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PubMed2004

Factors influencing dental utilisation in Greece.

OBJECTIVE: To identify factors that influence utilisation of dental services in Greece. METHODS AND MATERIALS: Data was obtained through the "WHO Multi-Country Survey Study on Health and Responsiveness", a survey organised by the WHO and locally executed by the National School of Public Health. A national random sample of 5,000 prospective participants was selected through the national phone directory. Of those, half (2,500 participants) were mailed the self-administered questionnaire designed to assess the general health status of the Greek population, while the other half were mailed the questionnaire designed to assess responsiveness of the Greek healthcare system. Both research instruments contained a question related to utilisation of dentists during the last month, and several potential predictors. 1,819 individuals answered the questions and participated in the analysis. Two main outcomes were identified: a) reporting of any utilisation vs. none, statistically analyzed using Logistic Regression, and b) frequency of utilisation (number of visits), analyzed using Poisson Regression. RESULTS: 25.1% reported at least one dental visit, while the mean number of visits during the last month was 0.48. Income gave an odds ratio of 1.139 (95% CI:1.038, 1.251). Dental visit frequency increased with increased income (b = 0.11, p = 0.004) and decreased whith improved self-rated health (b = 0.15, p = 0.003) and age (b = -0.006, p = 0.026). CONCLUSIONS: Income is an important determinant of dental utilisation in Greece; it influences both the percentages and the frequency of such utilisation. Additionally, increased age and high self-rated health are associated with less frequent dental utilisation.

Adolescent↗

PubMed1988

Malignant hyperpyrexia and sudden infant death syndrome.

This paper reports three investigations of the suggested relationship between sudden infant death syndrome (SIDS) and malignant hyperpyrexia (MH). In the first study 151 MH-susceptible families completed a questionnaire designed to identify the incidence of SIDS within their own pedigree. In the second study 106 SIDS families completed a questionnaire designed to identify the incidence of anaesthetic related problems. In the third study, 14 SIDS parents were subjected to muscle biopsy and in vitro halothane contracture and caffeine contracture screening for susceptibility to MH. From the results of the three studies it can be concluded that there is no association between SIDS and MH.

Disease Susceptibility↗

PubMed1999

PTSD symptoms, response to intrusive memories and coping in ambulance service workers.

OBJECTIVES: To examine the relationship of coping strategies and responses to intrusive memories with post-traumatic stress disorder (PTSD) and other psychiatric symptoms in ambulance service workers. METHOD: Fifty-six ambulance service workers describe the most distressing aspects of their work and completed questionnaires designed to measure their coping strategies in dealing with distressing incidents. They also described their intrusive memories of particularly distressing incidents and completed a questionnaire designed to measure their interpretation of these intrusions and their responses to them. In addition, they completed the Post-traumatic Stress Symptom Scale (PSS; Foa, Riggs, Dancu & Rothbaum, 1993) and the General Health Questionnaire (GHQ; Goldberg & Hiller, 1979). RESULTS: Of the participants, 21% met DSM-III-R criteria for PTSD, and 22% met GHQ screening criteria for psychiatric symptoms. Wishful thinking and mental disengagement when confronted with critical incidents at work, negative interpretations of intrusive memories, and maladaptive responses to these memories (rumination, suppression and dissociation) correlated with PTSD severity. CONCLUSION: The results are consistent with the hypothesis that coping strategies and responses to intrusive memories that prevent emotional processing of the distressing event maintain PTSD. They also support Ehlers & Steil's (1995) hypotheses about the role of negative interpretations of post-traumatic intrusions in PTSD. A substantial subgroup of emergency service personnel may need support in processing distressing incidents at work and may benefit from information that normalizes post-traumatic symptoms such as intrusions.

Adaptation, Psychological↗

PubMed1999

Studying the careers of nurse diplomates: the importance of branch-specific questionnaires.

Questionnaire design is considered in the context of a longitudinal panel study focusing on the careers of people qualifying from all four branches of the UK nurse diploma course. Separate, but comparable, questionnaires were developed for each branch in order to produce information which reflected the differences between branches, and the experiences of the cohort as a whole. This approach ensured that participants from the smaller branches did not feel their interests and concerns were overshadowed by those of the largest (adult) branch, as is often the case during the diploma course's Common Foundation Programme. The elements that needed to be tailored to each branch emerged during a three-stage piloting process used to develop and test the questionnaires. Differences were found between branches in their use of terminology; in certain issues being more relevant to some branches than others; and in questions which concerned all branches benefiting from the inclusion of branch-specific examples. The effectiveness of this approach to questionnaire design is borne out by the study's high response rates.

