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Training in neonatal cranial ultrasound: a questionnaire survey.

A questionnaire was sent to every paediatric specialist registrar in the West Midlands to assess the training of paediatric specialist registrars in neonatal cranial ultrasound. 26% had never carried out supervised scans. 51% lacked confidence in performance and 57% in interpretation of scans. The current pattern of training in neonatal cranial ultrasound lacks structure, supervision and assessment of competency.

Echoencephalography↗

Treatment of terminal cancer pain in Finland. A questionnaire survey.

A questionnaire concerning current practice in the treatment of cancer pain was sent to 783 Finnish physicians. This study is based on the replies from 421 physicians who stated that they at least sometimes see cancer patients. Three simulated patient cases were presented in the questionnaire, and the adequacy of the treatment suggestions was evaluated. The results indicated that drugs predominate in the treatment of cancer pain. The suggested doses of narcotic analgesics were well below the minimum effective daily doses. As many as half of the physicians failed to use the therapeutic modalities correctly, irrespective of the frequency of their seeing cancer patients. Education in effective pain treatment should therefore be intensified to ascertain that all physicians involved in clinical practice have satisfactory knowledge of the treatment of cancer pain.

Analgesics, Opioid↗

The pediatric prenatal visit: a questionnaire survey.

A questionnaire was sent to 83 pediatricians to determine which issues they considered important in the pediatric prenatal visit. Of the 64 respondents, 58 do prenatal interviews. Approximately half of the mothers of newborns entering these practices had prenatal visits. Most respondents indicated that the prenatal visit focused on meeting the family and discussing practical aspects of infant care. The finding that few respondents focused the interview on psychological aspects of parenthood raises questions about the role of the prenatal visit in pediatric care.

Female↗

New Zealand obstetricians' management of hypertension in pregnancy. A questionnaire survey.

A questionnaire about the management of hypertension in pregnancy was sent to the 150 members of the Royal New Zealand College of Obstetricians and Gynaecologists. Sixty five out of a total of 77 replies were suitable for analysis. There was a wide variation in the criteria for diagnosis and the outpatient and inpatient investigation and treatment. The commonest drugs prescribed in imminent eclampsia were hydralazine as an anti-hypertensive, and diazepam or phenytoin as anticonvulsants. All clinicians practised aggressive management with induction of delivery if significant proteinuria complicated hypertension in pregnancy. Glucocorticoid therapy for the premature induction of fetal lung maturity in mothers and severe hypertension was considered beneficial by some, yet contraindicated by others.

Adult↗

Voiding patterns in men evaluated by a questionnaire survey.

A questionnaire on obstructive and irritative voiding symptoms was sent to 572 men aged between 20 and 79 years, selected at random from the National Register; 337 questionnaires were completed. None of the responders had consulted a doctor because of voiding symptoms. There was a significant increase in voiding symptoms and in the obstructive, irritative and total symptom scores between the sixth and seventh [corrected] decades, whereas the increases in the other decades were small. Only the prevalence of terminal dribbling was uniform. The prevalence of single obstructive and irritative voiding symptoms in men aged 60 to 79 years without subjective prostatism was the same as in patients admitted with prostatism, although most of the men had milder symptoms. Only nocturia and urge incontinence were more prevalent in patients admitted with prostatism. About 20% of men in the oldest decades had symptoms equal in severity to those found in men undergoing prostatectomy; 29% and 11% of men in the eighth decade [corrected] had nocturia twice and 3 times or more respectively; 19% complained of urge incontinence. More information on possible treatment is needed.

Adult↗

Treatment of cerebellar hematoma in The Netherlands. A questionnaire survey.

A questionnaire was sent to Dutch neurosurgeons and neurologists in order to assess current management strategies for cerebellar hematoma. Seven patients were presented, using as determinants: size of hematoma, coma score, interval to clinical deterioration, hydrocephalus, comorbidity, anticoagulant treatment and age. Neurological management options were: no treatment, monitoring or referral for neurosurgery. Neurosurgical options were: no treatment, monitoring, hematoma evacuation, and/or external ventricular drainage. Ninety-seven of 161 (60%) neurologists, and 58 of 85 neurosurgeons (68%) responded. Only 20 respondents (13%) made use of a local guideline. Overall agreement was perfect in 1 case and moderate to high in the others, but chance-adjusted agreement (kappa) between pairs of neurologists and neurosurgeons who were matched for referral center was not statistically significant except in 1 case, a deeply comatose patient with a 4-cm hematoma. In an alert, slightly ataxic patient with a large (4.5-cm) hematoma, 84 neurologists (88%) decided not to refer the patient. The estimated time for transfer between centers was of no influence on this decision. We conclude that the management of cerebrellar hematoma can be improved upon by encouraging the use of local guidelines, and by promoting early referral to a center with neurosurgical facilities.

