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PubMed2002

Short- and long-term reliability of information on previous illness and family history as compared with that on smoking and drinking habits in questionnaire surveys.

To assess the reliability of responses to questionnaires regarding previous illness, family history of cancer, and smoking and drinking habits, we repeated questionnaire surveys four times at intervals of 2 weeks and 1 year (short-term), and 4.5 years (long-term) among 440 subjects aged 40-69. The reliability was assessed using kappa statistic. Kappa was calculated both for complete data and data including missing values. The changes of mode of pre-after paired responses were also investigated. Our results from complete data showed both short- and long-term reliabilities of replies regarding smoking or drinking were excellent (mean kappa 0.85-0.99). The reliability of previous illness was excellent except for stroke for short-term intervals (mean kappa 0.85-1.00), but varied depending on the kinds of illness with long-term intervals (mean kappa -0.01-0.75). Responses to family history had fair to excellent short-term reliability (mean kappa 0.54-0.85). Inclusion of missing value as an independent category reduced reliability remarkably. Subjects stating absence of medical history were more likely to have missing values for this item than subjects with some history. In conclusion, the reliability for information given on previous illness was as good as that on smoking and drinking for a short interval, but was lower for a long-interval probably due to the development of new cases. The reliability of a family history on cancer was slightly poorer than that of individual's previous cancer or other illnesses and that of smoking and drinking even for a short interval.

Adult↗

PubMed2002

[A questionnaire survey on antimicrobial chemotherapy for acute peritonitis].

A questionnaire survey on antimicrobial chemotherapy for acute peritonitis was conducted to obtain the consensus among abdominal surgeons in Japan in the period from January to March 2002. Forty-one of the 58 surgeons replied, and the following consensus was obtained. Antibiotics should be given as soon as possible the diagnosis of infection in the abdominal cavity is established. When the perforated viscus is demonstrated at operation, giving antibiotic should be reconfirmed whether it covers organisms in the perforated site or not. The ascites obtained at operation should be sent for bacterial culture. When postoperative course is eventful, considering WBC, body temperature and CRP, the drainage fluid should be sent for culture on 4 to 7 days postoperatively. Most commonly used antibiotic for perforation of duodenal ulcer is cefotiam, and it is given 4.1 +/- 1.2 days postoperatively. Target organisms at the perforation of the lower digestive tract were E. coli, Bacteroides spp., Klebsiella pneumoniae and Enterobacter spp. Carbapenems were likely given agents for the perforation of the colon, and they were given 5.0 +/- 1.4 days postoperatively.

Acute Disease↗

PubMed2005

Asthma prescribing practices of government and private doctors in Malaysia--a nationwide questionnaire survey.

A self-answered, anonymously completed questionnaire survey was performed between June 2002 and May 2003 where doctors from government and private sectors in Malaysia were invited to participate by post or during medical meetings. One hundred and sixteen government doctors and 110 private doctors provided satisfactorily completed questionnaires (effective respondent rate: 30.1%). The most preferred medications for 'first-line', 'second-line' and 'third-line' treatment were for government doctors: inhaled short-acting beta2-agonist (SABA) (98%), inhaled corticosteroids (CS) (75%), and leukotriene antagonist (52%); and for private doctors: oral SABA (81%), inhaled CS (68%), and oral CS (58%). The first choice inhaler device for most government and private doctors were metered dose inhalers, with cost and personal preferences (for private doctors), and technical ability (for government doctors) as the key considerations when deciding on the choice of device. This benchmark data on the asthma prescribing practices of a healthcare delivery system fully dichotomized into government and private sector, provides evidence for practice differences affected by the nature of the healthcare system, and might have implications on healthcare systems of other countries that share similarities with that of Malaysia.

Administration, Inhalation↗

PubMed2002

Questionnaire survey on the Japanese guidelines for treatment of hypertension in the elderly: 1999 revised version.

A questionnaire survey was administered to Japanese clinical specialists in hypertension in order to gauge their opinions on the 1999 revised version of the Guidelines for Hypertension in the Elderly prepared by the Comprehensive Research Project on Aging and Health of the Ministry of Health and Welfare. Out of 162 council members of the Japanese Society of Hypertension, 122 (75%) replied. The majority (93%) of respondents approved of the guidelines in general, and 72% of them approved of the age-related setting of a therapeutic goal for blood pressure. Sixty-five percent of respondents selected long-acting Ca antagonists, ACE inhibitors and low-dose diuretics as first-line agents for hypertension without complications in the elderly. The results of the questionnaire survey should be reflected in the next version of the guidelines.

