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The musculoskeletal pain literacy questionnaire (MSK-PLq) - Part 1: Development of a preliminary version through a systematic review and Delphi consensus.

OBJECTIVE: Chronic musculoskeletal (MSK) pain is a leading cause of disability worldwide, and self-management is a first-line approach recommended by international clinical guidelines. Access to evidence-based information that enhances health literacy may support patients' engagement in their self-management and treatment decision-making, potentially reducing disease burden and pain. However, no tool currently exists to assess health literacy specifically in MSK pain. This study aimed to develop and describe the preliminary version of a knowledge-based questionnaire to evaluate MSK pain literacy, the Musculoskeletal Pain-Literacy questionnaire (MSK-PLq). METHODS: A systematic literature review identified existing health literacy instruments and generated a preliminary list of domains. A two-round Delphi study with 22 panellists (19 experts and three people living with chronic MSK pain), followed by consensus meetings, was used to refine domains and items (≥70% agreement). Readability was assessed using the Flesch Reading Ease (FRE) score and three stakeholders were consulted to review the questionnaire for comprehensibility, clarity, and face validity. RESULTS: Six domains were retained (Understand, Access, Appraise, Apply, Digital, Beliefs), comprising 20 items in the preliminary version of MSK-PLq. Readability was acceptable (mean FRE 74, indicating fairly easy reading), and subject feedback supported the questionnaire's clarity and face validity. CONCLUSIONS: The preliminary version of the MSK-PLq is proposed as the first knowledge-based tool to assess functional, interactive, and critical aspects of MSK pain literacy. It may have applications in clinical practice, research, education, and digital health, by informing tailored patient education and supporting self-management strategies, although further psychometric validation is required.

Humans↗

Development and validation of a questionnaire to test knowledge and practices of dietitians regarding dietary supplements.

OBJECTIVE: We developed a questionnaire to evaluate dietitians' knowledge and practices about the use of dietary supplements in light of new draft regulations in South Africa that will allow dietitians to prescribe supplements for the management of nutrition-related diseases. METHODS: A cross-sectional validation study was carried out in two phases: 1) questionnaire planning and development and 2) determination of reliability (internal consistency). The study sample comprised 48 nurses, 105 dietetic interns, and 367 registered dietitians. An expert academic group comprising nine dietitians with research and teaching experience rated the academic relevance and importance of knowledge questions in an item pool of 355 questions to ensure face and content validity. Criterion validity was measured by testing the knowledge questions (KQs) on 48 nurses and 105 dietetic interns. Thereafter questions were deleted based on their difficulty, discrimination, and Cronbach's alpha values. The final questionnaire, which at this point included a test of 50 KQs, was mailed to registered dietitians (n = 1450) in South Africa to determine internal consistency of the final KQs. RESULTS: Criterion validity of the KQs was indicated by a significant difference (P = 0.000) in the mean test scores between nurses (36.9, 95% confidence interval 24.2 to 39.6) and dietetic interns (40.2, 95% confidence interval 38.8 to 41.7). Item discrimination was attained by the deletion of NQs having a minimum correlation of 0.20 with overall test score. Further, item difficulty was controlled for by removal of questions correctly answered by more than 80% (too easy) or fewer than 20% (too difficult). Internal consistency of the KQs, after completion by 367 dietitians, was 0.87 (Cronbach's alpha). The mean knowledge score of dietitians ranged from 56.5% to 62.5%, with the oldest group (> or =40 y) having the highest score (P = 0.018). Thirty-eight percent of dietitians recommended dietary supplements at least 3 times a week; 51% consumed dietary supplements themselves; and 17% sold them to clients. CONCLUSIONS: A valid and reliable questionnaire that tests knowledge and practices of dietary supplements was developed for dietitians. This tool can be used by academic institutions to evaluate the knowledge and practices of final-year students. It can also be used on a representative sample of dietitians in South Africa and possibly elsewhere within the profession.

