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When initial interviews are delayed a year: effect on children's 2-year recall.

Three- to nine-year-old children were interviewed about a medical emergency (injury requiring hospital ER treatment) two years after it occurred. Half of the number of children had been interviewed shortly after injury as well as 6 and 12 months later, while the remaining children had had only one prior interview a year after injury. There was remarkably little long-term deterioration in memory by both groups. Having a delayed initial interview had two effects, and both were relevant only to the harder-to-remember hospital treatment event: (a) The late-interview group was less accurate, and (b) early-interview children had more extensive free recall, suggesting that multiple prior interviews teach children the "rules of the memory game'' when they are asked open-ended questions. Forensic implications are discussed.

Child↗

Performance of two forms of a computer psychiatric screening interview: version I of the DISSI.

This study reports on the performance of two forms of version I of the Diagnostic Interview Schedule (DIS) computer screening interview, using the traditional interviewer-administered DIS (T-DIS) as the standard. The screening interview was either self-administered (called the S-DISSI) with the subject keying in responses, or interviewer-administered (I-DISSI), with the interviewer keying in the subject's responses. Sensitivity and specificity for both forms were ample (excluding antisocial personality), ranging from 60% to 100% for sensitivity and 54% to 95% for specificity. Concordances with the T-DIS were similar for both forms of the screening interview, ranging from .10 to .87 and compared favorably to those reported by other investigators. The I-DISSI took on average 30 min less than either the T-DIS and S-DISSI. Since the performances of both versions were equivalent, the decision to use either may be based on available resources and characteristics of the study population.

Adult↗

A comparison of computer-based and personal interviews for the gynecologic history update.

OBJECTIVE: To determine if patients would answer a computer-based interview in the same way as they would answer a personal interview. METHODS: Two hundred consecutive patients in a private practice setting were asked a set of eleven questions relating to their general and gynecologic health. The question set included issues appropriate to a routine, periodic gynecologic history update. Each subject was asked the same question set twice, once by a personal interview and once by a computer. This was done in a crossover fashion. One-half of the subjects were interviewed by a person first; the other half used the computer first. RESULTS: Statistical evaluation demonstrated that patient responses are equivalent. The two methods agreed overall in 96% of the responses. Analysis of the discordant responses showed that in some cases, the computer may be more effective than the personal interview in identifying risk factors. CONCLUSIONS: A computer-based questionnaire can generate responses that are equivalent to the responses to a traditional personal interview. In some cases, a computer may be more successful in eliciting risk factors. Further studies of the application of this technology for patient education and physician efficiency can now be carried out, knowing that subjects respond reproducibly to a computer interview format.

Adolescent↗

Outcome-based practice: disclosure rates of child sexual abuse comparing allegation blind and allegation informed structured interviews.

The way in which children are interviewed can make the difference between prosecution, or continued abuse. There is a clear need for the development of an interview style that is acceptable in the legal system without compromising disclosure rate. This study was conducted to compare the disclosure rate of alleged child sexual abuse victims interviewed in a formal forensic setting with a structured "allegation informed" technique versus a structured "allegation blind" technique. The only difference between techniques was that the interviewer did not know the allegation for condition "allegation blind." Of the 1,535 interviews, 1,330 or 86.64% were conducted "allegation blind," 196 or 12.76% were conducted "allegation informed" and for 9 or .6% the interview type was unknown. The "allegation blind" interview technique yielded a statistically higher disclosure rate (chi 2 p = 0.378). Further research is warranted.

Adolescent↗

Evaluation and training of medication adherence counselors in a clinical trial: application of a skill inventory to video-recorded interviews.

This report describes the procedures and feasibility of an integrated evaluation and training program developed at the Baylor-Methodist Lipid Research Clinic to examine the skills used by the clinic's professional staff in conducting medication adherence interviews with participants in the Coronary Primary Prevention Trial (CPPT). The specific aims of this project were to evaluate the staff's interviewing and counseling skills, identify strengths and deficits, provide needed training, and reexamine the staff's skills following this training. Each of five staff members conducted two 20-minute video-recorded interviews with two different simulated CPPT participants. A trained observer reviewed the video-recordings and evaluated, by an Inventory for Interviewing and Counseling Skills for Adherence to Medication (IICS-AM), each staff member's possession and frequency of use of 17 interviewing skills and 10 counseling skills. The 27 skills on the IICS-AM were selected from the literature as being most frequently recommended for effective interviewing and counseling for medication adherence. These rating data were used to design a 14-week training program to acquire and promote the use of these skills. Following training, the video-recorded interview procedure was repeated and the data analyzed to identify the effects of the training program. The integrated evaluation and training procedures used in this project offer a practical, objective method for examining, improving, and monitoring the skills of the adherence counseling staff in a clinic participating in a multicenter clinical trial.