Aged↗

PubMed1993

[Preoperative embolization using absolute ethanol for renal cell carcinoma--including the questionnaire survey in Japan].

The usefulness of transvascular embolization before radical nephrectomy using absolute ethanol was studied in thirty-two cases with renal cell carcinoma, among them, 30 cases received radical nephrectomy one day after transvascular embolization. And a nation wide questionnaire survey regarding the embolization was also reported. These results were as follows: 1. The infarcted areas were very extensive and among 28 cases examined, 26 cases showed more than 75% of infarct in the whole area of the cortex. 2. Among 32 cases, 22 cases complained of no pain after the embolization using absolute ethanol only by the preventive epidural administration of analgesics. 3. The questionnaire survey showed that the embolization before radical nephrectomy was performed in 62% of the hospitals as a whole, including 81 hospitals (41%) in which the embolization was performed case by case. In the whole of hospitals, 21% performed the embolization principally by evaluating the significance of the embolization. On the other hand, 19% of the hospitals did not perform by the reason of no significance of the embolization on the treatment of renal cell carcinoma. As shown in this questionnaire survey, the significance of the embolization before radical nephrectomy was still debatable in our country. 4. In 62% of the hospitals where the embolization is carried out, as a whole, the period from embolization to the nephrectomy was 3-7 days. And in 42% of the hospitals as a whole absolute ethanol was principally used as an embolizing agent. In conclusion we believe that absolute ethanol was useful and should find further application as an embolizing agent before the radical nephrectomy.

Aged↗

PubMed2003

Status of obstetric epidural analgesia services in Hong Kong public hospitals: postal questionnaire survey.

OBJECTIVE: To examine the status of obstetric epidural analgesia services in Hong Kong public hospitals in 2001, and to compare findings with those from a similar survey conducted in 1995. DESIGN: Postal questionnaire survey. SETTING: Hospital Authority hospitals in Hong Kong offering an obstetric and delivery service. PARTICIPANTS: Chiefs of Service of departments of anaesthesia and coordinators of obstetric anaesthesia and analgesia service. MAIN OUTCOME MEASURES: The availability of an obstetric epidural analgesia service, specialist staff allocation to the service, existence of clinical protocols, rate of epidural analgesia, techniques of epidural administration, obstetric outcome or mode of delivery, and the incidence of adverse events associated with the use of epidural analgesia. RESULTS: Between 1 January and 31 December 2001, all eight Hospital Authority hospitals with an obstetric service provided epidural analgesia for labour pain relief, but only six (75%) offered a 24-hour service. A dedicated anaesthetist provided obstetric anaesthesia and analgesia during office hours in all units, but after hours in only three. This level of service provision compared favourably with that available in 1995, when only 82% of public maternity units provided epidural analgesia and only 36% offered a 24-hour service. The median epidural analgesia rate was 15% (range, 8%-20%) compared with 10% in 1995. The incidence of adverse events and complications was very low. Formal written protocols for the conduct of epidural analgesia for labour were used in six units. All units used mixtures of local anaesthetic combined with opioid, administered as intermittent boluses, continuous epidural infusion, or patient-controlled epidural analgesia. CONCLUSIONS: Although there has been progress and improvement in the provision of obstetric epidural analgesia services in our public hospitals, the rate is still relatively low and the provision of services after hours is limited. Further progress will likely be hindered by current or future cutbacks in public hospital budgets.

Analgesia, Epidural↗

PubMed2005

Why do general practitioners prescribe antibiotics for acute infective conjunctivitis in children? Qualitative interviews with GPs and a questionnaire survey of parents and teachers.

BACKGROUND: Acute infective conjunctivitis in children is a common presentation in primary care. Treatment is usually with antibiotics and prescribing may be affected by non-clinical factors. AIMS: To investigate the non-clinical determinants of the management of acute infective conjunctivitis in children. DESIGN: Qualitative interviews with GPs and a questionnaire survey of parents of children with acute infective conjunctivitis and teachers. SETTING: GPs in Sheffield and Berkshire and parents of children with acute infective conjunctivitis and schools in Oxfordshire. METHODS: Semi-structured telephone interviews of 39 GPs. Questionnaire survey of 326 parents of children enrolled into a trial of acute infective conjunctivitis treatment. Questionnaire survey of 223 nurseries and primary schools in Oxfordshire. RESULTS: All three groups agreed that acute infective conjunctivitis was a mild condition. Parents were certain about the benefits of antibiotic treatment and sought early consultations with their GP in a desire to get their child back to school. GPs sometimes collude with a parent's request to prescribe to enable school attendance. Despite this 54.2% (95%CI 48.5-59.8%) children missed a mean of 1.85 days from school and 28.6% of parents (95%CI 23.5-33.7%) missed a mean of 1.5 days off work. CONCLUSION: Social factors, including the need for children to attend day care or school and parents to go to work, contribute to the decision to prescribe antibiotics for children with acute infective conjunctivitis. Understanding these issues and changing school policies in line with national guidance may reduce pressure on GPs to prescribe for this condition.

