domain. The other psychometric properties of the interview version were found comparable to the self-administered version. CONCLUSION: The self-administered and the interview version of the WHOQOL-BREF are regarded as identical in group comparison. The authors advise that it is acceptable to use different versions on different subjects in the same study, provided that the same version is applied on the same subject throughout the study.

Adult↗

Components of child and parent interviews in cases of alleged sexual abuse.

Considerable discussion in child sexual abuse evaluation centers around minimizing the number of victim interviews, however, the completeness of one professional's interview is not always addressed. In this study, professionals (medical, social, law enforcement/legal, mental health) indicated what components they included in their interviews of sexual abuse victims and their parents. Components included: details of abuse, family relationships, school situation/performance, child's development (toilet training, bed wetting, language development, etc.), child's knowledge of body part names, child's knowledge of body part functions, child-rearing practices (bathing, sleeping), medical history (illnesses, surgery), behavior problems, psychological symptoms (nightmares, sadness), physical complaints (pain, discharge), parental teaching about sex, and child's access to sexually explicit television or magazines. Interview components varied by profession, consistent with expected professional bias. This study demonstrates some professional bias in interviewing children and parents and suggests that having a single interview or interviewer may not always be optimal for a thorough evaluation. Increased communication and teamwork among professionals, and cross-training among disciplines could facilitate both the recognition of appropriateness of some "multiple interviews" as well as provide efforts to consolidate interviews when possible.

Adult↗

The telephone interview is an effective method of data collection in clinical nursing research: a discussion paper.

There are varying points of view regarding the advisability and utility of using the telephone to conduct research interviews. When undertaking the Women's Recovery from Sternotomy Study, we found the telephone was an effective mechanism for data collection. Our aim is to identify the advantages and challenges of using the telephone as a mechanism for data collection in clinical nursing research. The potential benefits associated with using telephone interviews as a mechanism of data collection include (a) using economic and human resources efficiently, (b) minimizing disadvantages associated with in-person interviewing, (c) developing positive relationships between researchers and participants, and (d) improving quality of data collection. The potential challenges to telephone interviewing include (a) maintaining participant involvement, (b) maintaining clear communication, (c) communicating with participants who offer extraneous information, (d) encountering participants with health concerns, and (e) communicating with a third party. Telephone interviewing can be an effective method of data collection when interviewers understand the potential benefits as well as challenges. We offer solutions to the identified challenges and make pragmatic recommendations to enhance researcher success based on the current literature and our research practice. Supportive training for interviewers, effective communication between interviewers and with research participants, and standardized telephone follow-up procedures are needed to ensure successful telephone data collection. We have found our 'Manual of Operations' to be an effective tool that assists research assistants to meet the requirements for successful telephone interviewing.

Canada↗

Telephone vs face-to-face interviews for quantitative food frequency assessment.

OBJECTIVE: To develop and test a quantitative food frequency method for administration by telephone. DESIGN: A comparison study of telephone and face-to-face interviews was conducted among a representative sample of the five major ethnic groups in Oahu, Hawaii. Two interviews were administered 4 to 6 months apart by trained interviewers using identical questionnaires and color photographs of food items showing three different portion sizes. The order of the interviewing methods was randomly assigned. The questionnaire included 115 food items selected to estimate 80% or more of usual dietary intakes. Frequencies and quantities of each item consumed during the past year were obtained. SUBJECTS/SETTING: Subjects were recruited from the Health Surveillance Program of the Hawaii State Department of Health and consisted of 167 men and 158 women, aged 45 to 74 years, who provided a telephone number. Eighty percent of the face-to-face interviews were conducted in the subjects' homes and 20% were conducted at the workplace or the University of Hawaii Cancer Research Center, if requested. STATISTICAL ANALYSES: The paired t test was used to compare the mean daily intakes obtained by the telephone and face-to-face methods. Agreement was measured by the intraclass correlation coefficient (ICC), Pearson correlation coefficient and weighted kappa statistic. RESULTS: The means of energy and each nutrient were slightly higher in the first interview than the second, regardless of the interviewing method. Because of close correspondence among all 3 statistical measures of agreement, only the ICCs are reported. The ICCs ranged from .61 for protein and vitamin A to .69 for dietary cholesterol among men, and from .61 for vitamin C to .74 for saturated fat among women. Agreement was not significantly affected by age, gender, ethnicity, order of interview, or educational level. APPLICATIONS: Telephone interviews to obtain quantitative food frequencies are cost-efficient methods for estimating usual dietary intakes among persons in widely scattered geographic areas. Photographs of the foods in 3 portion sizes mailed in advance help the respondents estimate amounts eaten.