Audiovisual Aids↗

Describing pain with physical disability: narrative interviews and the McGill Pain Questionnaire.

OBJECTIVES: To identify common pain descriptors used by people with physical disability-related pain and to suggest words that are likely to prompt responses in clinical interviews and assessments. DESIGN: Open-ended interviews were coded and then contrasted with responses to a pain questionnaire, obtained through mail or interview surveys. SETTING: Rehabilitation research program. PARTICIPANTS: Twenty-eight people with physical disability-related pain in a series (n=54) of in-depth interviews and 1053 participants with disabilities who responded to mailed questionnaires or structured interviews about pain and its impact (459 with acquired lower-limb amputation, 471 with spinal cord injury, 123 with cerebral palsy). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Pain interview descriptions and McGill Pain Questionnaire (MPQ). RESULTS: Different pain experiences were reflected in narrative descriptions and self-report questionnaire responses. We report the common terms, but across diagnoses use of terms does not appear to clearly differentiate distinct pain phenomenon. Narrative interviews support the use of several MPQ pain descriptors. However, discrete descriptors are recommended when assessing adults with physical disability. CONCLUSIONS: We identified pain descriptors that appear to be most useful in assessing daily life and participation experiences with physical disability-related pain. These may be clinically useful, but caution is advised when doing diagnostic workups based solely on sensory and affective pain descriptions.

Adult↗

Body mass index, sex, interview protocol, and children's accuracy for reporting kilocalories observed eaten at school meals.

This pilot study investigated body mass index (BMI; calculated as kg/m(2)), sex, interview protocol, and children's accuracy for reporting kilocalories. Forty 4th-grade children (20 low-BMI: >or=5th and <50th percentiles, 10 boys, 15 African American; 20 high-BMI: >or=85th percentile, 10 boys, 15 African American) were observed eating school meals (breakfast, lunch) and interviewed either that evening about the prior 24 hours or the next morning about the previous day, with 10 low-BMI (5 boys) and 10 high-BMI (5 boys) children per interview protocol. Five kilocalorie variables were analyzed using separate four-factor (BMI group, sex, race, interview protocol) analyses of variance. No effects were found for reported or matched kilocalories. More kilocalories were observed (P<0.02) and omitted (P<0.05) by high-BMI than low-BMI children. For intruded kilocalories, means were smaller (better) for high-BMI girls than high-BMI boys, but larger for low-BMI girls than low-BMI boys (interaction P<0.04); low-BMI girls intruded the most while high-BMI girls intruded the least. For interview protocol, omitted and intruded kilocalories were higher (worse), although not significantly so (P values <0.11), for interviews about the previous day than the prior 24 hours. These results illuminate relations of BMI, sex, interview protocol, and children's reporting accuracy, and are consistent with results concerning BMI and sex from studies with adults.

Analysis of Variance↗

The focus group method: insights from focus group interviews on sexual health with adolescents.

This article concerns the manner in which group interaction during focus groups impacted upon the data generated in a study of adolescent sexual health. Twenty-nine group interviews were conducted with secondary school pupils in Ireland, and data were subjected to a qualitative analysis. In exploring the relationship between method and theory generation, we begin by focusing on the ethnographic potential within group interviews. We propose that at times during the interviews, episodes of acting-out, or presenting a particular image in the presence of others, can be highly revealing in attempting to understand the normative rules embedded in the culture from which participants are drawn. However, we highlight a specific problem with distinguishing which parts of the group interview are a valid representation of group processes and which parts accurately reflect individuals' retrospective experiences of reality. We also note that at various points in the interview, focus groups have the potential to reveal participants' vulnerabilities. In addition, group members themselves can challenge one another on how aspects of their sub-culture are represented within the focus group, in a way that is normally beyond reach within individual interviews. The formation and composition of focus groups, particularly through the clustering of like-minded individuals, can affect the dominant views being expressed within specific groups. While focus groups have been noted to have an educational and transformative potential, we caution that they may also be a source of inaccurate information, placing participants at risk. Finally, the opportunities that focus groups offer in enabling researchers to cross-check the trustworthiness of data using a post-interview questionnaire are considered. We conclude by arguing that although far from flawless, focus groups are a valuable method for gathering data about health issues.