Adult↗

PubMed2003

Prevalence and characteristics of migraine among adolescents: a questionnaire survey.

A screening questionnaire was distributed to 1000 boys and 1000 girls, studying in classes VI to X (11 to 15 years) in two public schools of Jaipur. Questionnaire A consisted of a single question to parents. "Does your child suffer from recurrent headache?" To those who responded in the affirmative, a detailed questionnaire (B) was distributed Questionnaire B consisted of twenty questions pertaining to characteristics and associations of headache. From questionnaire B a diagnosis of common migraine was made according to IHS criteria (1988). The prevalence of recurrent headache was found to be 18% in boys and 21% in girls, while the prevalence of migraine was 9% in boys and 14% in girls. Among the other causes of recurrent headache tension type headache was seen in 3.6%, eye problems in 0.389% sinusitis in 0.22%, and undetermined etiology in 2.14% children. The clinical characteristics of migraine are described.

Adolescent↗

PubMed1985

Malignant melanoma, evaluation of clinical follow up by questionnaire survey.

A retrospective questionnaire study, by post, revealed that 69% of patients, still living following first tumour recurrence, had detected the recurrence themselves prior to routine clinic appointments. Nearly 90% developed their first recurrence in the first 5 years following primary surgical treatment. Not only could the length of routine clinic follow-up after primary melanoma treatment be shortened, but with further education of the patient and involvement of the general practitioner it seems likely that patients can be trusted to detect their own recurrences and seek appropriate advice.

Evaluation Studies as Topic↗

PubMed1993

Attitudes of British psychiatrists to the diagnosis of somatisation disorder. A questionnaire survey.

A postal questionnaire was sent to 195 senior British psychiatrists who were asked about their attitudes towards the DSM-III-R diagnosis of somatisation disorder (SD) and the ICD-10 diagnosis of multiple somatisation disorder. Of the 148 respondents, 98 (66%) had experience of liaison psychiatry, and these psychiatrists used the diagnosis significantly more often than those without liaison sessions. More than half the respondents perceived SD as both a personality disorder and a mental state disorder, although 27% thought that patients with SD had an undiagnosed physical disease. The marked discrepancy between British and North American psychiatrists in diagnostic practices was perceived to be a consequence of both the difference in health care systems and the interest shown in the disorder by North American psychiatrists, rather than a reflection of genuine differences in prevalence.

Attitude of Health Personnel↗

PubMed2003

[Citizen's understanding of anesthesia from a questionnaire survey].

BACKGROUND: In order to know general understanding or impression of anesthesia by citizens, we performed a questionnaire survey. MATERIALS AND METHODS: The participants for the survey were 218 citizens including 118 healthy persons with previous attendance to Kurume University Public Lecture for Citizens (group A) and 100 patients hospitalized in Kurume University Medical Center (group B). Their answers were collected prior to the lecture planned on the 39th Annual Meeting of Kyushu Society of Anesthesiologists. RESULTS: The recovery of the survey was 78.9%. The percentages of persons who wanted to know "How and by whom I am anesthetized" were 93.2% and 72.6% in groups A on B, respectively. The percentage of persons who wanted to know the name of surgeon was 91.7%. The answers to the question; "Which doctor do you think is responsible for the treatment of an intraoperative adverse event such as acute myocardial infarction?"; were in the order of an internist 37.5%, a surgeon 29.7% and an anesthesiologist 18.0%. CONCLUSION: We have realized through the questionnaire survey that the majority of citizens still consider an anesthesiologist as a technician merely putting patients into sleep for surgery. At the preoperative examination or round, we have to explain procedures and potential risks related to anesthesia to a patient and also have to answer patient's questions fully. We anesthesiologists should do more efforts to enlighten citizens at every opportunity so that citizens would understand our work fields and evaluate anesthesiologists correctly.

Adolescent↗

PubMed2005

[A questionnaire survey on judgment of criminal responsibility].