Aged↗

Long-term results of blunt suction lipectomy assessed by a patient questionnaire survey.

A questionnaire was sent to 1339 consecutive patients who had undergone blunt suction lipectomy during the period between April 1984 and April 1987. Seventy-four percent replied, thus providing information about the results of 1929 procedures. The overall reported rate of satisfaction was 76 percent, with no significant difference between males and females. Highest satisfaction referred to pseudogynecomastia, submental area, iliac crest, and lower extremities on females. The rate of dissatisfaction was 6 percent. Dissatisfaction was associated most frequently with lipectomy of the buttocks. Underresection was reported for 30 percent and over-resection for 2.2 percent of the procedures. The latter, in particular, seemed to lead to dissatisfied patients. Asymmetry was reported for 19 percent of the procedures. Recurrence ("return") of fatty tissue was reported for 29 percent at the resection site. Thirty percent of the patients reported compensatory increase ("came back elsewhere") in fat deposits in nontreated locations. Self-reported weight gain was found to be a significant risk factor for both types of "regrowth." Irregularities were the most frequently reported permanent changes to skin. There were twice as many negative as positive changes to skin. Most of the patients had benefited personally from the surgery and were willing to consider undergoing lipoplasty again. All in all, the long-term results of blunt suction lipectomy are satisfactory.

Adult↗

Somatoform disorders in different cultures--a mail questionnaire survey.

A mail questionnaire survey was organized by WHO to obtain expert opinion on the cross-cultural applicability of ICD-10 definitions of somatoform disorders. A response was obtained from 42 experts in 23 countries representing all five continents. The results showed that the ICD-10 concept of somatoform disorders was generally acceptable for use across cultures. However, a number of culture-specific symptoms, characteristics and terms that do not appear in ICD-10 were found to be common and important for the diagnosis of somatoform disorders in particular cultures. Pointing out the relative restrictiveness of ICD-10 criteria for somatization disorder, the experts emphasized the usefulness of having the more inclusive category of undifferentiated somatoform disorder. The survey was organized as the starting point of the WHO International Study of Somatoform Disorders. The major goal of the study is to improve understanding of the somatic presentation of psychological disorders in different cultures.

Cross-Cultural Comparison↗

Coping with pressures in acute medicine--the second RCP consultant questionnaire survey.

The second questionnaire survey of consultant physicians involved in acute unselected takes in 1999 achieved a 76% response rate, and the results have been compared with those from the first survey of 1997. The proportion of consultants whose trainees worked partial shifts had increased from 42% to 61%, although these patterns of duty were adjudged to have detrimental effects on the quality and continuity of care, and on junior staff education and training. The benefits of ward-based systems were counterbalanced by their disadvantages, but introductions of admission wards and assessment units were considered a resounding success. The number of hospitals with 'physician of the week' schemes had increased from 12 to 23, but opinion of their value was sharply divided. The provision and competence of all grades of locums was identified as an increasing problem. Seventy per cent of respondents stated that they would never participate in 'hands-on' emergency care, although 86% thought that future consultants might have to do so. Seventy-nine per cent reported increases in the pressures of their posts and in their working hours, and the tensions between general and specialist duties were highlighted. Most consultants considered that the only long-term solution to the staffing crisis was a marked expansion in the numbers of all grades of medical staff.

Adult↗

Ethnic minorities in British diabetic clinics: a questionnaire survey.

A questionnaire was sent by the British Diabetic Association to hospital consultant physicians caring for diabetic patients in the UK to estimate the number of ethnic minority patients attending British Diabetic clinics, and the availability of special facilities for their care. Sixty-two clinics were estimated to have at least 50 Asian patients, and 25 had at least 200 Asian patients. For Afro-Caribbeans the corresponding figures were 33 and 14 clinics, respectively. Clinics serving a relatively high proportion of these patient groups were situated primarily in Greater London, the Midlands and the North West. Approximately 40% of clinics with over 50 Asians had no specifically adapted diet sheets, and 34% had no hospital interpreter service. Tapes, slides or video presentations were available in only eight clinics. There is an urgent need to improve the provision of special facilities to clinics with substantial numbers of ethnic minority patients.