Adult↗

Development of the National Eye Institute refractive error correction quality of life questionnaire: focus groups.

OBJECTIVE: To identify the content area for a questionnaire designed to measure the vision-targeted, health-related quality of life for persons with well-corrected refractive error. DESIGN: Cross-sectional study. PARTICIPANTS: Fifty-two focus groups were conducted with 414 patients from 5 geographically diverse ophthalmic and optometric sites to identify the content area of a questionnaire for use among persons with myopia and hyperopia. METHODS: A standard protocol was used to structure each focus group discussion, and groups were led by centrally trained moderators at each participating site. Results were summarized and analyzed using a standard set of codes. Qualitative and quantitative analyses were conducted. MAIN OUTCOME MEASURE: Self-reported observations or comments about vision, vision correction, and other aspects of quality of life. RESULTS: Among the 414 participants, 9262 mentions of comments were recorded. The most frequent comments reported by participants were about types of vision correction, followed by comments with their own vision and vision-related symptoms. The distribution of comments by topic domain was generally similar across types of correction and type of refractive error. The most frequent specific comments about glasses concerned problems with reading, adjustment between near and far vision, and appearance. The most frequent comments about contact lenses included those on symptoms such as dry eyes, itching and tired eyes, and headaches, and negative comments about ease of use. The most frequent comments among patients with surgical correction concerned fewer driving problems; fewer symptoms; and improvement in vision, recreation, and comfort. Participants provided equal numbers of positive and negative comments about glasses. Twice as many positive as negative comments were given by contact lens wearers, and 4 times as many positive comments were provided by patients who had undergone surgical correction. CONCLUSIONS: Using focus groups, we were able to identify content areas and aspects of visual functioning in persons with refractive error that are not measured by standard visual acuity testing in the clinic or by other vision-targeted, health-related quality of life instruments such as the 25- or 51-item National Eye Institute-Visual Functioning Questionnaire. The similarity of problems mentioned across refractive error type and correction method suggests it will be possible to develop a single questionnaire with adequate content validity to compare the impact of different modes of correction in vision-targeted, health-related quality of life.

Adult↗

Depression and the 25-item National Eye Institute Visual Function Questionnaire in older adults.

PURPOSE: To examine the impact of depression in older adults on responses to the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) independent of demographics, vision, and general health. DESIGN: Cross-sectional. PARTICIPANTS: We took the opportunity of an ongoing study on older drivers to address the specific aim stated above. The recruitment population consisted of 6342 older adults (> or =60 years) who were licensed drivers residing in Birmingham, Alabama; who had been involved in a crash in the prior year, as identified by Alabama Department of Public Safety records; and whose phone numbers could be located. Additional eligibility criteria were visual acuity impairment, slowed visual processing speed, or both, and a Mini-Mental State Examination score of > or =23. Persons in the recruitment population who met these eligibility criteria and agreed to enroll in a study on driver safety (purpose of the main study) numbered 403. METHODS: The following questionnaires were interviewer administered in person and scored per standard procedures: the NEI VFQ-25, the Center for Epidemiological Studies Depression Scale (CES-D), a general health questionnaire, and a review of demographic information. Depressed persons were defined as those with CES-D scores of > or =16. There were complete data on 397 persons. MAIN OUTCOME MEASURE: Reduced score on the NEI VFQ-25 (defined by a score of <87.5) on the total questionnaire and 12 subscales. RESULTS: After adjusting for demographics, vision, mental status, and general health, depression was significantly associated with a reduced NEI VFQ-25 score for total score and the subscales of distance vision, peripheral vision, role difficulties, dependencies, and mental health. Odds ratio point estimates in these adjusted associations ranged from 2.9 to 4.6. CONCLUSIONS: The results imply that older persons who are depressed may have reduced scores on the NEI VFQ-25 independent of the impact of vision problems. Depression in the elderly could be influencing their self-perception of the burden of eye disease and treatment effectiveness in clinical and epidemiologic studies.

