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PubMed2003

Cognitive interviewing: verbal data in the design and pretesting of questionnaires.

PURPOSE: The purpose of this paper is to discuss problems that occur in questionnaire responses and how cognitive interviewing can be used to identify problematic questions prior to using the questionnaire in the field. BACKGROUND: Questionnaire design involves developing wording that is clear, unambiguous and permits respondents successfully to answer the question that is asked. However, a number of problems in relation to respondents' understanding and successfully completing questionnaires have been identified. Cognitive interviewing, an amalgamation of cognitive psychology and survey methodology, has been developed to identify problematic questions that may elicit response error. The overall aim is to use cognitive theory to understand how respondents perceive and interpret questions and to identify potential problems that may arise in prospective survey questionnaires. METHODS: A literature review is used to examine the process of questionnaire design and how cognitive interviewing can be used to reduce sampling error and increase questionnaire response rates. FINDINGS: Cognitive interviewing involves interviewers asking survey respondents to think out loud as they go through a survey questionnaire and tell them everything they are thinking. This allows understanding of the questionnaire from the respondents' perspective rather than that of the researchers. Cognitive interviews have been used in a number of areas in health care research to pretest and validate questionnaires and to ensure high response rates. Interviewing has been found to be highly effective in developing questionnaires for age specific groups (children and adolescents) and in ascertaining respondents' understanding in health surveys prior to distribution. However, cognitive interviews have been criticized for being overly subjective and artificial. CONCLUSION: Cognitive interviews are a positive addition to current methods of pretesting questionnaires prior to distribution to the sample. They are most valuable in pretesting questions that are complex, where questions are sensitive and intrusive and for specific groups for whom questionnaire completion may pose particular difficulties.

Cognitive Science↗

PubMed1993

[Evaluation of the design and reliability of a questionnaire to identify elderly individuals in need for social and health services].

BACKGROUND: To assess the construction of a short screening questionnaire designed for the detection of elderly people living in the community and in need of social and health care, and to test the reliability of the scores obtained on the scales of Activities of Daily Living (ADL) and mobility through its application. METHODS: A short screening questionnaire of 11 items was designed to score elderly community dwellings on the scales of ADL and mobility of the International Classification of Impairments, Disabilities and Handicaps of the WHO (ICIDH). A random sample of 1,000 people aged 65 and over from the community of a geographical area of Catalonia (Spain) were interviewed in 1989, either by telephone or in-home personal interview, by non-professional trained interviewers on the basis of the mentioned schedule, and scored on the ICIDH ADL and Mobility scales. The design of the screening questionnaire was evaluated on the construction, content and wording through a 16 opinion statements questionnaire upon which 12 professionals, familiarized with questionnaire construction, expressed agreement or disagreement. To test reliability, each interviewer re-scored, one month apart, 20 subjects based on the information they had registered on the questionnaires, and following the same procedure, a gold standard observer re-scored all 1,000 interviews. In addition, a number of interviews were tape recorded, with previous consent of the subjects, and re-scored by 9 different observers. Interobserver and intraobserver reliability was measured with Cohen's weighted kappa coefficient. RESULTS: The average time of questionnaire administration was approximately 10 +/- 5 min. Although the instrument was said to be a good tool for the interviewer to score the subjects on the scales, wording of some items of the questionnaire need to be reviewed. Both intraobserver and interobserver reliability were high: kappa coefficients of 0.79-0.97 and > 0.75 respectively. CONCLUSIONS: The use of a simple and reliable ADL and mobility questionnaire is a practical way to obtain information on the functional status of elderly people living at home, and to select elderly people for a further comprehensive assessment of their social and health care needs for planning the appropriate services in the community.

Activities of Daily Living↗

PubMed2002

Medical student contact with patients on a surgery clerkship: is there a chance to learn?

