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Methicillin-resistant Staphylococcus aureus in the UK and Ireland. A questionnaire survey.

The results of a questionnaire survey of the distribution of methicillin-resistant Staphylococcus aureus (MRSA) in the UK and Ireland between 1982 and 1983 are reported. Information was obtained about the geographical distribution of MRSA, the units affected, the sites of isolation and the preventive measures employed. Serious clinical problems were confined to a small number of hospitals with high isolation rates of MRSA.

Cross Infection↗

[Sleep disturbances complicated by surgical stress; a questionnaire survey of 50 patients].

A questionnaire survey of sleep disturbances was undertaken in 50 adult surgical patients to examine the prevalence of insomnias complicated with surgical stress. The survey about nocturnal sleep conditions was performed for consecutive four nights from two days before surgery. Defining early awakenings, difficulty of initiating or maintaining of sleep as manifestations of insomnias, the incidence of insomnias amounted to 72.9% on the night of two days before surgery, 72.0% on the night before surgery, 86.0% on the night of surgery, and 86.6% on the first night after surgery. High incidence of sleep disturbances complicated with surgical stress is noteworthy in the field of perioperative care.

Adult↗

[Current status of low-dose CDDP. 5-FU therapy for solid malignant tumors--nationwide questionnaire survey].

A nation-wide questionnaire survey was undertaken concerning low-dose anticancer therapy of CDDP plus 5-FU, which involves (5-10 mg CDDP/body/day + 300-500 mg/body/day) for 4-6 weeks. Out of 1,525 cases from 130 institutions, 847 cases with evaluable lesions were collected from 79 institutions. The response rate was 56.4% in esophageal cancer, 34.3% in gastric cancer, 35.3% in colorectal cancer, 47.2% in liver cancer and 35.9% in lung cancer, respectively. Adverse effects were found to be fewer and compliance was much better than the conventional therapy. Such figures suggest that the present regimen may be more effective than any so far. Problems for medical administration such as unlicensed CDDP for colorectal cancer were pointed out, which hinder the forthcoming third phase study.

Antineoplastic Combined Chemotherapy Protocols↗

'So much post, so busy with practice--so, no time!': a telephone survey of general practitioners' reasons for not participating in postal questionnaire surveys.

BACKGROUND: Response rates by general practitioners (GPs) to postal surveys have consistently fallen, compromising the validity of this type of research. If postal survey work is to continue we need to understand GPs' reasons for not participating and respond appropriately. AIM: To investigate GPs' reasons for not responding to postal surveys. METHOD: A qualitative study was carried out to determine GPs reasons for not participating in postal surveys, which were drawn from a telephone survey of 276 non-responders to a postal questionnaire survey. Practitioners' comments were recorded and reasons for their non-response quantified using content analysis. RESULTS: Primary reasons for GPs not replying to the postal survey were that questionnaires had got lost in paperwork (34%), that GPs were too busy for the extra work involved (21%), and that questionnaires were routinely 'binned' (16%). Higher practice workloads, including increased administration, meant that participation in research had become a low priority. GPs provided some suggestions for researchers that would increase their chances of questionnaires being returned. CONCLUSIONS: Researchers need to be aware of the pressures of service general practice and to rationalize the amount of research material sent to GPs. GPs were most likely to respond to postal surveys that had a high interest factor, that involved localized research relevant to general practice, and that incorporated a personalized approach by researchers, including good-quality explanatory information.

Attitude of Health Personnel↗

Management of acute leukemia during pregnancy: from the results of a nationwide questionnaire survey and literature survey.

In March, 1993, a questionnaire was sent to 362 gynecological and obstetric offices of national, prefectural and municipal hospitals and private university hospitals with 250 beds or more. Answers were collected from 260 institutions. Thus, this study analyzed 39 patients with acute leukemia during pregnancy collected by the questionnaires survey and 64 cases reported in the Japanese literatures during 1975-1993 (total 103 patients). The weeks of pregnancy were defined as the 1st (< 15th week), 2nd (16th-27th week), and 3rd (> 28th week) trimesters. The time of diagnosis of leukemia during pregnancy changed from 25% in the 2nd trimester and 62% in the 3rd trimester during 1975-1984 to 39% and 48% after 1985, respectively. After 1985, the remission rate was 72% in the questionnaire group and 75% in the group from literatures. There was no statistical difference. The 50% survival period was 12 months in the group during 1975-1984, but 25 months in the group after 1985. The survival was significantly longer in the patients whose induction therapy was started before delivery than in those treated after delivery. The results suggest that the treatment for acute leukemia during pregnancy should be initiated as soon as possible after the diagnosis of leukemia, with carefully selected regimens. It is important that the time of delivery should be selected considering the maternal and fetal conditions after consultation with an obstetrician.

