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PubMed1990

Psychological and biographical differences between secondary school teachers experiencing high and low levels of burnout.

A total of 750 teachers from 16 government and non-government schools from areas of contrasted socio-economic status (SES) responded to a questionnaire designed to investigate associations between selected aspects of burnout among teachers working in secondary schools in Victoria, Australia. By comparing high and low burnout groups on biographic, psychological and work pattern variables, differences between teachers experiencing high and low levels of burnout were identified. Multiple regression analyses assessed the relative importance of these variables in accounting for the variance in each of the three burnout subscales. School type was related to perceptions of stress and burnout. Higher levels of burnout were associated with poorer physical health, higher rates of absenteeism, lower self-confidence and more frequent use of regressive coping strategies. Teachers classified as experiencing high levels of burnout attributed most of the stress in their lives to teaching and reported low levels of career commitment and satisfaction. Further, teachers who recorded high levels of burnout were characterised by lower levels of the personality disposition of hardiness, lower levels of social support, higher levels of role stress and more custodial pupil control ideologies than their low-burnout counterparts. Psychological variables were found to be more significant predictors of burnout than biographical variables.

Australia↗
PubMed1983

An assessment of the diabetic knowledge of school teachers.

Ninety seven teachers of diabetic pupils in Liverpool completed a questionnaire designed to assess their knowledge of diabetes mellitus and the sources from which they had obtained information. The survey aimed to evaluate their understanding and to aid in planning an alternative policy of teacher education. Only 24 teachers (25%) seemed to have adequate understanding of diabetes and there was little knowledge of recognition and treatment of emergency diabetic problems and aspects of diet. Most information had been obtained from either diabetic pupils or their parents and not from medical or nursing personnel.

Adolescent↗
PubMed1994

Wheeze in preschool children and its relation with doctor diagnosed asthma.

OBJECTIVE: To describe the characteristics of wheeze and its relation with doctor diagnosed asthma in children aged 5 years and under. DESIGN: Questionnaire survey of population based random sample of children registered on Leicestershire Health Authority's child health index for immunisation; questionnaire completed by parents. SUBJECTS: 1650 white children born in 1985 to 1989 who were surveyed in 1990. MAIN OUTCOME MEASURES: Age distribution, severity, precipitants, seasonal characteristics, and diurnal variation of wheeze, family history of asthma/atopy, and their association(s) with doctor diagnosed asthma. RESULTS: There were 1422 replies (86.2%). Two hundred and twenty two (15.6%) were reported to have wheezed and of these 121 (8.6%) had formally been diagnosed as having asthma. More than 80% of the former had recurrences of wheeze and 40% (72) had three or more episodes in the preceding 12 months. Age, number of episodes per year, the severity of shortness of breath with attacks, and precipitants other than colds were the major factors determining the probability that a wheezy child will be diagnosed as having asthma. The data also suggest that despite the strong association of symptom based criteria with the label asthma, asthma was not diagnosed by these same severity criteria in one quarter of cases. CONCLUSIONS: Clinical and physiological follow up studies of children identified as asthmatic by the above criteria during the preschool years should validate or refute the predictive value of these measures of wheeze severity.

Age Distribution↗
PubMed1995

Psychosocial and clinical burden of thalassaemia intermedia and its implications for prenatal diagnosis.

Twenty eight patients with thalassaemia intermedia and their parents were interviewed using specifically designed questionnaires to evaluate psychosocial burden. Hospital notes were analysed for clinical burden. A wide variation was found for both patients and parents, ranging from virtually unaffected to severely affected. Normal sexual function and setting up a family were mentioned by patients and parents as being particularly important for quality of life. Over half (58%) of the patients had problems with sexual maturation and functioning, and continuous monitoring of all patients with thalassaemia intermedia by a paediatric endocrinologist is therefore strongly indicated. Most parents said, in light of their experiences, that they would opt for prenatal diagnosis and termination of affected pregnancies even if a genotype predicting the mild form of disorder were discovered.

Abortion, Legal↗
PubMed1995

Foot pathology in insulin dependent diabetes.