BACKGROUND: Earlier studies of medical students on nonsurgical rotations have shown that clinical clerks usually first interact with their patients late in the clinical course. This would seem disadvantageous to the student's learning because they would have less opportunity to generate diagnoses or a management plan. STUDY DESIGN: A questionnaire designed to assess the nature of medical student-patient interactions in all potential clinical sites was administered to third year medical students during their surgical clerkship. Students received questionnaires each day to evaluate their clinical experiences from the previous day. RESULTS: The results from 311 student-patient encounters were collected and analyzed by clinical site as follows: outpatient clinics, outpatient surgery, inpatient surgery, day of surgery admission, inpatient consults, or emergency room consults. Students reported significantly more opportunities to elicit chief complaint, generate potential diagnosis, develop or suggest a management plan, and perform the initial examination when in the clinic setting. CONCLUSIONS: Overall, students were given relatively few opportunities to be the first to interact with any patient in any setting. They infrequently had an opportunity to independently generate a hypothesis or generate a management plan. Currently, the clinic offers the best opportunity for the student to complete these processes.

Clinical Clerkship↗

PubMed1999

Asian students change their eating patterns after living in the United States.

OBJECTIVE: To collect information on changes in dietary patterns among Asian students before and after immigration to the United States. DESIGN: A questionnaire designed to collect information about background, changes in food habits, and frequency of food consumption from a 72-item food list was mailed to subjects. SUBJECTS/SETTING: Potential participants were students of local universities and junior colleges who were born in China, Taiwan, Hong Kong, Japan, or Korea and were aged 18 years or older. All subjects were required to have been residing in the United States for at least 3 months before the start of the study. Questionnaires were mailed to 120 potential participants. STATISTICAL ANALYSIS: Paired t tests were used to determine differences in eating patterns and frequency of food consumption of subjects before and after immigrating to the United States. RESULTS: Seventy-one questionnaires were returned. Because of missing information on 8 of these questionnaires, only 63 were used in the analysis, which gave a response rate of 53%. The number of students consuming only 2 meals per day increased significantly; 29 (46%) respondents skipped breakfast because of their school schedules. Despite no significant change in the frequency of snack consumption, a majority (n = 46; 73%) of the respondents were consuming more salty and sweet snack items. Subjects were eating out less often, but they were selecting more American-style fast foods when they did eat out. Significant increases were noted in consumption of fats/sweets, diary products, and fruits, and significant decreases were noted in the consumption of meat/meat alternatives and vegetables after immigration to the United States. APPLICATIONS/CONCLUSIONS: Results of this study could be useful to dietetics practitioners as they observe changes in dietary patterns of Asian immigrants. These health professionals can use this information to plan nutrition education programs for Asian groups so that they can make informed decisions in adapting to new eating patterns and make wise food choices in their new environment. It is important to help Asian immigrants retain healthful food habits from their original country and to encourage them to choose eating patterns of the new culture that are nutritionally sound.

Adult↗

PubMed2001

Psychological correlates of vasectomy.

OBJECTIVE: To examine the thoughts and concerns of men contemplating vasectomy before speaking to a physician as well as their partner's role in reaching this decision. DESIGN: A questionnaire analysis using response rates, ANOVA, and regression analyses. SETTING: A large Midwestern teaching hospital. PATIENT(S): Visitors to the urology clinic of the hospital. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): [1] Questionnaire designed by authors. [2] Measures of self-concept, relationship satisfaction, and problem-solving abilities. RESULT(S): [1] Subjects had been considering vasectomy for an average of 1 year and were fairly certain of their decision. [2] Anxiety about vasectomy surgery was mostly driven by fear about pain and fear of the unknown. [3] Concerns about the finality of the procedure did not emerge as a big concern. [4] There is confusion about the reversibility of the procedure. [5] Subjects are better problem solvers and have a higher self-concept than people in general. CONCLUSION(S): Our findings demonstrate the need for adequate prevasectomy counseling, particularly in the area of postoperative expectations, as well as reversibility of the procedure.

Adult↗

PubMed2002

The provision of family planning services in the Caribbean.