Adult↗

[A questionnaire survey on urinary incontinence in geriatric nursing home patients].

A survey by questionnaires was performed to understand the present conditions of urinary incontinence in the aged. The objects were 748 persons who were residing in eight geriatric nursing homes locating in Nara Prefecture. The answers from 183 males and 565 females ranging from 57 to 101 years old were collected and analyzed. The answers were interpreted as follows: (1) Of these 748 persons 422 (56%) were incontinent, 94 males (51%) and 330 females (58%). (2) The higher age group tends to show the higher rate of incontinence. (3) The rate of incontinence seems to highly correlate with the degree of dementia and impaired mobility. (4) Sixty-nine persons (16%) had consulted a nursing home doctor and/or other medical doctors, only 20 of whom had been medicated for incontinence. (5) An institution where a behavioral therapy program had been employed showed a lower rate of incontinent persons. From these results, it is considered that not only an increase of nursing staff but also aggressive participation of medical specialists including urologists are needed to improve their quality of life.

Activities of Daily Living↗

[Clinical features and outcomes in patients with asymptomatic moyamoya disease--from the results of nation-wide questionnaire survey].

After induction of noninvasive diagnostic tools, asymptomatic moyamoya disease is occasionally being diagnosed. However, there is no epidemiological or clinical data concerning this condition because of its rarity. To elucidate clinical features and outcomes in patients with asymptomatic moyamoya disease we conducted a nation-wide questionnaire survey. Questionnaires were sent to 88 neurosurgical institutes in 1994 and we received answers from 66 institutions (75% recovery). Diagnosis of moyamoya disease is based on the guidelines established by the research committee on moyamoya disease of the Ministry of Health and Welfare, Japan. Thirty three asymptomatic moyamoya disease patients were collected (11 male, 22 female) and divided into 2 groups; group 1 defined as patients without any symptoms, and group 2 as patients who did not show any symptoms except headache. 80% of group 1 patients were adults, whereas in group 2, children and adults were equally distributed. Follow-up periods were 3 years and 8 months on average. Among conservatively treated 28 patients, 2 patients died from suspected bleeding (mortality 7%) and 4 patients with TIAs resulted in good outcome. Among surgically treated 5 patients, 1 patient showed poor outcome due to post-operative infarction. Other 26 patients showed excellent outcome. Natural course of asymptomatic moyamoya disease seemed benign, but mortality from bleeding is not negligible. A prospective study of asymptomatic moyamoya disease is necessary to clarify its natural course and appropriate management strategy.

Adolescent↗

Response rate and nonresponse bias in a questionnaire survey of dentists.

OBJECTIVES: (a) To report on response rate and nonresponse bias of a questionnaire survey of dentists. (b) To make recommendations for future questionnaire survey research in dentistry. METHODS: A questionnaire was mailed to a stratified systematic sample of 908 Australian dentists. The strategy included three mailings, a final telephonic contact, university stationery, paid reply envelopes and personalized correspondence. Nonresponse bias was assessed by comparing responses to a simple 'yes/no' question from each contact (late responders), and by comparing demographic information (nonresponders). RESULTS: The response rate achieved was 87% and there was no evidence of nonresponse bias based on practice location or year of graduation. The cumulative proportions of 'yes/no' responses essentially remained constant after each contact, but significantly more late responders answered in the negative to the test question than did early responders. The telephonic contact aided in the identification of nonparticipants and ineligible units. CONCLUSIONS: The current survey indicates that differences in data between early and nonresponders can occur despite there being no demographic differences. Therefore, assessment of nonresponse bias based on demographic data alone would seem to be insufficient. Questionnaire survey research must first be based on sound sampling techniques, and then on achieving as high a response rate as possible using the many incentives available.