Career Choice↗

PubMed2006

And--how was it for you dad?

This article describes a small pilot study which used a structured questionnaire designed to promote communication between health visitors and fathers. A review of literature revealed a lack of research and resources to support men's mental health and wellbeing through the transition to fatherhood. A convenience sample of 20 fathers completed the 'And--how was it for you dad?' questionnaire designed to encourage men to express their thoughts and feelings about becoming a parent. An evaluation questionnaire was also completed by the participants to assess the worth of the 'And - how was it for you dad?' project. This revealed that fathers welcomed the opportunity to express their feelings and emotions on becoming a parent. It is recommended that research should be extended further in order to develop a validated questionnaire to assist men to think about how they feel on becoming a father.

Adaptation, Psychological↗

PubMed2003

Do they practise what we teach? A survey of manual handling practice amongst student nurses.

Experience of training students of nursing in manual handling suggested that they did not practise the techniques they had been taught. A search of the literature revealed that there was indeed a theory-practice gap. The aim of the project was to answer three questions: do students know what they should be doing, do they do what they should be doing, and if not, why not. A survey design was used, with questionnaires designed specifically for the study. Self report questionnaires were distributed to students of nursing (n = 148) on the adult branch in one higher education institution in England. One hundred and thirty-nine completed questionnaires were returned. Results showed that students' knowledge of whether particular techniques were 'recommended' was fair. They indicated however, that they were frequently unable to use recommended techniques in practice. The most frequent explanation given was the influence of other nurses. Results of this small study indicated that male students and younger students were more susceptible to socialization into poor ward practice than others. Other reasons for not using recommended techniques were unavailability of manual handling aids, lack of time and patient needs. The complexity of relationships within the nursing team emerged, with students ever aware of the impression they were making with regard to their assessment of practice, and their need to be accepted as a member of the team. Changes to training are suggested, to help reduce the theory-practice gap.

Adult↗

PubMed2000

Factorial validity and invariance of questionnaires measuring social-cognitive determinants of physical activity among adolescent girls.

BACKGROUND: There are few theoretically derived questionnaires of physical activity determinants among youth, and the existing questionnaires have not been subjected to tests of factorial validity and invariance. The present study employed confirmatory factor analysis (CFA) to test the factorial validity and invariance of questionnaires designed to be unidimensional measures of attitudes, subjective norms, perceived behavioral control, and self-efficacy about physical activity. METHODS: Adolescent girls in eighth grade from two cohorts (N = 955 and 1,797) completed the questionnaires at baseline; participants from cohort 1 (N = 845) also completed the questionnaires in ninth grade (i.e., 1-year follow-up). Factorial validity and invariance were tested using CFA with full-information maximum likelihood estimation in AMOS 4.0. Initially, baseline data from cohort 1 were employed to test the fit and, when necessary, to modify the unidimensional models. The models were cross-validated using a multigroup analysis of factorial invariance on baseline data from cohorts 1 and 2. The models then were subjected to a longitudinal analysis of factorial invariance using baseline and follow-up data from cohort 1. RESULTS: The CFAs supported the fit of unidimensional models to the four questionnaires, and the models were cross-validated, as indicated by evidence of multigroup factorial invariance. The models also possessed evidence of longitudinal factorial invariance. CONCLUSIONS: Evidence was provided for the factorial validity and the invariance of the questionnaires designed to be unidimensional measures of attitudes, subjective norms, perceived behavioral control, and self-efficacy about physical activity among adolescent girls.

Adolescent↗

PubMed1997

The Estonian study of Chernobyl cleanup workers: I. Design and questionnaire data.