The authors conducted questionnaire surveys utilizing model cases with the aim of investigating the current views of psychiatrists regarding criminal responsibility judgments in forensic psychiatric evaluations. Six model cases-injury by a person with acute schizophrenia, indecent assault by a person with chronic schizophrenia, attempted murder by a woman with depression, arson by an alcohol abuser, burglary by an amphetamine abuser, rape and indecent assault by a person with personality disorder-were presented to 345 psychiatrists, who were asked about criminal responsibility and appropriate treatment for each of the cases. One hundred eighty-five of the psychiatrists responded. In the case of acute schizophrenia with hallucination and delusion, the case of severe depression, and the personality disorder case, there was a high level of agreement between the evaluations of criminal responsibility made by the different respondents, but in the case of chronic schizophrenia, the case of alcohol-induced psychotic disorder, and the case of amphetamine abuse, there were variations in the evaluation of criminal responsibility, with many respondents emphasizing the patient's symptoms and condition at the time of the offense, and relatively few emphasizing whether the disorder was endogenous. Regarding the form of treatment, many of the respondents recommended compulsory hospitalization for the case of acute schizophrenia with hallucination and delusion, while at the same time recommending treatment in a prison environment for the personality disorder case. In contrast, for the case of chronic schizophrenia and the case of alcohol-induced psychotic disorder, opinion was divided as to whether the subject should be handled with a medical or a judicial approach. Regarding treatment for the case of alcohol-induced psychotic disorder and the case of amphetamine abuse, there was a tendency to make a judgment based on the subject's condition at the point of psychiatric evaluation, which was not necessarily linked to the criminal responsibility.

Adult↗

PubMed1995

Misclassification in a questionnaire survey of varicose veins.

The objective of this study was to assess the determinants and the effect of misclassification in a questionnaire survey of varicose veins. A random sample of 166 individuals aged 50 years in a larger prevalence study (n = 6874) was examined by a surgeon to validate the self-reporting of varicose veins. Varicose veins were assessed by a mailed questionnaire completed by the study subjects themselves and validated in a clinical examination by a surgeon. The sensitivity, specificity, positive and negative predictive values, kappa coefficient, and Chamberlain indices of the self-assessed diagnosis in reference to the diagnosis by surgeon were estimated overall and in categories of determinants. The overall sensitivity and specificity estimates were 0.92 and 0.93, respectively. The specificity appeared to be poorer among subjects who reported positive family history of varicose veins (0.83) than among those with negative family history (0.98). With respect to some other determinants of varicose veins such as gender, height and weight, occupational status and position at work, there was at best weak but nevertheless inconclusive evidence on possible differential misclassification. Sensitivity appeared to be relatively good for epidemiologic purposes but one could have hoped for better specificity. The correction for misclassification resulted in estimated prevalence of 19% (uncorrected 24%) in men and 43% (uncorrected 45%) in women. A questionnaire survey of varicose veins showed a relatively good validity. The effect of misclassification in the total 5-year-old study population was small in women but moderately large in men. Familial predisposition to varicosis was associated with a lower accuracy of self-assessed diagnosis.

Adult↗

PubMed1980

Life with an ileal conduit: results of questionnaire surveys of patients and urological surgeons.

Two questionnaire surveys were undertaken to investigate the problems experienced by patients and staff in coping with ileal conduits. A survey of 34 patients showed that the major problems were urinary leakage and skin excoriation. In 7 out of 13 patients, leakage was associated with contour problems due to abdominal hernias of recession of the stoma. Fifty-seven questionnaires were received from British urologists, who each constructed, on average, 7 ileal conduits per annum. Twenty of 57 surgeons had no stomatherapist. Leakage and skin reactions were once again the most commonly encountered problems. It was concluded that the most severe leakage problems could be prevented by careful surgical technique. However, most of the day-to-day problems could be handled by a competent stomatherapist.

Aged↗

PubMed2003

Severe complications in advanced esophageal cancer treated with radiotherapy after intubation of esophageal stents: a questionnaire survey of the Japanese Society for Esophageal Diseases.