This article examines the provision of family planning services in selected countries in the Caribbean. The potential impact of the funding shortfall resulting from the phasing out of funding by the International Planned Parenthood Federation (IPPF), and the strategies being adopted by the selected countries to cope with this, are considered. Stratified random sampling methods were employed to select eight Caribbean countries and a pre-designed questionnaire was administered to the agency responsible for family planning services in each country. The sample was stratified geographically to include countries from different parts of the Caribbean. The questionnaire was designed to collect information on the services provided, the name of the agency responsible for the provision of services and, where possible, the number of users of each type of service in 1998 and 1997. Vast disparities were found in the provision of family planning services in different Caribbean countries, in terms of the groups involved, the services available in each country, as well as methods of data collection and compilation. Anguilla and Bermuda were found to provide only limited family planning services, while Barbados, Jamaica and Grenada provide much more sophisticated services. A salient finding was the innovative approaches that various countries in the region have adopted to fund family planning programmes in anticipation of the phasing out of IPPF funding. The standpoint taken in the study is that countries such as Anguilla and Bermuda must strive to improve their provision of family planning services, and that they could learn from Barbados, Grenada and Jamaica, which provide much more comprehensive services. It is also concluded that, unless alternative funding sources are identified and accessed, the provision of family planning services in the Caribbean is likely to decline in the future.

Caribbean Region↗

PubMed1999

Associations between self-assessed masticatory ability, nutritional status, prosthetic status and salivary flow rate in hospitalized elders.

OBJECTIVES: To compare the association between self-assessed masticatory ability and nutritional status with general health status, salivary flow and dental/prosthetic status. DESIGN: A questionnaire and a cross-sectional clinical investigation combined with a measurement of salivary flow rates. SUBJECTS AND METHODS: A cohort of 99 elderly, non-psychiatric patients in a geriatric hospital; clinical examination to determine dental and prosthetic status, oral health and whole unstimulated (USFR) and stimulated (SSFR) salivary flow rates, examination of anthropometric measures, serum albumin level and body mass index (BMI); questionnaire designed to produce yes or no answers related to masticatory function, nutritional status, appetite and prosthesis function; mini mental score examination (MMES). MAIN OUTCOME MEASURES: USFR, SSFR, BMI, anthropometric measures and serum albumin level; complaints related to appetite and xerostomia. RESULTS: Mean age of the 99 patients was 82.5 +/- 4.04 with a MMES of > 21; 50% with malnutrition of severe or intermediate degree, and 86% with moderately or severely reduced serum albumin concentration; 55% reported recent loss of appetite and 52% had symptoms of oral dryness. Recent loss of appetite was associated with reduced serum albumin and complaints of dry mouth and lack of appetite was associated with BMI < 21, 10% weight loss during the preceding 6 months, SSFR < or = 0.5 ml min-1 and wearing dentures. Complaints on poor retention of the maxillary denture were associated with recent weight loss and SSFR < or = 0.5 ml min-1. CONCLUSIONS: Malnutrition in hospitalized elders is primarily associated with recent loss or lack of appetite whereas complaints related to dentures are associated with poor denture quality.

Aged↗

PubMed2005

Internet use by parents of children undergoing outpatient otolaryngology procedures.

OBJECTIVES: (1) To determine the prevalence of Internet medical information searches by parents prior to their child's surgical procedure, and (2) to evaluate whether Internet-based health information influences parents' medical decisions on behalf of their children. DESIGN: A questionnaire designed to gather information regarding preoperative use of the Internet by parents of children who were scheduled to undergo outpatient otolaryngology procedures. Parents were asked to respond to questions regarding Internet searches for information specific to their child's diagnosis and anticipated surgical procedure. SETTING: Tertiary care pediatric hospital. RESULTS: Internet access was available to 83% of respondents. Of those parents with Internet access, 48% searched the Internet for information regarding their child's diagnosis and surgical procedure. Of those who searched the Internet, 93% said they found information that was both understandable and helpful. More important, 84% of parents using the Internet said the information influenced or somewhat influenced the medical decisions they made on behalf of their child. Only 43% of parents discussed the information they found on the Internet with their child's surgeon. CONCLUSIONS: Approximately 50% of the parents in our study with Internet access used it to find medical information prior to their child's surgery. Parents who used the Internet found the information helpful and influential, although physicians remain the most important source of information that guides a parent or patient in their medical decision making. Ideally, surgeons would direct parents or patients to a few trusted Internet sites and be prepared to discuss this information.