Nearly 2% of the male population of Estonia aged 20-39 years were sent to Chernobyl to assist in the cleanup activities after the reactor accident. A cohort of 4,833 cleanup workers was assembled based on multiple and independent sources of information. Information obtained from 3,704 responses to a detailed questionnaire indicated that 63% of the workers were sent to Chernobyl in 1986; 54% were of Estonian and 35% of Russian ethnicity; 72% were married, and 1,164 of their 5,392 children were conceived after the Chernobyl disaster. The workers were less educated than their counterparts in the general population of Estonia, and only 8.5% had attended university. Based on doses entered in worker records, the mean dose was 11 cGy, with only 1.4% over 25 cGy. Nearly 85% of the workers were sent as part of military training activities, and more than half spent in excess of 3 months in the Chernobyl area. Thirty-six percent of the workers reported having worked within the immediate vicinity of the accident site; 11.5% worked on the roofs near the damaged reactor, clearing the highly radioactive debris. The most commonly performed task was the removal and burial of topsoil (55% of the workers). Potassium iodide was given to over 18% of the men. The study design also incorporates biological indicators of exposure based on the glycophorin A mutational assay of red blood cells and chromosome translocation analyses of lymphocytes; record linkage with national cancer registry and mortality registry files to determine cancer incidence and cause-specific mortality; thyroid screening examinations with ultrasound and fine-needle biopsy; and cryopreserved white blood cells and plasma for future molecular studies. Comprehensive studies of Chernobyl cleanup workers have potential to provide new information about cancer risks due to protracted exposures to ionizing radiation.

Alcohol Drinking↗

PubMed1996

Quality of life and driving in recipients of the implantable cardioverter-defibrillator.

UNLABELLED: The efficacy of a treatment is primarily based on objective criteria, such as mortality and morbidity. Besides these criteria, the interest in measuring quality of life (QOL) in relation to health care has increased in recent years. Although the concept of patients' QOL is inherently subjective, and definitions vary, it can be assessed on a basis of 3 major components: physical condition, psychological well-being, and social activities. The basic requirements of QOL assessments are: multidimensional construct, reliability, validity, sensitivity, responsiveness, appropriateness to question or use, and practical utility. The instruments to assess QOL can be disease specific or generic, depending on the context. In 1991 a prospective and systematic evaluation of QOL in implantable cardioverter-defibrillator (ICD) recipients was started at the University of Bonn: psychological profile and patient acceptance were assessed in 57 consecutive patients using a specifically designed questionnaire. The results of this pilot study demonstrated that the acceptance of the ICD was remarkably high. Restrictions on driving a vehicle may have a substantial impact on QOL in patients with ICDs. A specifically designed questionnaire was addressed to 47 European national delegates in order to determine their present practices and criteria utilized when advising driving restrictions to patients after ICD implantation. Of the 39 (83%) respondents, 22 (56%) cardiologists advised all patients to abstain from driving--13 (33%) advising permanent abstinence, while 26 (67%) recommended temporary driving abstinence for periods of 3-18 months (mean 9 +/- 4 months). Despite medical advice not to drive, one third of the patients resume driving; half of the patients resumed driving after 6 months, with the vast majority driving within 12 months after ICD surgery. Two patients experienced ICD discharges while driving, but no motor vehicle accident occurred. Another patient had a motor vehicle collision with a fatal outcome, which was not caused by loss of consciousness or ICD discharge. CONCLUSIONS: (1) Fatal accidents or ICD discharges while driving are a rare finding in ICD patients. (2) About half of the physicians always advise their patients to cease driving for a period of 9 +/- 4 months. Despite this medical advice, the majority of the patients resume driving within 6 months of ICD implantation. (3) Criteria used in advising driving abstinence are not uniform among physicians.

Attitude↗

PubMed2004

Seeking the patient's perspective: a qualitative assessment of EuroQol, COOP-WONCA charts and MYMOP.

An outcome questionnaire that is patient-centred should encompass the aims, values and treatment effects that are prioritised by individuals, and should enable each individual to provide an unambiguous assessment of change over time. There is little evidence about how well outcome questionnaires perform in this regard. This paper describes how interviews that combined in-depth enquiry and cognitive techniques were used to explore patients' experiences of completing three outcome questionnaires over a 6 month period. The 23 interviewees all had chronic disease and were receiving acupuncture treatment for the first time. Many of the problems uncovered by this study can be ameliorated by attention to questionnaire design. For example, by the provision of at least five response options, by being explicit about including co-morbidity, and by measuring medication change as a separate outcome. The study also highlighted more fundamental conceptual difficulties, such as response shift and the respondent's conflict between scoring external function and internal distress (what they did, vs. what they felt). These issues relate to the co-existence of different perspectives and the impossibility of reducing health status to one 'single truth'. The study concludes that qualitative evaluations have an important role to play in questionnaire design and development and are likely to lead to more modest and realistic appraisals of outcome questionnaire performance.