Australia↗

[Adequacy of translating health survey questionnaires for cross-cultural surveys--the case of the Todai Health Index].

The adequacy of the language translation of self-administered questionnaire items was examined in a comparative study of adolescent mental health between Japan and the United States. As a screening instrument to be used in both countries, the Todai Health Index (THI) questionnaire had been translated from original Japanese into English. The original version was administered to 570 Japanese adolescents and the translated version was given to 295 middle school students in the United States (aged 12 to 15). The equivalence of the two versions was re-examined based on the results of the surveys by a team of researchers from both countries including a bilingual investigator. For the items which produced a statistically significant different response pattern between the two samples, the investigators attempted to determine whether the observed difference could be attributed to an inadequate translation or to a real cultural difference. For those items judged to suffer from inadequate translation, modifications were made to improve cross-cultural equivalence. The above methodological procedure, though not perfect, proved to be relatively simple but very useful in resolving many practical issues in cross-cultural studies and produced interesting findings. For example, the phrase "worry about" was found to not adequately capture the Japanese meaning of "ki-ni-naru" and instead the phrase "concern about" or "care" was suggested as a more appropriate substitute. Very little is known and insufficient attention has been given to the effect of translation in cross-cultural surveys. These investigations suggest the benefit of more extensive studies and focused discussions of reliability of the translated survey instruments by public health researchers involved in international comparisons.

Adolescent↗

Methodical approach to data processing from a questionnaire survey.

For conducting questionnaire studies there exist generally recommended methods that were also respected during the project funded by the Grant Agency MoH CR - "Subjective approach of inhabitants of Ostrava to their health in association with their life-style, socio-economic status and education". The preparatory phase included the collection of literature and information on the investigated theme. The questionnaire had got five parts - A. General questions, B. Employment, C. Way of life, D. Health state and E. Personality. The validity of questionnaire was tested in the pre-research. In the main questionnaire study 3,000 questionnaires were sent. The total response rate was 21.1% (634 completed questionnaires). In the sample there were no differences in percentage rate by sex and age, but there are differences in the educational structure. After realizing the main questionnaire study, the repeatability study was carried out to find out the reliability of the answers. The response rate was 60.3% (181 questionnaires). The Kappa index and the total percentage of agreement were used for the evaluation of the repeatability study. The agreement was almost perfect and good in the total of 62.3 % of the questions. The quality of data was ensured by double data entry and by choosing the appropriate software. The selection of data for the complex analysis was based on the results of the repeatability study. On the basis of individual information from the questionnaire, new groups of individuals were generated. These groups of individuals were analysed further in relation to health and life-style by socio-economic factors in the models.

Electronic Data Processing↗

Voiding patterns and prevalence of incontinence in women. A questionnaire survey.

A detailed questionnaire on the occurrence of irritative and obstructive voiding symptoms, incontinence and the number of childbirths was sent out to 600 women aged between 20 and 79 years, randomly selected from the National Register; 432 (72%) returned the questionnaire and 414 (69%) were evaluable. The frequency of obstructive symptoms such as hesitancy, intermittency and decreased stream was low. Diurnal frequency with voiding intervals less than 3 h were recorded by more than 50% of the women and about 10% voided more frequently than every second hour. Nocturia increased significantly with age; 54 (13.6%) voided at least twice per night. About 40% complained of incontinence but this was troublesome in only 6%; 15.3, 13.3 and 11.5% had stress, urge and mixed incontinence respectively. More than 8% wore nappies or sanitary towels every day to protect against urinary leakage. Although the tendency to wear nappies or sanitary towels increased with age, the increase was not statistically significant. There was a positive correlation between the occurrence of stress incontinence and childbirth in the group as a whole.

Adult↗

[A questionnaire survey for TURP hospitalization by clinical path].