Aged↗

The relationship between observer-based toxicity scoring and patient assessed symptom severity after treatment for head and neck cancer. A correlative cross sectional study of the DAHANCA toxicity scoring system and the EORTC quality of life questionnaires.

BACKGROUND AND PURPOSE: Morbidity is an important issue in cancer research. The observer-based toxicity scoring system used by DAHANCA (the Danish head and neck cancer study group) has proved itself sensitive to differences in toxicity in a large randomised study, but like other toxicity scoring systems it has not been formally validated. Conversely, the EORTC quality of life questionnaire (QLQ) has been validated as a tool for collecting information about the consequences of disease and treatment on the well being of cancer patients. The purpose of this study was to examine the relationship between the two methods of side effect recording. PATIENTS AND METHODS: One hundred and sixteen recurrence free patients with laryngeal (n=44), pharyngeal (n=34) and oral cavity (n=38) cancer attending follow-up after radiotherapy (n=83) or surgery (n=33) completed EORTC C30, the core questionnaire concerning general symptoms and function and EORTC H&N35 the head and neck specific questionnaire. The attending physicians in the follow-up clinic evaluated and recorded DAHANCA toxicity scores on the same patients. RESULTS: The DAHANCA toxicity scoring system and the EORTC QLQ correlated with several clinical endpoints. The conceptually similar endpoints of the two methods correlated significantly. The objective endpoints of the DAHANCA scoring system were only correlated with quality of life endpoints to a very low degree. The DAHANCA toxicity scores had a low sensitivity (0.48-0.74) in detecting equivalent subjective complaints from the questionnaires and the observer-based scoring system severely underestimated patient complaints. A specific patient group where the DAHANCA score had a higher tendency to fail could not be detected. CONCLUSION: The DAHANCA toxicity score is an effective instrument in assessing objective treatment induced toxicity in head and neck cancer patients but insensitive and non-specific with regard to patient assessed subjective endpoints. This weakness seems inherent in an observer-based scoring system, and will probably also apply to newer ones like CTCAE 3.0.

Adult↗

Validity of the CAGE questionnaire in schizophrenic patients with alcohol abuse and dependence.

The objective of the study was to assess the sensitivity and the specificity of the CAGE questionnaire in 114 schizophrenic patients. The Composite International Diagnostic Interview was used to assess the DSM-III-R diagnosis of abuse of or dependence on alcohol. The CAGE questionnaire can be reliably used to assess alcohol use disorders in schizophrenic patients: with a cutoff score of 1 or more, the sensitivity of the CAGE questionnaire was 0.91 and the specificity was 0.83. With a cutoff score of 2 or more, the sensitivity of the CAGE questionnaire was 0.82 and the specificity was 0.94. The post test probabilities (PPV) were high (PPV1=0.74; PPV2=0.85) compared to the primary probability of alcoholism (29.8%).

Adult↗

Measurement characteristics of diet-related psychosocial questionnaires among African-American parents and their 8- to 10-year-old daughters: results from the Girls' health Enrichment Multi-site Studies.

OBJECTIVE: This paper presents the reliability and validity of several diet-related psychosocial questionnaires. METHODS: At baseline and 12 weeks follow-up, parents/caregivers of one hundred fifty 8- to 10-year-old African-American completed questionnaires on food preparation habits for their daughter, perceived home barriers to healthy eating, and fruit, juice, vegetable (FJV), low-fat and high-fat food availability. Girls completed a sweetened beverage preferences questionnaire and two 24-h dietary recalls to assess intake. Principal components analyses were conducted for two newly designed measures. Internal consistency was calculated and construct validity was assessed between the psychosocial scales and obesity-related dietary variables. RESULTS: Low-fat and high-fat food preparation for daughters, and perceived home barriers to eating low-fat food and FJV subscales were derived from the new questionnaires. Internal consistency reliabilities were moderate (0.58) to substantial (0.80) across all new and existing scales. Test-retest reliabilities were moderate (0.44) to substantial (0.79). Girls' intake of fat as a percentage of energy was positively related to parental high-fat food preparation for daughters (P < 0.01) and negatively related to parental low-fat food preparation practices for daughters (P < 0.05). CONCLUSIONS: Measures of family influences on FJV, fat, and sweetened beverage consumption were internally consistent with moderate to substantial stability. Scales for low-fat and high-fat food preparation practices for daughters achieved construct validity with fat consumption in the hypothesized direction. Family food preparation habits appear to be important targets for future interventions.