OBJECTIVES: Foot pathology is a major source of morbidity in adults with diabetes. The aim of this study was to determine if children with insulin dependent diabetes have an increased incidence of foot pathology compared with non-diabetic children. DESIGN: Questionnaire, clinical examination, and biomechanical assessment. SUBJECTS: 67 diabetic children and a comparison group matched for age, sex, and social class. RESULTS: We found significantly more foot pathology in the children with diabetes (52 children) than the comparison group (28 children); with more biomechanical anomalies (58 children with diabetes, 34 comparison group); and a higher incidence of abnormal skin conditions (53 children with diabetes, 27 comparison group). Forty two children with diabetes had received foot health education compared with 27 in the comparison group, but the study revealed ignorance and misconceptions among the diabetic group, and previous contact with a podiatrist was minimal. CONCLUSIONS: The survey suggests that children with diabetes have an increased incidence of foot pathology justifying greater input of podiatric care in the hope of preventing later problems.

Adolescent↗
PubMed1998

Health at age 11: reports from schoolchildren and their parents.

OBJECTIVE: To present self reports by children and reports by parents on behalf of their children relating to general health, current conditions, and recent symptoms. DESIGN: Questionnaires completed by children and parents as part of the longitudinal "West of Scotland 11 to 16 study: teenage health." SETTING: 135 primary schools in Central Clydeside. SUBJECTS: 2586 children aged 11 years, surveyed from October 1994 to March 1995 (response rate 93%). Questionnaires also completed by parents of 86% of the sample. MAIN OUTCOME MEASURES: Ratings of health over the past 12 months, presence of (limiting) longstanding illness, nine current conditions, and 11 recent symptoms. RESULTS: Only 47% of children described their health as "good" in the previous year. Around 20% reported a longstanding illness and 8% a limiting illness; 20% reported migraine or headaches, 13% reported asthma. Recent stomach aches or sickness, colds or flu, and headaches were each reported by around 60%. "Malaise" (emotional) symptoms were common. Parents reported similar levels of (limiting) longstanding illness, but rates of conditions and symptoms reported by parents were lower than reported by their children. Parent-child agreement was greatest for the presence of longstanding illness and the conditions of asthma, diabetes, and skin problems. It was lower for recent symptoms, particularly those categorised as reflecting malaise. CONCLUSIONS: These results challenge assumptions of good health and wellbeing at this age. Illness reporting depends on various factors, including saliency, social desirability, and definitions of normality. Parent-child discrepancies may reflect different definitions of illness or symptoms; they do not mean that one should be dismissed as "wrong."

Adolescent↗
PubMed1999

Preliminary report of a toxicity study of hydroxyurea in sickle cell disease. French Study Group on Sickle Cell Disease.

AIM: To evaluate the tolerance of hydroxyurea in children affected with sickle cell disease. DESIGN: Questionnaire study of French physicians likely to treat patients with sickle cell disease. Data were collected on 101 children with sickle cell disease, treated for a median of 22 months, 36 of whom were treated for more than three years. 13 children were younger than 5 years of age at inclusion. RESULTS: Hydroxyurea was stopped for medical reasons in 11 patients: 6 failures, 1 pregnancy, 1 cutaneous rash, 1 leg ulcer, 1 lupus. Acute lymphoblastic leukaemia occurred in a girl treated for 1.5 months with hydroxyurea, this short interval arguing against a causative association. One 17 year old boy had paraparesis after 8 years of treatment. CONCLUSIONS: No major short or medium term toxicity was related to hydroxyurea in this cohort of 101 children. However, the number of children treated for more than 3 years is too few to make firm conclusions on the long term tolerance of this drug.

Adolescent↗
PubMed2004

Current practice in the management of anterior cruciate ligament injuries in the United Kingdom.

OBJECTIVE: To outline the current practice in the management of anterior cruciate ligament (ACL) injuries in the United Kingdom. METHODS: A postal questionnaire designed to include various clinical scenarios was sent out to the 321 orthopaedic surgeons in the United Kingdom who, being affiliated to one of the specialist societies of the British Orthopaedic Association, namely the British Association for Surgery of the Knee (BASK) or the British Orthopaedic Sports Trauma Association (BOSTA), have a manifested interest in treating such injuries. RESULTS: The response rate was 60% (192/321). Most surgeons diagnose and operate on less than 50 ACL injuries a year. The following results were obtained: 58% (76/132) use bone-patellar tendon-bone autografts, whereas 33% (44/132) use semitendinosis/gracilis autografts; 84% (108/129) would not incorporate the ACL remnant in the reconstruction; 14% (19/135) would perform an ACL reconstruction in an 8 year child with an acute rupture; 30% (42/141) would perform an ACL reconstruction in a 14 year old with an acute ACL rupture. CONCLUSIONS: There is wide variation in the management of acute and chronic ACL injuries among orthopaedic surgeons in the British Isles. Future research and randomised controlled trials should address the issues that this investigation has raised.