Acting Out↗

Domestic abuse in pregnancy: A comparison of a self-completed domestic abuse questionnaire with a directed interview.

OBJECTIVE: The purpose of this study was to compare the results of a standardized self-completed domestic abuse questionnaire with those of a directed interview in the identification of domestic abuse in pregnant patients. STUDY DESIGN: All patients with a first prenatal visit between March 1 and September 30, 1997, were assessed for self-reported domestic abuse with a standardized domestic abuse questionnaire. This was followed by a directed interview that involved verbal review of the standardized domestic abuse questionnaire. Self-reported domestic abuse was defined as any positive response to the domestic abuse questionnaire or the directed interview. The number of patients with a positive response to either the standardized questionnaire or the directed interview, or both, were recorded. The 2 techniques were compared by the McNemar chi(2) test. The group demographics and characteristics were evaluated. RESULTS: Among the 224 patients evaluated, a total of 36% (n = 80) of the patients reported domestic abuse by either method. The standardized domestic abuse questionnaire identified 85% (n = 68) compared with 59% (n = 47) by a directed interview (P =.03). The use of the standardized domestic abuse questionnaire and the directed interview in parallel identified an additional 15% (n = 12) of patients with domestic abuse. CONCLUSION: A standardized domestic abuse questionnaire is superior to a directed interview in identifying self-reported domestic abuse in pregnancy. Utilizing both methods in parallel further increases the number of patients identified.

Adult↗

The role of blinded interviews in the assessment of surgical residency candidates.

BACKGROUND: Interview assessments of surgical residency candidates may be biased by prior knowledge of objective data. METHODS: Each candidate (site 1: n = 88; site 2: n = 44) underwent two interviews, one by faculty members informed only of a candidate's medical school, the second with prior knowledge of the complete application. Interviewers (site 1: n = 28; site 2: n = 14) independently rated candidates overall and on nine qualitative characteristics. RESULTS: At site 1 only, overall ratings were significantly more favorable for unblinded than blinded interviews (23.0 +/- 17.7 versus 32.6 +/- 23.1, P < 0.01). Blinded and unblinded overall ratings correlated -0.01 (P = 0.90) and 0.31 (P = 0.05) at sites 1 and 2, respectively. At site 1 only, overall ratings correlated significantly with USMLE scores, but in opposite directions for blinded (r = 0.32, P = 0.003) versus unblinded interviews (r = -0.32, P = 0.003). CONCLUSION: Interview assessments may be influenced by objective data, and faculty and program variables. The value of blinded interviewing may vary as a function of individual program characteristics.

Educational Measurement↗

Telephone or face-to-face interviews?: a decision made on the basis of a pilot study.

De Vaus (1991) highlights five main considerations that may be key factors in decisions about whether to use telephone or face-to-face interviews for survey work: response rates, ability to produce representative samples, effects on interview schedule design, quality of responses and implementation problems. De Vaus' discussion of these five issues is outlined at the start of this article. The five issues are then applied to the experiences of researchers conducting a study on continence care. Description and discussion of pilot interviews, which explored both interview modes, are followed by a similar examination of the main study which employed telephone interviews. Ideas in this discussion are supported and challenged by reference to other publications on the subject of telephone and face-to-face interviews. The success of the decision to use telephone interviews in the main study is evaluated and recommendations are made.

Humans↗

Investigative interviews of child witnesses in Sweden.

OBJECTIVE: To evaluate the structure and informativeness of interviews with 4- to 13-year-old alleged victims of sexual abuse in Sweden. METHOD: Seventy-two alleged victims of sexual abuse were interviewed by six experienced officers from one police district in Sweden. Our evaluation focused on the structure of the interviews, the distribution and timing of the investigators' utterance types, and the quantity and quality of the information provided by the children. RESULTS: Content analysis revealed that the interviewers relied primarily on option-posing and suggestive questions--together, these comprised 53% of their utterances--when interviewing the alleged victims. As a result, most of the details (57%) obtained from the children were elicited by option-posing and suggestive utterances. Only 6% of the interviewers' utterances were open-ended invitations, and these elicited only 8% of the information obtained. CONCLUSION: The reliance on option-posing and suggestive prompts may have reduced the accuracy of the information obtained, thereby interfering with the investigations, and reducing the forensic admissibility of the children's statements. This suggests a continuing need in Sweden, as in other countries, for interview practices that enhance the quality of information provided by young victims.