Black or African American↗

Simple school questionnaires can map both Schistosoma mansoni and Schistosoma haematobium in the Democratic Republic of Congo.

The use of self-administered questionnaires has been shown in different African countries to be inexpensive and reliable for the rapid identification of communities at highest risk of urinary schistosomiasis. For intestinal schistosomiasis due to Schistosoma mansoni there is a clear need for a similar approach. We report the results from a large-scale study undertaken in the western part of the Democratic Republic of Congo (DRC, formerly Zaire). Within 4 weeks questionnaires were correctly completed in 136 out of 160 schools (85%). In 57 of these schools children were screened for infections with schistosomes and geohelminths. The prevalence of 'schistosomiasis' as reported in the questionnaires showed the best correlation with the prevalence of S. mansoni infections (r = 0.77, P < 0.0001). Calculations of the diagnostic performance of reported 'schistosomiasis' to detect schools with a high risk of intestinal schistosomiasis gave positive predictive values of 87 and 62%, and negative predictive values of 74 and 87% for moderate and high infection thresholds, respectively. Reported 'blood in stool' was another useful indicator for intestinal schistosomiasis. Reported 'blood in urine' showed the best correlation with urinary schistosomiasis (r = 0.75, P < 0.001) and the positive predictive values were 81 and 50%, and the negative predictive values were 89 and 95% for moderate and high infection thresholds, respectively. We conclude that school children in DRC have a distinct perception of intestinal and urinary schistosomiasis and that questionnaires could be useful to identify high-risk schools for both parasites.

Adolescent↗

Improving food frequency questionnaires: a qualitative approach using cognitive interviewing.

In an attempt to improve data quality and ease of administration of standard self-administered food frequency questionnaires, various alternative approaches were tried for inquiring about frequency of consumption, portion size, seasonal intake, and food preparation. Evaluation consisted of a cognitive interviewing method in which respondents verbalize their thought process while completing several variations of a questionnaire. Interviewers observed and asked follow-up probe questions to evaluate problems or inconsistencies verbalized by respondents. Consensus and judgment by interviewers and observers suggested several problematic features of food frequency questionnaires: formatting of questions about frequency and portion size; computing average frequencies for aggregated food items or for foods eaten seasonally; comprehension of many items; and ordering of foods. These findings led to cognitive refinement and innovations, which included detailed questions regarding preparation or use of low-fat varieties or other alternatives to help better describe specifics of intake for some foods; questions on seasonal intake for several foods; inclusion of portion size ranges; and additional response categories for frequency of intake. Cognitive interviewing is an important step in pinpointing cognitive problems in dietary questionnaires.

Aged↗

A specific activity questionnaire to measure the functional capacity of cardiac patients.