Acupuncture↗

PubMedDate not supplied

Comparison between telephone and self-administration of Short Form Health Survey Questionnaire (SF-36).

OBJECTIVE: The characteristics of the 36 item Medical Outcome Short Form Health Study Survey (SF-36) questionnaire, designed as a generic indicator of health status for the general population, allow it to be self-administered or used in personal or telephone interviews. The main objective of the study was to compare the telephone and self-administered modes of SF-36 for a population from Girona (Spain). METHODS: A randomized crossover administration of the questionnaire design was used in a cardiovascular risk factor survey. Of 385 people invited to participate in the survey, 351 agreed to do so and were randomly assigned to two orders of administration (i.e., telephone-self and self-telephone); 261 completed both questionnaires. Scores were compared between administration modes using a paired t test. Internal consistency and agreement between modalities were analyzed by respectively applying Chronbach's alpha and intraclass correlation coefficients. The effect of the order of administration on the test-retest difference was analyzed by one-way ANOVA for repeated measurements. RESULTS: Physical function, physical role and social functioning received significantly lower scores when the self-administered questionnaire was used prior to the telephone survey. When the initial survey was conducted by telephone, all Chronbach's alpha coefficients (except social functioning) scored over 0.70 in the self-administered modality. The intraclass correlation coefficient ranged from 0.41 to 0.83 for the telephone-self order and from 0.32 to 0.73 for the self-telephone order. No clinically significant effect was observed for the order of application. CONCLUSIONS: The results of the present study suggest that the telephone-administration mode of SF-36 is equivalent to and as valid as the self-administered mode.

Adult↗

PubMed2006

Screening for autistic spectrum disorder in children aged 14-15 months. II: population screening with the Early Screening of Autistic Traits Questionnaire (ESAT). Design and general findings.

A two-stage protocol for screening for autistic spectrum disorders (ASD) was evaluated in a random population of 31,724 children aged 14-15 months. Children were first pre-screened by physicians at well-baby clinics using a 4-item screening instrument. Infants that screened positive were then evaluated during a 1.5-h home visit by a trained psychologist using a recently developed screening instrument, the 14-item Early Screening of Autistic Traits Questionnaire (ESAT). Children with 3 or more negative scores were considered to be at high-risk of developing ASD and were invited for further systematic psychiatric examination. Eighteen children with ASD were identified. The group of children with false positive results had related disorders, such as Language Disorder (N = 18) and Mental Retardation (N = 13).

Autistic Disorder↗

PubMed1998

Beneficial effects of long-term GH replacement therapy on quality of life in adults with GH deficiency.

OBJECTIVE: Quality of life tends to be adversely affected in adults with GH deficiency. The aim of this study was to examine changes in quality of life in a large group of GH-deficient adults receiving long-term GH replacement therapy. DESIGN: The study was conducted in two stages. The first stage was a prospective, open trial of GH replacement therapy in 71 GH-deficient adults, during which GH was administered for 20-50 months. For the second stage, a further 90 patients were recruited to create a population of 161 GH-deficient adults, all of whom had received GH replacement therapy for more than 12 months. This population was investigated retrospectively, using a questionnaire designed specifically for this study. PATIENTS: All patients were GH deficient and showed a peak GH response of less than 3.0 micrograms/l during an insulin tolerance test in which blood glucose levels dropped to 2.2 mmol/l or below. MEASUREMENTS: The quality of life of patients in the prospective stage was assessed using the Nottingham Health Profile (NHP) parts I and II, and the Psychological General Well-Being (PGWB) index. In the retrospective study patients completed a specially developed questionnaire, designed to determine whether changes in quality of life were sudden or gradual, and whether quality of life continued to change after GH had been administered for more than 12 months. RESULTS: In the prospective stage, mean overall score on the NHP I improved significantly during the first 6 months of GH therapy, and remained at its new level thereafter. Scores in all areas of the NHP II improved significantly between baseline and 20-50 months, as did the total score and five of six area scores on the PGWB index. The total PGWB score and three area scores improved significantly between 6 or 12 months and 20-50 months. In the retrospective stage, 92.7% of the patients reported that they had experienced positive effects of GH therapy. In 30.3% of patients, however, such effects did not become apparent until GH had been administered for more than 6 months. Almost 60% of patients felt that their condition was still improving. CONCLUSIONS: These results indicate that the previously reported beneficial effects of GH therapy on quality of life in GH-deficient adults are sustained during long-term therapy. In addition, they suggest that, once started, GH therapy should be continued for at least 6 months before judgements are made regarding its efficacy in improving quality of life.