Adult↗

[A group of homosexuals change their sex habits after information about AIDS. A questionnaire survey].

A questionnaire investigation to which 144 homosexual persons replied anonomously revealed alterations in the sexual habits after information about AIDS. Significant reduction in the annual number of partners and significantly fewer employ the more dangerous sexual practices which now occur particularly in more permanent partnerships are among the alterations started. An unchanged number still employ active anal and orogenital coitus. Employment of condoms has increased significantly, particularly in anal coitus and "casual" partners (from 3% to 82%). The majority accept the use of condoms and state that they employ more "safe sex" than prior to information about AIDS. 12% stated that they had sex with both sexes and the possibility of spread of infection from homosexual to heterosexual groups is present. The intensive informative work from the homosexuals own organisation and from public health authorities appear to have had some effect but further information and influencing are necessary if the spread of HIV infection is to be stopped.

Acquired Immunodeficiency Syndrome↗

Nonresponse bias to mail survey questionnaires within a professional population.

Mail survey questionnaires are often used in dental research. In most instances, results depend on a single mailing and an incomplete return rate. The possible bias resulting from excluding nonresponders in tabuling data from mail survey questionnaires in a dentist population was investigated. Two different questionnaires, one soliciting attitudes, the other knowledge, were sent to randomly selected dentists. The differences between the responders and the nonresponders were analyzed with respect to the dentists' demographic data, attitudes, and knowledge. It was concluded that: (1) subject matter does affect dentist response rates to mailed survey questionnaires, (2) there are no differences in demographic data between dentist responders and nonresponders, and (3) nonresponse bias does not affect the results of dental surveys on a typical dentist response rate.

Attitude of Health Personnel↗

[What do cancer chemotherapy outpatients want?--results of a questionnaire survey].

We conducted a questionnaire survey to evaluate patients at the cancer chemotherapy center of the university of occupational and environmental health hospital from January to March 2006. Thirty-three (61.1%) and 5 (9.2%) of 54 patients wished to receive chemotherapy on an outpatient basis and as inpatients, respectively. Among the reasons for wishing to be treated as outpatients were the following: Keeping in touch with family, not wanting to be hospitalized, a desire to work, and the wish to continue hobbies, at 45.5 (15/33), 36.4 (12/33), 24.2 (8/33), and 24.2 (8/33), respectively. Twenty-four (44.4%) patients voiced concerns about chemotherapy at an outpatient clinic in terms of associated adverse events, feeling bad about causing trouble to their family, and the desire to have consultations at night or on holidays. Thirty-eight (70.4%) patients wished to have chemotherapy within 3 hours, and 42 (77.7%) of them requested improvements in the examinations, time, duration of chemotherapy, and the effect of chemotherapy. These findings indicate that a major part of patients wish to receive cancer chemotherapy at an outpatient clinic within 3 hours. However, they also have serious reservations about any associate adverse events. We therefore need to improve the overall environment for cancer chemotherapy patients in order to allow them to feel safe when undergoing such treatments.

Ambulatory Care↗

The epidemiology of overactive bladder among females in Asia: a questionnaire survey.

A questionnaire-based survey was performed in 5502 females from 11 countries in Asia to establish the prevalence overactive bladder (OAB) and identify the factors related to the occurrence of the condition. The overall prevalence of OAB was 53.1%. The most common presenting symptom was urgency (65.4%). Twenty-one per cent of the OAB population presented with incontinence, giving an overall prevalence of 11.4% for urge incontinence among Asian females. The majority (75.4%) were not significantly bothered by the condition. Only 21.1% sought treatment. Older age, multiparity, a positive family history, residence in a rural area and the use of a sitting type of toilet were found to be associated with a greater occurrence of OAB. The study has shown that overactive bladder in Asian females is significant and warrants closer attention. It has also highlighted the low treatment-seeking rate among its sufferers. This is the first report on the epidemiology of overactive bladder among Asians in the medical literature.

Adolescent↗

Predictors of non-response to a questionnaire survey of a volunteer twin panel: findings from the Australian 1989 twin cohort.