Adolescent↗

PubMed2003

Cancer knowledge and skills of interns in Australia and New Zealand in 2001: comparison with 1990, and between course types.

OBJECTIVE: To compare the cancer knowledge and skills of interns in 2001 who graduated from graduate medical program (GMP) courses with those from non-GMP courses, and to compare the cancer knowledge and skills of interns in 2001 with those who completed a similar survey in 1990. DESIGN: Questionnaire survey of recently graduated interns in a random sample of Australian and New Zealand hospitals. The questionnaire was designed to allow direct comparison with the 1990 survey, and was guided by the Australian Cancer Society's Ideal Oncology Curriculum for Medical Schools. RESULTS: 443 interns completed the survey (response rate, 62%; 42 were excluded, leaving 401 surveys for analysis: 118 from GMP courses and 283 from non-GMP courses). Interns from GMP courses felt more competent than those from non-GMP courses at discussing death (P = 0.02), breaking bad news (P = 0.04) and advising on smoking cessation (P = 0.02), but less competent at preparing a patient for a hazardous procedure (P = 0.02). More GMP interns would refer a breast cancer patient to a multidisciplinary clinic (83% versus 70%; P = 0.03). Knowledge about cancer risks and prognosis was significantly less in GMP interns, but GMP interns rated their clinical skills, such as taking a Pap smear, higher than non-GMP interns. The GMP and non-GMP groups did not differ in their exposure to cancer patients, but compared with 1990 interns recent graduates had less exposure to patients with cancer. CONCLUSIONS: GMP curricula appear to have successfully introduced new course material and new methods of teaching, but have not always succeeded in producing doctors with better knowledge about cancer. Recent graduates have less exposure to cancer patients than those who trained 10 years ago.

Adult↗

PubMed2003

Practice of pediatric critical care medicine: results of the Future of Pediatric Education II survey of sections project.

OBJECTIVE: To summarize the demographics and practice patterns of the current pediatric critical care workforce and to identify the key workforce issues that may affect the delivery of pediatric critical care services in the future. DESIGN: A questionnaire designed to analyze current pediatric critical care workforce demographics and future workforce trends. SUBJECTS: Pediatric critical care physicians from the United States were identified from the American Academy of Pediatrics Critical Care Section, from a list of physicians certified in pediatric critical care medicine (PCCM) by the American Board of Pediatrics, and from a list of pediatrician members of the Society for Critical Care Medicine. INTERVENTIONS: None. MEASUREMENTS: PCCM physicians were polled regarding board certification, practice characteristics, professional activities, referral patterns, patient profiles, competition, job satisfaction, and projected retirement age. MAIN RESULTS: A total of 805 PCCM physicians completed the survey. When grouped by age, 40% of the responding PCCM physicians were younger than 40 yrs, 49% were 40 to 49 yrs old, and only 11% were 50 yrs of age or older. The younger group had a higher percentage of female pediatricians than the older groups. For all age groups, the largest proportion of time was devoted to direct patient care time in pediatric critical care. This was especially true for the youngest age group that had the largest amount of patient care time devoted to critical care (43%). Time devoted to research was also significantly higher for the younger age group, although very few respondents reported that they have >50% of their time protected for research. For all age groups, those reporting increases in referral volume and referral complexity over the previous 12 months far outnumbered those reporting decreases. The majority of respondents reported being satisfied with their career choice. In general, respondents were more likely to report that too many rather than too few PCCM physicians were currently being trained. Approximately one third of respondents (34%) planned on leaving the field of critical care medicine before retiring from medicine completely. CONCLUSIONS: PCCM physicians were increasingly women and working for >65 hrs/wk, with a good level of job satisfaction. Competition from a variety of sources seems to affect the work of PCCM physicians. The relatively small percentage of time devoted to research, however, is a finding of great concern.