Adult↗

PubMed1999

Patients' perceptions of the Odstock Dropped Foot Stimulator (ODFS).

OBJECTIVE: To determine the perceived benefit, pattern and problems of use of the Odstock Dropped Foot Stimulator (ODFS) and the users' opinion of the service provided. DESIGN: Questionnaire sent in a single mailshot to current and past users of the ODFS. Returns were sent anonymously. SETTING: Outpatient-based clinical service. SUBJECTS: One hundred and sixty-eight current and 123 past users with diagnoses of stroke (CVA), multiple sclerosis (MS), incomplete spinal cord injury (SCI), traumatic brain injury (TBI) and cerebral palsy (CP). INTERVENTION: Functional electrical stimulation (FES) to correct dropped foot in subjects with an upper motor neuron lesion, using the ODFS. MAIN OUTCOME MEASURES: Purpose-designed questionnaire. RESULTS: Return rate 64% current users (mean duration of use 19.5 months) and 43% past users (mean duration of use 10.7 months). Principal reason cited for using equipment was a reduction in the effort of walking. Principal reasons identified for discontinuing were an improvement in mobility, electrode positioning difficulties and deteriorating mobility. There were some problems with reliability of equipment. Level of service provided was thought to be good. CONCLUSION: The ODFS was perceived by the users to be of considerable benefit. A comprehensive clinical follow-up service is essential to achieve the maximum continuing benefit from FES-based orthoses.

Adult↗

PubMed1998

Introductory notes regarding a European Medical Risk Related History questionnaire (EMMRH) designed for use in dental practice.

The Medical Risk Related History (MRRH) has been in use for several years in the Netherlands. Since 1994 the MRRH system has been subject to research in nine European countries. Legal and ethical demands in all participating countries have been listed, and a national epidemiological analysis of pathology interfering with dental treatment has been undertaken for every participant.

Dental Care for Chronically Ill↗

PubMed2005

Type A behaviour differentiates bipolar II from unipolar depressed patients.

BACKGROUND: A relation between the type A behaviour pattern (TABP) and coronary heart disease has been found in many studies and the existence of a psychiatric coronary-prone mood profile has been suggested. TABP consist of fairly stable character traits such as time urgency, impatience, irritability and competitiveness, which in patients with affective disorders could be bipolar traits. The aim of this study was to compare TABP in depressed unipolar and bipolar II patients, and explore the relation between TABP, affective temperaments and migraine headaches, another disorder associated with bipolar II disorder. METHODS: The Jenkins Activity Survey (JAS) (Form C), a self-report multiple-choice questionnaire designed to measure TABP, was given to 99 patients diagnosed with a DSM-IV major affective disorder. Affective temperaments were diagnosed according to Akiskal's criteria and migraine diagnosed according to the criteria of the International Headache Society. The JAS was scored in the traditional manner, yielding scores for TABP and three factorially independent components, speed and impatiens (factor S), job involvement (factor J) and hard-driving and competitive (factor H). RESULTS: 65 patients diagnosed with a unipolar (n = 42) or bipolar II (n = 23) disorder had valid scores on the JAS. Patients with bipolar II diagnosis had significantly higher JAS scores than the unipolar patients (Wilks' lambda = 0.851, F = 2.62, df = 4, 60, p < 0.05). Type A behaviour differed (total JAS score: mean square 509.3, df = 1, F = 9.4, p < 0.005), mainly due to a divergence in factor S (mean square 465.5, df = 1, F = 6.0, p < 0.02). Higher JAS scores were significantly associated with having a cyclothymic temperament (Wilks' lambda = 0.728, F = 4.30, df = 4, p = 0.005) and lower JAS scores with having a depressive temperament (Wilks' lambda = 0.747, F = 3.13, df = 4, p = 0.026). TABP was not associated with migraine. LIMITATIONS: Non-blind, cross-sectional assessment of affective disorders and migraine headaches and questionnaire-based type A behaviour assessment. CONCLUSIONS: These results indicate that a well-established questionnaire designed to recognize the type A behaviour pattern, distinguishes depressed unipolar from depressed bipolar II patients as well.