Questionnaire surveys, while more economical, typically achieve poorer response rates than interview surveys. We used data from a national volunteer cohort of young adult twins, who were scheduled for assessment by questionnaire in 1989 and by interview in 1996-2000, to identify predictors of questionnaire non-response. Out of a total of 8536 twins, 5058 completed the questionnaire survey (59% response rate), and 6255 completed a telephone interview survey conducted a decade later (73% response rate). Multinomial logit models were fitted to the interview data to identify socioeconomic, psychiatric and health behavior correlates of non-response in the earlier questionnaire survey. Male gender, education below University level, and being a dizygotic rather than monozygotic twin, all predicted reduced likelihood of participating in the questionnaire survey. Associations between questionnaire response status and psychiatric history and health behavior variables were modest, with history of alcohol dependence and childhood conduct disorder predicting decreased probability of returning a questionnaire, and history of smoking and heavy drinking more weakly associated with non-response. Body-mass index showed no association with questionnaire non-response. Despite a poor response rate to the self-report questionnaire survey, we found only limited sampling biases for most variables. While not appropriate for studies where socioeconomic variables are critical, it appears that survey by questionnaire, with questionnaire administration by telephone to non-responders, will represent a viable strategy for gene-mapping studies requiring that large numbers of relatives be screened.

Adult↗

Validity of a questionnaire survey: the role of non-response and incorrect answers.

Errors in questionnaire surveys are usually of one of two sources: non-responses or incorrect answers. The aim was to investigate the validity of a questionnaire survey and to estimate the respective bias of these answers. Of 9,283 subjects selected to receive a questionnaire by post, 3,949 (43%) responded, and, of these, 3,400 correctly reported their Swedish social security number. Answers in the questionnaire survey were given as proportions of the claims registered at local insurance offices. In the group of respondents who had correctly reported their social security number, the answers were compared individually with the registrations in dental insurance claims. In Sweden, these claims are labeled with the patient's social security number and it is thereby possible to make such comparisons. It was shown that errors were caused by non-response and also by respondents giving incorrect answers. Incorrect answers accounted for approximately one-third of the total bias. The remaining bias was caused by a non-response error. It is concluded that questionnaire studies have a bias caused by both non-response and incorrect answers and that together these can be substantial. Scientific reports that include questionnaire surveys must describe the procedure carefully. If possible, other sources of information should be considered.

Bias↗

[Actual condition survey on inclusive child day-care--a questionnaire survey of child day-care facilities in K city].

The purpose of this questionnaire survey is to gather information on actual conditions of inclusive child day-care in K City in order to qualify what support we can provide as part of the community. The questionnaire was sent to 148 child-care facilities (day nurseries) in date, of which 116 provided sufficient data for analysis. Of these 116 facilities, 104 (89.7%) accepted children with disabilities, while 12 (10.3%) did not. The number of disabled children accepted by the 104 facilities over a 2.5-year period was 275. Mental retardation (including children with multiple disabilities) was the most common type of disability; autism, physical disability and cerebral palsy were also seen. Thus, nursery staff, whose training is largely geared toward education and child development, is faced with a particularly difficult task. What we envisage as one of our future roles is to train and provide nursing experts with a specialized knowledge of medical rehabilitation, day-to-day medical care, training and support of children with various types of disabilities. Such nurses could then be introduced to child day-care facilities to provide individualized child-care services, which would take into account all factors relating to the child's condition and developmental stage. The results of our survey also suggest that close coordination and partnership with specialized/related agencies and institutions should be pursued in order to both enrich the support systems of child day-care facilities and to enhance their inclusiveness.

Child↗

Bias of vaccination coverage in a household questionnaire survey in Japan.

BACKGROUND: Although a household questionnaire survey is important for estimating vaccination coverage, it raises several problematic issues. METHODS: A household survey was conducted on 900 subjects aged 2, 4, and 6 years living in Obu City, Japan, and a second survey for non-respondents to the first survey was then conducted. Questionnaires bearing a subject's name were used for half of the subjects, while the others were anonymous (the named and nameless groups, respectively). The vaccination dates of six kinds of vaccines, including poliovirus and measles vaccine, for those in the named group were reviewed using the administrative records at the Obu City Health Center. RESULTS: The response rate was 70.1% in the first survey and 84.1% in the first and second surveys combined. The response rate for both groups was nearly equal. Based on administrative records in the named group, the vaccination coverage in the respondents was 0.9-2.9% higher than that in total subjects, and that in the respondents to the first survey was 0.8-4.9% higher. There were very few inconsistencies in the vaccination status between responses to the questionnaire and data of administrative records among respondents in the named group. CONCLUSIONS: These results suggested that vaccination coverage from a household questionnaire survey in Japan might not be extremely biased by either non-responses or incorrect answers.

Bias↗