Adult↗

PubMed1999

Questionnaire about calcium intake: can we trust the answers?

The aim of this study was to construct and evaluate reliable questions concerning calcium intake and to include them in a questionnaire to be used in a community-based intervention program for preventing osteoporosis. Estimating calcium intake is an important factor in evaluating risk profiles for community residents. A very large amount of calcium in the Swedish diet comes from dairy foods. Two questionnaires were designed. Questionnaire A contained eight questions concerning consumption of dairy foods. Questionnaire B contained 52 questions on consumption of calcium-rich food groups and dishes, and also included the eight questions mentioned above. Questionnaire A was sent to 467 randomized women aged 20-30 and 50-60 years. Women with a low calcium intake also answered questionnaire B. In order to validate the questionnaires a selected number of the women were interviewed using a dietary history. In total 363 women answered questionnaire A, 118 of whom had a calcium intake below the recommended amount. Ninety-six women completed questionnaire B. Twenty-two women were interviewed with the dietary history. Statistical analyses using t-tests of the differences between answers to the same questions in two questionnaires and the interview, gave the following results. Questionnaire A provides reliable information about those who do not reach the recommended level of calcium intake. Questionnaire B does not provide any more information than questionnaire A. It is not possible to rank calcium levels in the diet with the questionnaires. Using the estimated calcium intake from dairy foods obtained in questionnaire A, individuals at risk of consuming less than the recommended intake of calcium can be identified, as can those consuming the required amount. In conclusion, questionnaire A is useful in discriminating between subjects with low and high calcium intake.

Adult↗

PubMed1999

Diagnosis and treatment of the solitary thyroid nodule. Results of a European survey.

BACKGROUND AND OBJECTIVE: The optimum diagnostic and therapeutic strategy for the euthyroid patient with a solitary thyroid nodule is still a matter of debate. The aim was to assess the attitudes towards management of such patients in clinical centres throughout Europe by means of a questionnaire. DESIGN: The questionnaire was circulated to all clinical members of the European Thyroid Association (ETA). A case report was followed by diagnostic investigations and choice of therapy in the index case (a 42-year old woman with a solitary 2 x 3 cm thyroid nodule and no clinical suspicion of malignancy). Eleven variations of the basic case report were proposed in order to evaluate how each alteration would affect management. MATERIAL: 151 members replied to the letter and 110 individuals from 20 countries completed the questionnaire (corresponding to approximately two-thirds of the clinical members of the ETA). They represented clinicians who had diagnosed and treated more than 50 (76%) or less than 50 (24%) patients with nodular thyroid disease within the previous 6 months. RESULTS: Based on the index case, basal serum TSH was the routine choice of 99% and serum T4 and/or free T4 were included by 70% of the respondents. Almost 50% included determination of serum thyroid autoantibodies (TPOab: 47%, Tgab: 26%) and 43% measured serum calcitonin. Thyroid scintigraphy was used by 66% (99mTc: 86%, 123I: 10%, 131I: 4%), ultrasonography (US) by 80% (size: 75%, grey scale: 57%, Doppler: 33%). Scintigraphy in addition to US was used by 58%. Fine-needle aspiration biopsy (FNAB) was routinely used by 99% of the respondents, and performed under US-guidance by 42%. Based on the individually chosen diagnostic tests indicating a benign solitary thyroid nodule, a nonsurgical strategy was advocated by 77%. Despite controversies on L-T4 treatment this treatment was supported by more than 40% of the clinicians. Surgery was advocated by 23% and the preferred technique was hemithyroidectomy (70%). Clinical factors raising suspicion of thyroid malignancy (e.g. family history of thyroid cancer, history of external radiation, rapid nodule growth and a large nodule of 5 cm) lead the majority (70-91%; P < 0.000001) to disregard FNAB results and to choose a surgical strategy. CONCLUSIONS: The favoured diagnostic strategy in the workup of patients with a solitary thyroid nodule include determinations of serum TSH combined with serum T4 and/or free T4 followed by FNAB and US together with scintigraphy. A nonsurgical strategy was favoured by the majority supporting the use of L-T4 as the first choice. In case of clinical factors raising the likelihood of malignancy, the majority recommended diagnostic thyroidectomy despite FNAB suggesting a benign condition.