Adolescent↗
PubMed1996

The musculoskeletal effect of intense physical training of non-athletic youth corps conscripts.

OBJECTIVE: To determine the musculoskeletal problems associated with high intensity physical exercise among non-athletic youth subjects. METHODS: 484 fresh Nigerian graduates participating in the mandatory National Youth Service Corps (NYSC) programme were studied. At the start of the four week intensive physical training which formed part of the orientation course for the programme, the subjects completed a questionnaire designed to determine their previous exercise habit. The physical training consisted of jogging, physical drills, games (soccer and volleyball), and man o'war activities. During the period of physical training, the subjects were instructed to report all ailments to the camp clinic. RESULTS: Muscular pain/soreness and injuries were major problems associated with the exercise. The lower limbs were most affected and the ankle joint was found to be more injury-prone than other joints. CONCLUSIONS: Most of these graduates were physically unfit and the intense fitness programme produced adverse effects on their physical health. Precamp physical preparation would be desirable.

Ankle Injuries↗
PubMed1981

Postmarketing surveillance of adverse drug reactions in general practice. II: Prescription-event monitoring at the University of Southampton.

An independent, non-regulatory drug surveillance research unit has been established at the University of Southampton. Its first task will be to set up a prescription-event monitoring scheme in general practice to enable the pattern of adverse events, as distinct from suspected adverse reactions associated with new drugs to be compared with that of older medicines. Prescriptions for selected drugs will identify patients and a simple questionnaire, designed to be completed in under five minutes, will be used to obtain the required information. Medical opinions about causation need not be given, and the scheme will not interfere with normal prescribing practice.

Drug Prescriptions↗
PubMed1986

The "five minute" consultation: effect of time constraint on clinical content and patient satisfaction.

An experiment was carried out in which patients who were seeking appointments for a consultation in a general practice in south London attended consulting sessions booked at 5, 7.5, or 10 minute intervals. The particular session that the patient attended was determined non-systematically. The clinical content of the consultation was recorded on an encounter sheet and on audio-tape. At the end of each consultation patients were invited to complete a questionnaire designed to measure satisfaction with the consultation. The stress engendered in doctors carrying out surgery sessions booked at different intervals of time was also measured. At surgery sessions booked at 5 minute intervals, compared with 7.5 and 10 minute intervals, the doctors spent less time with the patients and identified fewer problems, and the patients were less satisfied with the consultation. Blood pressure was recorded twice as often in surgery sessions that were booked at 10 minute intervals compared with those booked at 5 minute intervals. There was no evidence that patients who attended sessions booked at shorter intervals received more prescriptions, were investigated or referred more often to hospital specialists, or returned more often for further consultations within four weeks. There was no evidence that the doctors experienced more stress in dealing with consultations that were booked at 5 minute intervals than at consultations booked at 7.5 and 10 minute intervals, though they complained of shortage of time more often in surgery sessions that were booked at shorter intervals.

Appointments and Schedules↗
PubMed1989

Consultations in general practice: a comparison of patients' and doctors' satisfaction.

OBJECTIVE: To provide an objective means of assessing patients' and doctors' satisfaction with a consultation. DESIGN: Questionnaire study of patients and general practitioners after consultations. SETTING: Urban general practice. SUBJECTS: 250 Patients attending consecutive consultations conducted by five general practitioners. MAIN OUTCOME MEASURE: Identification of deficiencies within a consultation as perceived by both doctors and patients. RESULTS: The doctor's and patient's questionnaires for each consultation were matched and the results analysed on a group basis. The response rate for individual questions was high (81-89%). The doctors and patients significantly disagreed about the doctors' ability to assess and put patients at ease, to offer explanations and advice on treatment, and to allow expression of emotional feelings and about the overall benefit that the patients gained from the consultation. In all cases of disagreement the doctor had a more negative view of the consultation than the patient. CONCLUSIONS: The results of giving structured questionnaires on consultations to both patients and doctors could be a useful teaching tool for established doctors or those in training to improve the quality and sensitivity of care they provide.