Exercise testing is often performed in persons with cardiac disease to measure their functional capacity. Physical activity questionnaires assessing functional capacity have been used a low-cost and convenient alternative to exercise testing, but have not been well validated against measured oxygen consumption in a cardiac population. This study assesses the ability of a simple, 13-item activity questionnaire, known as the Specific Activity Questionnaire (SAQ), to measure functional capacity prospectively in a large sample of cardiac patients. Ninety-seven consecutive cardiac outpatients (85 men and 12 women aged 59 +/- 10 years [mean +/- SD]) completed the SAQ before an elective symptom-limited treadmill test. Subjects returned within 10 days to repeat the treadmill test, following the same protocol, with the additional measurement of peak oxygen consumption, VO2 (ml x kg(-1)min(-1)), using open circuit spirometry. The SAQ score was significantly related to measured peak VO2(r=0.57, p<0.001). Stepwise multiple linear regression analysis found that the addition of patient age, height, and body weight to SAQ score improved the measurement of peak VO2, accounting for 51% of the sample variance (R=0.71, p<0.001). Peak VO2 was obtained from the following regression formula: [formula: see text]. Thus SAQ, a simple 13-item self-administered activity questionnaire, is able to provide a moderately good measure of functional capacity in cardiac patients and may be useful tool in studies of the cardiac population when formal exercise testing is impractical or uneconomical.

Activities of Daily Living↗

Self-reported visual dysfunction in multiple sclerosis: new data from the VFQ-25 and development of an MS-specific vision questionnaire.

PURPOSE: To examine vision-specific health-related quality of life in a cohort of patients with multiple sclerosis (MS) using the 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25), and to identify content areas for a brief MS-specific vision questionnaire. DESIGN: Cross-sectional survey. METHODS: The VFQ-25 and a modified version of the Optic Neuritis Treatment Trial (ONTT) Patient Questionnaire were administered by in-person interview to 80 patients at the University of Pennsylvania MS Center. Binocular visual acuities were obtained following a standard protocol using retroilluminated Early Treatment Diabetic Retinopathy Study charts. RESULTS: Despite a median binocular visual acuity of 20/16 (20/12.5-20/250), VFQ-25 subscale scores in the MS cohort were significantly lower (worse) compared with those of a published reference group of eye disease-free patients (P =.0001-0.009, two-tailed t tests). Rank-correlations of VFQ-25 composite (overall) scores with visual acuity were modest, but significant (r(s) = 0.33, P =.003), supporting construct validity for VFQ-25 scores in MS populations. Seven additional aspects of self-reported visual dysfunction in MS were also identified. CONCLUSIONS: Patients with MS have a high degree of self-reported visual dysfunction that is not entirely captured by visual acuity. The VFQ-25 is an effective measure of self-reported visual loss in MS. A brief MS-specific vision questionnaire may provide additional useful information when administered concurrently with the VFQ-25 in future investigations of MS and other neuroophthalmologic disorders.

Adult↗

Three traditional and three new childhood anxiety questionnaires: their reliability and validity in a normal adolescent sample.

The current study examined the psychometrics of three traditional [i.e., the trait anxiety version of the State-Trait Anxiety Inventory for Children (STAIC), the Revised Children's Manifest Anxiety Scale (RCMAS), and the Fear Survey Schedule for Children - Revised (FSSC-R)] and three new childhood anxiety scales [the Multidimensional Anxiety Scale for Children (MASC), the Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Spence Children's Anxiety Scale (SCAS)] in a large sample of normal adolescents (N=521). Childhood anxiety scales were generally found to be reliable in terms of internal consistency. Furthermore, evidence was obtained for the convergent and divergent validity of the various anxiety questionnaires. That is, anxiety questionnaire scores were found to be substantially intercorrelated. Particularly strong associations were found between total scores of the STAIC and the RCMAS, total scores of the SCARED and the SCAS, and between subscales that intend to measure specific categories of anxiety symptoms. Childhood anxiety questionnaires were substantially connected to an index of depression, although correlations among anxiety questionnaires were generally higher than those between anxiety scales and a measure of depression.

Adolescent↗

[A food cognition questionnaire].