Adolescent↗

Neuroendocrine measures and lymphocyte subsets in depressive illness: influence of a clinical interview concerning life experiences.

The effects of a clinical interview concerning either positive or negative day-to-day events on lymphocyte subpopulations, and on plasma cortisol, ACTH and norepinephrine, were determined in depressive patients (major depressive and dysthymic) and in normal controls. Irrespective of its content, the interview provoked an elevation of circulating natural killer (NK) cells, suggesting that this effect was related to either a change in mood state (regardless of its valence) or to the stress associated with the interview procedure. Since the interview did not influence plasma cortisol, ACTH or norepinephrine, it is likely that the NK cell variations were independent of these endocrines. Although basal NK cells were elevated in the depressive group relative to controls, the extent of the NK cell increase provoked by the interview was comparable in depressive and control subjects. The failure to detect differences between these populations could not be attributed to ceiling effects precluding more pronounced alterations in the depressed subjects. Indeed, variations of circulating cell subtypes were found to be exquisitely sensitive to differences in stressor intensity. In a subset of control subjects, a more potent stressor (anticipation of an academic examination) increased the plasma endocrine levels, increased circulating NK cell number beyond that associated with the interview stress, and provoked an increase of several T cell subsets (CD3, CD4 and CD8). Evidently, while a clinical interview may be sufficiently stressful to influence circulating NK cells, the stress of such a procedure seems no greater in depressed than in control subjects. It is suggested that although depressed patients may exhibit higher basal NK levels, this effect is likely not related to increased reactivity to stressors.

Adrenocorticotropic Hormone↗

[The interview with the relatives of the neurosurgical patient].

INTRODUCTION: Information of diagnosis, therapeutic managements and inabilities are a very difficult task for neurosurgeons and very important for relatives. The interview is the best instrument that the neurosurgeon has to inform integrally; but many young physicians are not well prepared to deal with medical information and the educational work to achieve it still is insufficient. OBJECTIVE: To provide some general, organized and practical experiences on how to develop the interview with the relatives of the neurosurgical patient. DEVELOPMENT: The importance of the interview demands of: a) knowledge of the patient's data, b) reaching a specific diagnosis and appropriate therapy, c) accurate selection of the participants in the interview and d) specify when and where we will met the relatives. Most families prefer a physician that maintains an attitude of trust and sincerity and expresses clearly and slowly his thought. The explanations should be direct and simple. Repeated interviews can be concerted and we will perform a similar interview in emergent cases. CONCLUSIONS: The interview should be carried out as soon as possible and as soon as results of the medical investigations were available. The pessimism should be avoided and support will be given, without losing the contact with the reality. Information, which is sacrificed frequently in the art of the Medicine to give more importance to the science, indeed germinates much of the criticism to neurosurgeons and neurosurgical centers in the last two or three decades. We should not conform with the signature of an elementary and insufficient informed consent.

Humans↗

Informed consent: the assessment of two structured interview approaches compared to the current approach.

We prospectively studied 190 patients undergoing tonsillectomy or nasal surgery to assess the value of two structured interview techniques. There were four groups: Group A did not have a consent interview during the study period. Group B had an informal interview. Group C had a structured interview and Group D had a structured interview and were given an information sheet. Anxiety assessments were made and patients' recall of the operation name, details of the operation and its complications was assessed. Patients had higher than normal anxiety levels when admitted, but several hours after the interview anxiety was normal for Groups B, C and D. Group A maintained a higher anxiety level. Only 37 per cent correctly recalled the operation name, where as 87 per cent of all groups recalled the explanation of the operation. However, Groups C and D recalled a higher mean number of complications per patient. A structured interview when obtaining informed consent increases the number of complications recalled without increasing pre-operative anxiety.

Adult↗

A comparison of clinical and structured interview diagnoses in a homeless mental health clinic.