Attitude of Health Personnel↗
PubMed1990

Hearing disability in people aged 50-65: effectiveness and acceptability of rehabilitative intervention.

OBJECTIVE: To determine the best means of detecting hearing disability in subjects aged 50-65 and whether rehabilitative intervention is acceptable in this age group. DESIGN: Questionnaire survey of patients on general practice age-sex registers. Two types of questionnaire were used, one being based on the closed set approach of the Institute of Hearing Research questionnaire, which had been used in a pilot study, and the other being a simplified version of this questionnaire developed by the Welsh Hearing Institute and based on open set questions. Questionnaires were sent up to three times, and any patients who had not responded two months after the last posting were personally contacted. SETTING: Two general practices in Glyncorrwg and Blaengwynfi in the Afan valley, West Glamorgan. PATIENTS: 271 Patients in Glyncorrwg (136 men, 135 women) and 333 patients in Blaengwynfi (173 men, 160 women) aged 50-65. INTERVENTIONS: All patients indicating hearing disability in answering the questionnaires were invited to attend for a evaluative session in their village. After audiometric testing advice and arrangements for fitting a hearing aid were offered as appropriate. MAIN OUTCOME MEASURES: Response rates and prevalence of hearing disability before intervention and of possession of hearing aids before and after intervention. RESULTS: After three postings and personal contact the response rate was 98% (266/271) in Glyncorrwg, where the complex questionnaire was used, and 97% (322/333) in Blaengwynfi. The prevalence of hearing disability was respectively 53% (141/266) and 46% (148/322) and the prevalence of owning a hearing aid 7% (19/266) and 8% (24/322). After intervention the possession of hearing aids rose to 24% (64/266) in Glyncorrwg and 22% (71/322) in Blaengwynfi; six months later the aids were being used regularly. A direct comparison of the two questionnaires in 69 subjects from Blaengwynfi showed no significant differences in the amount of disability detected by each one. The first posting of questionnaires detected 65% (189/289) of the hearing disability in the two villages or 78% (72/92) of those prepared to accept hearing aids for the first time; 96% (88/92) of those who accepted hearing aids were detected by two postings. CONCLUSIONS: Simple questionnaires are effective in detecting hearing disabilities in people aged 50-65, and intervention was acceptable in many of those who reported having difficulties in hearing. The response rates from successive postings suggest that two postings are sufficient in terms of the return in detecting those who will accept intervention.

Aged↗
PubMed1990

Diagnosis and antibiotic treatment of acute otitis media: report from International Primary Care Network.

STUDY OBJECTIVE: The relation between a history of disorders suggestive of acute otitis media, symptoms, and findings of an examination of the tympanic membrane and doctors' certainty of diagnosis. Also, to examine differences in prescribing habits for acute otitis media among doctors from different countries. DESIGN: Questionnaires were completed by participating doctors for a maximum of 15 consecutive patients presenting with presumed acute otitis media. SETTING: General practices in Australia, Belgium, Great Britain, Israel, The Netherlands, New Zealand, Canada, Switzerland, and the United States. PATIENTS: 3660 Children divided into the three age groups 0-12 months, 13-30 months, and greater than or equal to 31 months. MAIN OUTCOME MEASURES: General practitioners' responses to questions on their diagnostic certainty and resolution of patients' symptoms after two months. RESULTS: The diagnostic certainty in patients aged 0-12 months was 58.0%. This increased to 66.0% in those aged 13-30 months and 73.3% in those aged greater than or equal to 31 months. In all age groups diagnostic certainty was positively associated with the finding of a tympanic membrane that was discharging pus or bulging. Redness of the membrane and pain were also associated with certainty in patients aged 13-30 months, and a history of decreased hearing or recent upper respiratory infection was positively associated in patients aged greater than or equal to 31 months. The proportion of patients prescribed antibiotics varied greatly among the countries, from 31.2% in The Netherlands to 98.2% in both Australia and New Zealand, as did the duration of treatment. Patients who did not take antibiotics had a higher rate of recovery than those who did; the rate of recovery did not differ between different types of antibiotic. CONCLUSIONS: Doctors' certainty of diagnosis of acute otitis media was linked to patient's age. Improved criteria or techniques for diagnosing acute otitis media, especially in very young children, need to be developed. Antibiotic treatment did not improve the rate of recovery of patients in this study.