BACKGROUND: Many authors evoke the role of cognition in the persistence of symptoms or in relapse. In pathology the cognitions produced by the patients are called dysfunctional or erroneous. The content of the cognitions are words or images issued from the treatment of information. In emotional disorders, the structure of thoughts named dysfunctional "schemata" involves a biased treatment of information and leads to erroneous cognitions. Several studies have attempted to elicit the most specific cognitions of different diseases. In this field, Hollon and Kendall found 36 cognitions specific to depression gathered in the automatic thoughts questionnaire (ATQ). In the same spirit, Beck et al. gathered 14 cognitions of anxiety and 12 depressed cognitions in the cognition check list (CCL). In the etiology and maintenance of eating disorders the cognitions take a large place. Around 1980 cognitive dysfunctioning was described and concerned food, interpersonal relationship and body shape. A few years later, some experimental studies explored these processes. The Stroop test, a categorization task, showed specific cognitive impairment in with patients eating disorders versus normal control subjects. It was then established that cognitive errors were based on food cognitions in restrictive patients, whereas they were based on body shape cognitions in bulimic patients. In several famous papers, Garner described typical cognitions of eating disorder patients and distinguished food-cognitions, eating-cognitions using case reports. As far as we know there is no clinical tool concerning such cognitions in France. That is the main motivation of the authors. AIM OF THE STUDY: The aim of this paper was to determine the characteristic cognitions of anorexic, anorexic-bulimic and bulimic patients and to compare them with those of normal control subjects. The goal of the study was to create a food cognition questionnaire. FIRST STEP METHODS: In the first step, food cognitions were collected among female eating disorder patients and normal female control subjects during systematic investigation. Ninety-two women were assessed and provided more than 3 000 food cognitions. Two independent psychologists identified the most frequent cognition per group and thus retained 115 food items. These items were randomly assigned. This provided the questionnaire. To illustrate the latter, here are the first five items: 1) Apricots are good for the health because they are rich in vitamins. 2) Pears are big fruit, difficult to digest. 3) Canned fruit is soaked with sugar. 4) Banana is a fruit which makes one put on weight. 5) White coloured food give the impression that it is not alive... The list of possible answers was: never, rarely, sometimes, often enough, often, always. SECOND STEP METHODS: In the second step, the food cognition questionnaire was proposed to 217 women including 131 eating disorder patients (53 anorexic, 50 anorexic bulimic, 28 bulimic) and 86 normal control subjects. The values of body mass index and the eating attitude test differed when we compared the two groups, and the mean age was close to 26 years in both groups. RESULTS: The statistic analysis highlighted six discriminative variables: two clinical criteria (weight and height) and four food-items given below: Q24: When I see food being fried, I feel the grease all over my body. Q76: When I start a cookie packet, I eat it up. Q102: When I feel anxious, I crave for food to fill my body. Q106: Eating pastry gives me heart-burn and makes me belch. The statistical model allowed us to differentiate eating disorder patients from normal control subjects. The content of the four food items is in agreement with experimental and clinical data. All these items included some aspects of the quality or quantity of food and also the negative consequences of food consumption on the body. CONCLUSION: To conclude, the model can help clinicians identify the patients and then initiate treatment. We also insist on the fact that this study is new and empirical, and should be extended by determining some food items for example, which would clarify the difference of behaviour between anorexics and bulimics.

Adult↗

Results of pubovaginal sling for the treatment of intrinsic sphincteric deficiency determined by questionnaire analysis.

PURPOSE: We evaluated by questionnaire analysis the success rate and overall patient satisfaction after pubovaginal sling surgery. MATERIALS AND METHODS: A total of 40 women (mean age 65.7 years, range 45 to 79) underwent pubovaginal sling surgery for stress urinary incontinence due to intrinsic sphincteric deficiency. Patients completed a detailed questionnaire to assess voiding symptoms, urinary control and satisfaction. Of 40 patients 37 (92.5%) returned the questionnaire, with a mean postoperative followup of 48.2 months (range 24 to 60). RESULTS: Patients with preoperative stress urinary incontinence alone were more likely to be dry than were patients with preoperative mixed incontinence (67% versus 36%, p < 0.001). Ten patients (27%) reported stress urinary incontinence recurrence. Of the patients 23 (62.2%) reported urgency symptoms at followup, with de novo urgency occurring in 4 patients. Permanent retention was noted in 3 patients, including 2 with sacral arc denervation. Overall patients reported 86% postoperative improvement in urinary continence, and 81% would recommend the operation. CONCLUSIONS: At mean 4-year followup after pubovaginal sling surgery, this outcome study using a self administered questionnaire confirms high patient satisfaction despite significant postoperative urgency symptoms.