PURPOSE: We conducted a questionnaire survey to elucidate the rating of the patients who underwent transurethral resection of the prostate (TURP) and were managed by a common clinical path during hospitalization. PATIENTS AND METHODS: At the day of discharge from seven hospitals in Japan, the questionnaires were handed to 298 patients who underwent TURP in 2002. In the path, it was determined that the patients should be admitted one day before surgery and discharged on the seventh postoperative day. RESULTS: The questionnaires were returned by 240 (80.5%) patients. Of the 212 patients answering a question regarding the desirable preoperative hospital stay, 58 (27.4%), 85 (40.1%) and 46 (21.7%) considered 1, 2 and 3 days as a desirable preoperative stay, respectively. Of the 206 answering a question about the desirable postoperative hospital stay, 54 (26.2%), 28 (13.6%) and 60 (29.1%) considered 7, 8 and 9-10 days as a desirable postoperative hospital stay, respectively. Of the 240 patients, 229 (95.4%) received the path for the patients, 234 (97.5%) understood the treatment methods well and 229 (95.4%) understood the schedule during hospitalization well. Two hundred thirty-six (98.3%) and 218 (90.8%) patients answered that as scheduled, they started to have meals and started to walk, respectively. Continuous drip infusion was terminated in 219 (91.3%) as scheduled, and indwelling catheters were removed in 215 (89.6%) as scheduled. CONCLUSIONS: This questionnaire survey elucidated that approximately 70% of the patients who underwent TURP wanted to stay 1 or 2 days before surgery and 7 to 10 days after surgery. We consider it very important that patients understand well the treatment methods, complications, schedules during hospitalization and criteria for discharge when they are managed using the clinical path, so they will accept better a length of hospital stay that is shorter than that which they had desired.

Critical Pathways↗

Validity of a questionnaire survey: response patterns in different subgroups and the effect of social desirability.

Questionnaire surveys are often used in epidemiology and survey research. However, investigations have shown that the method suffers from biases. If the intention is to examine differences between subgroups in a sample, studies have shown that people tend to give answers to questionnaires more according to a social norm than to the actual situation. This has been called social desirability. The aim of this study was to investigate response bias in subgroups of a sample in a large questionnaire survey (n = 9,200) and to study whether social desirability has an impact on survey results in dental research. The answers were divided into subgroups according to gender, age, and residence and were compared with corresponding data from dental insurance claims. The levels of agreement were found to vary considerably and the differences were highly statistically significant. The variation in agreement showed that bias on the group level increased when the distance from an anticipated social norm was larger. This implies that the divergence from a socially desirable mode of action influences the magnitude of the bias.

Adult↗

There are a few things you did not ask about my pain: writing on the margins of a survey questionnaire.

This qualitative study is a secondary analysis of comments written on survey questionnaires about pain mailed to community-dwelling persons with spinal cord injury (SCI) or amputation. Narrative comments were added by 54.1% of 797 respondents. The purpose of this study was to determine the characteristics of those who wrote comments and to understand what was being communicated in their comments. A qualitative content analysis was used to identify the major themes, subthemes, and thematic categories in the unsolicited comments. The overarching theme was desiring dialogue with the researcher. Presenting themselves as experts on living with pain because of a chronic disabling condition, respondents described personal experiences of living with pain, coping with pain, and educating others about pain. Examining comments and narratives written in the margins of quantitative survey questionnaires can add value to and extend understanding of survey findings and implications.

Activities of Daily Living↗

Questionnaire surveys of cases of tick bite and Lyme borreliosis in hunters in Hokkaido with reference to detection of anti-Borrelia burgdorferi antibody.

An epidemic of Lyme borreliosis on Hokkaido island, Japan, was surveyed by questionnaire in 587 hunters. The 308 returns (52.4%) revealed episodes of tick bite (usually 2 or more) in 210 cases. Skin rashes appeared in 164 cases. Associated itching, pain, etc., but not skin rash, were more frequent after 2 or more tick bite. Previous determinations of anti-Borrelia burgdorferi antibody titers in these subjects and in controls suggested an association with outdoor activities other than hunting, and among 33 cases of dermatological symptoms and 23 of articular symptoms, 4 and 2, respectively, were antibody-positive. Most of these antibody-positive subjects had suffered tick bite at least twice, but had had no antibiotic treatment. Three subjects with joint disorders were antibody-positive. These findings suggested that the many hunters exposed to Borrelia burgdorferi frequently carried latent infections, and that some had latent form of arthritis, dermatitis and other disorders.

Adult↗

[Risk factors for suicide: a questionnaire survey by psychiatrists in Fukuoka Prefecture].