Acute Disease↗
PubMed1990

Conductive education for physically handicapped children: parental expectations and experience.

Conductive education, an educational approach devised by Andras Petö in Hungary after the second world war, has attracted considerable media attention. Eight Northern Ireland families who recently had treatment for their disabled child at the Petö Institute in Budapest were identified. Six families returned postal questionnaires designed to look at parental experience of conductive education. An improvement in existing local services, as opposed to the wholesale introduction of this facility was the commonest parental hope for future provision for physically handicapped children.

Cerebral Palsy↗
PubMed1990

Source of stress in women junior house officers.

OBJECTIVE: To determine the causes of stress in women doctors and relate these to levels of depression. DESIGN: Questionnaire study. SUBJECTS: Of 92 women doctors who had graduated from the universities of Leeds, Manchester, and Sheffield in 1986 and had been working as junior house officers for eight months 70 (76%) returned completed questionnaires. MAIN RESULTS: Mean score on the general health questionnaire was 13.79 (SD 5.20) and on the symptom checklist for depression was 1.43 (0.83). The scores of 32 subjects (46%) were above the criterion for clinical depression. Overwork was perceived as creating the most strain, followed by effects on personal life, serious failures of treatment, and talking to distressed relatives. Both stress and depression were related to effects on personal life, overwork, relations with consultants, and making decisions. Sex related sources of stress were conflicts between career and personal life, sexual harassment at work, a lack of female role models, and prejudice from patients. In addition to these, discrimination by senior doctors was related to depression. CONCLUSION: Changes are needed in the career paths of women doctors, and could be implemented.

Decision Making↗
PubMed1990

Tired, weak, or in need of rest: fatigue among general practice attenders.

OBJECTIVES: To determine the prevalence and associations of symptoms of fatigue. DESIGN: Questionnaire survey. SETTING: London general practice. PARTICIPANTS: 611 General practice attenders. MAIN OUTCOME MEASURES: Scores on a fatigue questionnaire and reasons given for fatigue. RESULTS: 10.2% Of men (17/167) and 10.6% of women (47/444) had substantial fatigue for one month or more. Age, occupation, and marital status exerted minor effects. Subjects attributed fatigue equally to physical and non-physical causes. Physical ill health, including viral infection, was associated with more severe fatigue. Women rather than men blamed family responsibilities for their fatigue. The profile of persistent fatigue did not differ from that of short duration. Only one person met criteria for the chronic fatigue syndrome. CONCLUSIONS: Fatigue is a common complaint among general practice attenders and can be severe. Patients may attribute this to physical, psychological, and social stress.

Adult↗
PubMed1991

Study of general practice consultations and menopausal problems. Oxford General Practitioners Menopause Study Group.

OBJECTIVE: To investigate the nature of work related to the menopause in general practice. DESIGN: Questionnaire study over six months among general practitioners after each consultation with a woman aged 40-69 at which issues related to the climacteric had been discussed. SETTING: 9 General practices in the Oxford area. SUBJECTS: 416 Women who had 572 consultations. MAIN OUTCOME MEASURES: Age, menopausal state, and first or subsequent consultation. Symptoms were classified together with the treatment and the outcome of the consultation. RESULTS: The consultation rate varied greatly between practices, the overall rate being 4.4%. There were many premenopausal women and women in their 60s presenting; women with hysterectomies presented more often--36% (37/103) of women with hysterectomies had more than one consultation compared with 26% (38/144) for premenopausal women and 24% (38/155) for postmenopausal women. 409 women had symptoms and 218 were prescribed oestrogen treatment. 156 of the consultations involved discussion and advice only. Only four women were referred to a local specialist clinic. CONCLUSION: There is a low overall use of hormone replacement therapy in the general postmenopausal population despite the recent media coverage of its benefits in the prevention of osteoporosis and subsequent fractures.

Adult↗