OBJECTIVE: This study compared psychiatric diagnoses ascertained by independent clinicians with structured research interviews of homeless psychiatric patients assessed in a mental health clinic and in the community. Problems of both overdiagnosis and underdiagnosis in structured research interviews compared to clinician assessment were predicted. METHOD: Over a period of a year, 97 patients referred to a mental health clinic for homeless people were assessed with the Diagnostic Interview Schedule (DIS) administered by a clinical social worker who then completed a full clinical psychiatric social work assessment. These same patients received a thorough and systematic clinical psychiatric evaluation by a psychiatrist or psychologist, both experienced with this population. These clinicians gathered data from multiple sources, often with extended observation over time. The DIS and clinician diagnoses were made blind to one another and then compared; the clinician was often made aware of some of the symptoms that the social worker had elicited, but not whether the elicited material was from the DIS or from the clinical assessment. Diagnoses of 33 clinic patients previously assessed by trained nonclinician DIS interviews in an epidemiologic study of the homeless population in the community were also compared to clinician diagnoses, and no information from these patients' survey DIS interviews was made available to the clinicians. RESULTS: Compared to clinician assessment, structured interviews underdiagnosed antisocial personality disorder (ASPD) and overdiagnosed major depression. Alcohol use disorder and schizophrenia showed only small discrepancies by assessment method. Drug use disorder revealed no bias according to method of ascertainment, but showed very discrepant kappa levels comparing DIS to clinician assessment in the two different comparison contexts. CONCLUSIONS: If structured research methods assessing the homeless population actually overestimate depression, underestimate ASPD, and misclassify drug abuse, then policies stemming from structured interview research recommendations may call for levels and types of services not optimally suited to the reality of this population's needs. Because mental illness and substance abuse are thought to be critical factors in the generation and perpetuation of homelessness, the issue of accurate diagnosis is tantamount to understanding and providing workable solutions to the problem of homelessness. Further research is needed to untangle potential confounders of the homeless situation to psychiatric diagnosis.

Community Mental Health Centers↗

Ethnic differences in reported smoking behaviors in face-to-face and telephone interviews.

Different modes of gathering data on self-reported health measures and self-reported risk factors are used frequently in research. However, data on the influence of the mode of collection of data on self-reporting are limited. The aim of the study was to identify associations between the mode of data collection and self-reported smoking in two distinct ethnic groups, Jews and Arabs in Israel. During the last 2 years, data were collected in two national surveys regarding the smoking behaviors of Jews and Arabs in Israel. In the telephone surveys 4713 Israeli residents were interviewed and in the face-to-face interviewees 3239 people were interviewed. The interviewees were between the ages 25 and 64. There was no significant difference in smoking rates between face-to-face interviews and telephone interviews among Jewish men or women after adjusting for other variables associated with smoking. However, there was a difference between the two methods of data collection in the Arab population also after the adjustment. In this group, respondents tended to report more often being a smoker in the face-to-face interviews. This was especially apparent in Arab women. There was no significant difference in the reported number of cigarettes smoked in the two modes of data collection. In Arabs compared to Jews there is a significant difference between reporting smoking during a telephone interview and a face-to-face interview. The mode of data collection can affect comparisons between different groups.

Adult↗

Telepsychiatry: assessment of televideo psychiatric interview reliability with present- and next-generation internet infrastructures.

OBJECTIVE: We assessed the reliability of remote video psychiatric interviews conducted via the internet using narrow and broad bandwidths. METHOD: Televideo psychiatric interviews conducted with 42 in-patients with chronic schizophrenia using two bandwidths (narrow, 128 kilobits/s; broad, 2 megabits/s) were assessed in terms of agreement with face-to-face interviews in a test-retest fashion. As a control, agreement was assessed between face-to-face interviews. Psychiatric symptoms were rated using the Oxford version of the Brief Psychiatric Rating Scale (BPRS), and agreement between interviews was estimated as the intraclass correlation coefficient (ICC). RESULTS: The ICC was significantly lower in the narrow bandwidth than in the broad bandwidth and the control for both positive symptoms score and total score. CONCLUSION: While reliability of televideo psychiatric interviews is insufficient using the present narrow-band internet infrastructure, the next generation of infrastructure (broad-band) may permit reliable diagnostic interviews.

Analysis of Variance↗