Adult↗

PubMed2000

Management of the nontoxic multinodular goitre: a European questionnaire study.

BACKGROUND AND OBJECTIVE: The optimum management strategy for the patient with a multinodular nontoxic goitre is still a matter of debate. Our aim was to assess the attitudes towards management of such patients throughout Europe by means of a questionnaire. DESIGN: The questionnaire was circulated to all clinician members of the European Thyroid Association (ETA). A case report was followed by diagnostic investigations and choice of therapy in the index case (a 42-year-old woman with an irregular nontender bilaterally enlarged thyroid of 50-80 g and no clinical suspicion of malignancy). Eleven variations of the basic case report were proposed in order to evaluate the impact on management of each alteration. SUBJECTS AND METHODS: One hundred and sixty-seven members replied to the letter, and 120 individuals from 22 countries completed the questionnaire (corresponding to approximately two-thirds of the clinical members of the ETA). RESULTS: Based on the index case, serum TSH was the routine choice of 100%, and serum free T4/T4-index was included by 74%. Serum TPO autoantibodies, Tg autoantibodies and calcitonin were measured by 65%, 49% and 32%, respectively. The median number of blood tests used was four (range 1-11). Considerable intercountry variations were seen in the preferred imaging methods. Ninety-one percent of the clinicians would use at least one imaging modality. Ultrasound (US) was used by 84%, thyroid scintigraphy by 76%, and both methods by 69%. US had first priority (53% vs. 19% for scintigraphy). If scintigraphy was performed, fine-needle aspiration cytology was routinely used by 17% (inhomogeneous uptake) and 95% (dominant 'cold' area), and 63% used US-guidance. L-T4 treatment was supported by 52% of the clinicians, iodine supplementation by 4%, radioiodine by 6% and surgery by 10%. In the case of a suppressed serum TSH, radioiodine treatment was preferred by 44%, while surgery was the favoured recommendation in four clinical variations with a large goitre or suspicion of malignancy. Marked differences between the countries were suggested by L-T4 therapy being the dominant treatment in Italy, France and Germany in contrast to the prevailing use of radioiodine in Denmark and a wait and see policy in the UK. CONCLUSIONS: Fundamental differences between European countries exist as regards diagnosis and treatment of the multinodular nontoxic goitre suggesting difficulties in reaching a consensus.

Biomarkers↗

PubMed1990

Sociodemographic and motivational characteristics of parents who volunteer their children for clinical research: a controlled study.

OBJECTIVE: To determine the sociodemographic and motivational characteristics of parents who volunteer their children for clinical research. DESIGN: A questionnaire was administered to parents who volunteered their children for a randomised, double blind, placebo controlled trial of a drug to treat asthma and to a control group of parents whose children were eligible for the trial but had refused the invitation. SETTING: A children's hospital in Australia. SUBJECTS: 68 Parents who had volunteered their children and 42 who had not; a response rate of 94% and 70%, respectively. MAIN OUTCOME MEASURES: Responses of parents to questionnaire designed to assess their perceptions, attitudes, and health seeking behaviour as well as sociodemographic data. RESULTS: Volunteering parents were less well educated with only 15% (10/68) of mothers and 16% (11/68) and of fathers having had a tertiary or university education compared with 26% (11/42) of mothers and 45% (19/42) in the non-volunteering group. Fewer volunteering parents had professional or administrative jobs than did non-volunteering parents (mothers 6% (4/68); fathers 9% (6/68) v mothers 14% (6/42); fathers 31% (13/42)). Volunteering parents had less social support, and they displayed greater health seeking behaviour and consumed more habit forming substances. They were motivated by a desire to help others and to contribute to medical research, but they were also searching for more information and better ways to help their own children. CONCLUSION: Parents who volunteer their children for medical research are significantly more socially disadvantaged and emotionally vulnerable.