Aged↗

Audio-computer interviewing to measure risk behaviour for HIV among injecting drug users: a quasi-randomised trial.

BACKGROUND: We aimed to assess audio-computer-assisted self-interviewing (audio-CASI) as a method of reducing under-reporting of HIV risk behaviour among injecting drug users. METHODS: Injecting drug users were interviewed at syringe-exchange programmes in four US cities. Potential respondents were randomly selected from participants in the syringe exchanges, with weekly alternate assignment to either traditional face-to-face interviews or audio-CASI. The questionnaire included items on sociodemographic characteristics, drug use, and HIV risk behaviours for 30 days preceding the interview. We calculated odds ratios for the difference in reporting of HIV risk behaviours between interview methods. FINDINGS: 757 respondents were interviewed face-to-face, and 724 were interviewed by audio-CASI. More respondents reported HIV risk behaviours and other sensitive behaviours in audio-CASI than in face-to-face interviews (odds ratios for reporting of rented or bought used injection equipment in audio-CASI vs face-to-face interview 2.1 [95% CI 1.4-3.3] p=0.001; for injection with borrowed used injection equipment 1.5 [1.1-2.2] p=0.02; for renting or selling used equipment 2.3 [1.3-4.0] p=0.003). INTERPRETATION: Although validation of these self-reported behaviours was not possible, we propose that audio-CASI enables substantially more complete reporting of HIV risk behaviour. More complete reporting might increase understanding of the dynamics of HIV transmission and make the assessment of HIV-prevention efforts easier.

Adult↗

Lack of coordination of nonverbal behaviour between patients and interviewers as a potential risk factor to depression recurrence: vulnerability accumulation in depression.

BACKGROUND: Coordination of nonverbal behaviour during interactions is a prerequisite for satisfactory relationships. Lack of coordination may form a risk factor for depression. The 'vulnerability-accumulation hypothesis' assumes that vulnerability to recurrence of depression will increase with increasing experience of depressive episodes. Therefore it is expected that interviewers and patients remitted from a recurrent episode of depression would reach less coordination during a clinical interview compared to interviewers and patients remitted from a first lifetime episode. Moreover, we assumed that prior severity of depression modifies this reciprocal coordination process. METHODS: During discharge interviews, interviewers were videotaped in interaction with remitted patients with unipolar major depression recurrent depression (REC); n=28; first episode (SEP); n=22. Durations and frequencies of nonverbal involvement behaviour was registered during the first 15 min. Involvement of the patients consisted of gesticulating, looking at the interviewer, and general head movements; yes--nodding and hm, hm, yes, yes reflected involvement of the interviewer. Coordination between patients and interviewers was analyzed per 3-min epochs and defined as 'attunement': the absolute difference between patients' and interviewers' involvement. Averaged attunement, its time course and variability (presumably reflecting control of the attunement process) were assessed. RESULTS: The time course of nonverbal attunement differed between the REC and SEP condition. A larger variability of attunement was found in patients remitted from a relatively severely depressed episode, compared to patients remitted from a severe first life time episode. No other significant differences were found. CONCLUSIONS: Partial support was found for the notion that nonverbal vulnerability accumulates in depression and that the severity of prior depression modifies this process.

Adult↗

Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers.

Many of the standardized interviews currently used in psychiatry require the interviewer to use expert psychiatric judgements in deciding upon the presence or absence of psychopathology. However, when case definitions are standardized it is customary for clinical judgements to be replaced with rules. The Clinical Interview Schedule was therefore revised, in order to increase standardization, and to make it suitable for use by 'lay' interviewers in assessing minor psychiatric disorder in community, general hospital, occupational and primary care research. Two reliability studies of the revised Clinical Interview Schedule (CIS-R) were conducted in primary health care clinics in London and Santiago, Chile. Both studies compared psychiatrically trained interviewer(s) with lay interviewer(s). Estimates of the reliability of the CIS-R compared favourably with the results of studies of other standardized interviews. In addition, the lay interviewers were as reliable as the psychiatrists and did not show any bias in their use of the CIS-R. Confirmatory factor analysis models were also used to estimate the reliabilities of the CIS-R and self-administered questionnaires and indicated that traditional measures of reliability are probably overestimates.

Adult↗