Adolescent↗

PubMed2005

Seven eating styles linked to overeating, overweight, and obesity.

OBJECTIVE: To broaden the perspective on the causes of overeating, overweight, and obesity and provide cross-cultural, comprehensive treatment approaches. BACKGROUND: Through food-related research into the world's wisdom traditions, cultural traditions, Eastern healing systems, and Western nutritional science, the authors present recurrent themes derived from ways in which cultures regarded, experienced, prepared, and shared food for millennia. DESIGN: An 80-item questionnaire, designed to measure food, nutrition, and eating themes was administered to 5,256 participants who registered for a Web-based integrative nutrition e-course. When the 80-items were factor analyzed separately in two randomly split halves of the sample as well as within age and sex categories, seven coherent and consistent factors or eating styles emerged. These eating styles were entered into a multiple regression analysis to predict overeating frequency and body mass index (BMI). RESULTS: Each of the newly identified eating styles was independently related to self-reports of overeating frequency; five of the seven were significantly related to overweight and obesity. The eating styles include the following: (1) "Emotional Eating" (eating to manage feelings); (2) "Fresh Food, Fast Food" (eating mostly processed, high-calorie food; less fresh food); (3) "Food Fretting" (judgmental thoughts and overconcern about food); (4) "Task Snacking" (eating while doing other activities); (5) "Sensory, Spiritual Nourishment" ("flavoring" food with meaning); (6) "Eating Atmosphere" (dining aesthetics and surroundings); (7) "Social Fare" (eating alone vs with others). CONCLUSIONS: Further research is needed to assess the degree to which practicing and implementing these eating styles integratively will decrease overeating, overweight, and obesity.

Adult↗

PubMed2004

Survey of general practitioner, family physician, and chiropractor's beliefs regarding the management of acute whiplash patients.

STUDY DESIGN: Questionnaire Survey. OBJECTIVE: The purpose of this study was to survey the whiplash management beliefs for practicing general practitioners, family physicians, and chiropractors. SUMMARY OF BACKGROUND DATA: Many treatments are prescribed by general practitioners, family physicians, and chiropractors for acute whiplash, but to date no survey of management beliefs for acute whiplash has been reported. METHODS: A total of 483 physicians and 123 chiropractors in the urban setting of Edmonton, Alberta, Canada were asked to participate by completing a questionnaire with 24 items designed to assess management beliefs regarding acute whiplash. RESULTS: A total of 362 physicians (75%) and 88 chiropractors (72%) completed the survey. Only 1% of physicians and none of the chiropractors believed that whiplash patients should be prescribed bed rest until almost all their pain goes away. As well, only 1% of physicians and none of the chiropractors believed that patients with acute whiplash should not return to work until almost all their pain goes away. More than 89% of physicians and 76% of chiropractors believed that encouragement of maintaining normal activities, even if they hurt, is important in the recovery from whiplash. Also, 91% of physicians and 84% of chiropractors agreed that exercise therapy was effective in acute whiplash patients. Physicians are more likely to have negative feelings about treating patients who have whiplash, were more likely to believe there was nothing physically wrong with many patients with chronic whiplash, and agree that nonsteroidal anti-inflammatory drugs and muscle relaxants are effective in acute whiplash. Chiropractors are more likely to agree that traction, transcutaneous electrical nerve stimulation, manipulation, massage, and acupuncture are effective in acute whiplash. CONCLUSIONS: Physicians and chiropractors generally hold beliefs that are consistent with the current evidence regarding the most helpful approaches to acute whiplash, although chiropractors were more likely to be supportive of passive therapy methods.

Acute Disease↗