Adult↗

PubMed1993

Safe sex? Misconceptions, gender differences and barriers among injection drug users: a focus group approach.

Heterosexual transmission is one factor involved in the spread of the human immunodeficiency virus (HIV) within the injection drug use (IDU) population and between IDU and non-IDU individuals. Insufficient information is currently available to reduce this heterosexual transmission. As a basis for designing a questionnaire aimed at the IDU population, we conducted 5 focus groups to collect information on knowledge of and attitudes toward safe sex as held by male and female IDUs in methadone treatment. We identified misconceptions related to HIV infection, condoms, and sexual behavior. We also found gender-based differences in knowledge and learning style. Also, while individuals felt a responsibility to prevent HIV transmission, they lacked sufficient control to do so. The wide range of responses on questions concerning sexually transmitted diseases (STDs), condoms, reproductive decisions, and methods of promoting safe sex provides a basis for developing a questionnaire designed to identify and target specific subgroups for educational intervention.

Adult↗

PubMed1984

Assessment of change-agent expectations in reversal-to-baseline designs.

Questionnaires similar to those used in previous research to assess behavioral expectations produced by differing reversal-to-baseline rationales were presented to 160 male and female parents in rural South Dakota. Given two case histories, respondents were asked to predict, as simulated change agents, the frequency of problem behavior during reversal in an ABAB design intervention. The five rationales for reversal were: (a) withdrawal, (b) withdrawal and counter-expectancy, (c) problem switch and counter-expectancy, (d) fade and counter-expectancy and (e) inert treatment and counter-expectancy. While obtained means were close to those of a previous study, there were no significant sex or treatment effects. This fails to confirm the earlier results obtained from university undergraduates. Implications for internal validity of ABAB designs are discussed.

Adult↗

PubMed2005

A new questionnaire specifically designed for patients affected by chronic obstructive pulmonary disease; The Italian Health Status Questionnaire.

The aim of this study was to develop a specific and valid questionnaire for Italian COPD patients, living on the north or the south of Italy-which are two culturally distinct areas. The project consisted in three steps: (1) initial item set generation to identify items relevant to both genders, all ages and both regions; (2) item reduction including tests of regional specificity; (3) tests of internal validity using item-response theory using Rasch one-parameter modelling. Ninty-six COPD patients (mean aged 69 yr; 78 Male) completed the original set of 124 items of the Italian Health Status Questionnaire (IHSQ). Item reduction was carried out using an established standardised approach employing classical psychometric test theory. The internal construct validity of the 47 items that survived this process were tested to determine whether they constituted a unidimensional construct "impaired health due to COPD" using Rasch analysis. This showed that the questionnaire had very good psychometric properties, with an excellent Person Separation Index of 0.95 and no evidence of bias due to item-trait interaction (chi104(2)=127.1, P=n.s.). The combination of classical test theory and modern item-response methodology has produced a questionnaire with excellent measurement properties suitable for COPD patients whether from the north or south of Italy.

Adult↗

PubMed1985

Developing effective questionnaires.

Many research questions are effectively answered by collecting data about the opinions, beliefs, and perceptions of large numbers of persons in widely dispersed areas. The questionnaire is an economical means of gathering such information. Properly designed questionnaires can collect valid and reliable data for analyzing a research problem. This article reviews fundamental principles of questionnaire design and presents a matrix to guide the construction of a questionnaire. Methods to avoid common problems and pitfalls in developing a questionnaire are also presented. Field testing is recommended to ensure validity and reliability.

Data Collection↗