In our previous study, we demonstrated a preliminary questionnaire survey to psychiatrists from university hospitals, psychiatric hospitals, psychiatric clinics, and departments of psychiatry in general hospitals in Fukuoka Prefecture. In that study, 324 psychiatric patients who committed suicide between January 1, 1998 and December 31, 2001 were ascertained. In the present study, we have recruited matched control patients from the same clinics/hospitals and further demonstrated a secondary questionnaire survey to the psychiatrists in order to reveal the various risk factors for suicide suggested by the literature. Associations between completed suicide and possible risk factors were examined in 192 completed suicide psychiatric patients and 356 non-suicidal psychiatric patients (controls). Significant association was found for history of admission to psychiatric hospitals, history of suicide attempts, history of substance abuse, cluster B personality disorders, and hopelessness in our sample. In male samples, history of suicide attempts, cluster B personality disorders, recent loss, and hopelessness were significantly associated with suicide. In females, history of admission to psychiatric hospitals, history of suicide attempts, and hopelessness were significant.

Female↗

Questionnaire survey and environmental measurements that led to smooth implementation of smoking control measures in workplaces.

In order to promote smoking countermeasures in a manufacturing plant, we conducted a questionnaire survey about smoking control measures in workplaces. Twenty nine point five percent of the subjects responded that they were exposed to passive smoking where they worked and that the most common source of passive smoking in the workplace and rest areas was environmental tobacco smoke (ETS) leaking from smoking areas. For smoking control measures, 27.8% of employees preferred a total ban on smoking in the building while 55.2% preferred measures to prevent ETS leakage from smoking areas. Regardless of whether they were smokers or not, 99.2% of respondents believed that passive smoking countermeasures in the workplace were necessary and 88.9% of smokers responded that banning smoking in the building was unavoidable. Based on these results, a total ban on smoking in the building was implemented in those workplaces where it was feasible to do so, smoking areas in the remaining workplaces were upgraded to prevent ETS infiltration, and the effects were evaluated by real-time monitoring of the concentration of suspended particle matter. The questionnaire survey results showed that 79.9% of smokers were interested in smoking cessation, that awareness of the adverse health effects of smoking on the smoker and surrounding non-smokers and the nuisance it caused was significantly lower among smokers compared to non-smokers (p<0.01), and that 65.5% of non-smokers believed that smoking was beneficial to the mental health of smokers, despite the fact that they had no experience of smoking themselves. Reporting these results to the Safety and Health Committee was found to be useful both in ensuring thorough segregation of smoking areas and in supporting smoking cessation programs in places where no previous action had been taken because smoking was viewed as a matter of personal choice. We also believe that provision of accurate information tailored to actual smoking conditions in the workplace is useful in effectively implementing anti-smoking campaigns on the adverse effects of smoking and smoking cessation programs. The implementation of a questionnaire survey and environmental measurements that lead to countermeasures was shown to be effective in establishing designated smoking areas and educational programs for smoking cessation.

Air Pollution, Indoor↗

Perioperative antibiotic prophylaxis in Spanish hospitals: results of a questionnaire survey. Hospital Pharmacy Antimicrobial Prophylaxis Study Group.

A questionnaire survey was sent to a random sample of the Spanish network of National Health System public acute-care hospitals. Of responding institutions (representing 25% of Spanish hospital beds), nearly 75% had active surveillance programs for the prevention and control of surgical-site infections (SSIs), but only 20% performed postdischarge surveillance. Overall, perioperative antibiotic prophylaxis (PAP) was used in 84% of all surgical procedures. For 77% of procedures, there were written guidelines for the choice and use of PAP. Cefazolin was the most commonly used antibiotic (38%). Duration of PAP was shorter than 24 hours in 75% of procedures, and only a single dose was given in 52% of procedures. PAP was commonly used in breast (52%) and inguinal hernia repair (69%) procedures, as well as in laparoscopic abdominal surgery (86%). In summary, the use of PAP in Spanish hospitals is adequate, but improvements can be made in the frequency of prolonged PAP and in the use of broad-spectrum antibiotics. Surveillance systems for SSI, including postdischarge follow-up, also should be improved.

Antibiotic Prophylaxis↗