PURPOSE: A questionnaire survey was performed to evaluate the complications and prognosis of esophageal cancer treated with esophageal intubation before or during radiotherapy. METHODS AND MATERIALS: Clinical data were accumulated on a total of 47 patients treated at 17 institutions in Japan. Five patients had Stage II, 30 Stage III, and 11 Stage IV, and the stage was unknown in 1 patient. Covered expandable metallic stents were inserted in 30 patients, uncovered expandable metallic stents in 13, plastic or silicon prosthesis in 3, and an unknown type in 1 patient. Esophageal stenting was performed before the start of RT for 23 patients and during the course of RT for 24 patients. The reasons for the stenting were severe stricture in 32 patients (Group 1) and esophageal fistula in 15 patients (Group 2). RESULTS: The most frequent toxicity was formation or worsening of esophageal fistulas in 13 patients (28%), followed by massive hematemesis or GI bleeding in 10 patients (21%). In total, 24 patients (51%), including 10 patients with possible treatment-related deaths (Grade 5), had nonhematologic toxicities of Grade 3-5. The interval from the start of RT to the nonhematologic toxicity ranged from 16 to 312 days (median 78). The incidence of toxicities was higher for Group 1 (59%) than for Group 2 (33%), although the difference was not statistically significant. The median survival time for those with Stage II-III and Stage IV was 5 and 3.5 months, respectively. CONCLUSIONS: Patients with esophageal intubation before or during RT have a high risk of life-threatening complications, especially for those with severe esophageal stricture. Because long survival is expected for a substantial proportion of patients with locally advanced esophageal cancer after chemoradiotherapy, palliative intubation should be delayed until radiotherapy or chemoradiotherapy appears to have failed.

Aged↗

PubMed1990

Precise diagnosis of airflow obstruction - does it matter for treatment? An international questionnaire survey and its implications.

As emphasised by the recent international questionnaire survey, the absence of an agreed terminology in chronic non-specific lung diseases leads to much confusion and undoubtedly impairs communication between physicians. In each patient within the scope of CNSLD, the presence and combination of a number of basic features should be identified. The term bronchial asthma should be used when a number of features are present which are sufficiently characteristic to differentiate it from other forms of permanent airway obstruction. In non-asthmatic obstructive disease the term 'COLD' (or COPD), followed by some qualifying labels, seems preferable. Use of the term 'chronic bronchitis' should be restricted to refer as 'chronic mucus hypersecretion' or be abandoned.

Data Collection↗

PubMedDate not supplied

Analysis of cost and assessment of computerized patient record systems in Japan based on questionnaire survey.

PURPOSE: The purpose of this study was to clarify the implementation and maintenance costs of a computerized patient record (CPR) system by means of a questionnaire survey. Moreover, the benefits of CPR systems were evaluated to determine their contribution to enhancing the quality of medical care and hospital management. METHODS: Data were collected by a questionnaire survey mailed out to participants. RESULTS: The per-bed mean cost for implementation was 14,308 dollars (range: 3538-38,077 dollars). The mean annual maintenance cost for the CPR system was 457,615 dollars (range: 39,769-2,307,692 dollars). The multivariate analysis (Hayashi's Quantification Type I) revealed high partial correlation coefficients between implementation cost and the CPR system maker. In addition, the multiple correlation coefficient for four factors (CPR system maker, number of servers, institution type and implementation date) in predicting implementation cost was 0.798. Over 60% of respondents replied that their satisfaction with the CPR system was 'very high' or 'high.' Eighty-two percent of the hospitals responded positively that CPR systems improve the quality of medical care, and 70% felt that the systems help prevent medical errors. CONCLUSIONS: Our findings indicate that the maker of CPR system, number of servers, institution type and implementation date had a strong influence on per-bed implementation costs in that order. Finally, it was found that CPR systems were considered effective for hospital administration and medical examinations, based on the high assessments of the results of installing a CPR system.

Costs and Cost Analysis↗

PubMed2002

[A questionnaire survey of the neurology training program in Japan].

A questionnaire survey was performed in order to see the current trends of the neurology training program in Japan. A questionnaire was sent out to 81 neurology program directors of the medical schools and large hospitals. 72 program directors answered the questionnaires. According to the summed results, each program had an average of 37 inpatient beds, 7 teaching staffs with the neurology board certification. The program had an average of 4 residents annually, and they served as junior neurology residents for 1.8 years, and as chief residents for 1 year with 6 months of hospital consultation. 1.4 years training in the internal medicine was prerequisite for the neurology program. The training of clinical neurophysiology was done mainly by the own faculty staff in each program, but the training of neuroradiology and neuropathology varied. A quarter of the training programs had their own teaching staffs of neuroradiology and the rest of three quarters asked for training to the neuroradiology department. 32 of 72 programs had their own teaching neuropathologists and 26 programs asked the training in the pathology department and 14 programs did not have any teaching staffs of neuropathology. It seems that these numerical data are quite similar to those of the American standard of Accreditation Councils. We must still improve the real contents of the neurology training program with more capable teaching staffs.

Education, Medical, Graduate↗