Aged↗

A new questionnaire for gastroesophageal reflux disease.

OBJECTIVE: To develop a questionnaire to measure gastroesophageal reflux disease in the community and to test its reliability and validity. MATERIAL AND METHODS: The reliability of the questionnaire was measured by a test-retest procedure in 38 outpatients and 77 community residents 25 to 74 years of age, whereas concurrent validity was evaluated by comparing findings from a physician interview with self-report data from 51 patients. For statistical analysis of the reliability of each question, the kappa statistic and the 95% confidence interval were calculated. RESULTS: The questionnaire was easy to understand and well accepted. The reliability (median kappa for outpatients, 0.70 [interquartile range, 0.59 to 0.81]; median kappa for population sample, 0.70 [interquartile range, 0.60 to 0.81]) and validity (median kappa, 0.62 [interquartile range, 0.49 to 0.74]) were acceptable. CONCLUSION: Our initial results suggest that this questionnaire is valid and should be applicable in population-based studies to assess gastroesophageal reflux disease.

Adult↗

Attitudes and approach to cardiovascular risk factors in Italy: results of an electronic questionnaire survey.

BACKGROUND: The advent of computer-based technology has led to innovative epidemiological research methods to exploit the advantages of computer-mediated communications. The aim of the present study was to develop and evaluate a self-administered electronic questionnaire for acquiring information on cardiovascular health, knowledge and behaviours in a representative, stratified sample of the Italian population. METHODS: We report information on the attitudes and approach to cardiovascular disease prevention in a representative sample of Italian families who were interviewed at home by electronic questionnaires. The panel of families is currently used for national opinion polls and marketing surveys. Electronic questionnaires were filled out by 1683 males and 1736 females during a weekend period. RESULTS: Two-thirds of respondents reported having their blood pressure measured while only half reported having blood lipid and glucose tests over the previous 2 years. Prevalence of reported hypertension, hypercholesterolaemia, diabetes and smoking were 15.2, 13.0, 9.8 and 37.1% in men and 10.1, 8.1, 2.6 and 28.0% in women, respectively. More than 50% of hypertensives and diabetics were on drug treatment, while only 20% of subjects reporting hyperlipidaemia were on medication. CONCLUSIONS: The results suggest the usefulness of self-administered electronic questionnaires for acquiring quick, low-cost and high response rate information in epidemiological surveys.

Adolescent↗

Visual function assessment questionnaires.

With increased emphasis on functional outcomes in ophthalmology, third-party health care payers and research funding agencies have turned their attention to the development and use of visual function questionnaires. Since 1980, more than a dozen such self-report visual function questionnaires have been developed. All of these instruments include items that ask about specific daily activities; patients must respond with a rating that represents the level of difficulty that they experience with the activity described. This article reviews all of the known instruments, with special attention paid to their validity and reliability. Most validation studies have reported high response consistency across items and significant correlations of instrument scores with visual impairment measures. Only two studies have measured test-retest reliability. The developers of visual function questionnaires typically divide the items into several different subscales, suggesting that different variables are being measured. Although the items are very similar for the different instruments, there is little agreement among instruments on the definition of subscales. All instruments are scored as the average of the ordinal patient ratings across items for each subscale and/or for the total instrument. Measurement issues underlying the scoring of ordinal patient ratings are discussed. It is argued that unless the instruments can be converted to interval scales, the averaging of patient ratings does not yield true measurements. The three visual function questionnaires that were calibrated with a statistical item response model, which estimates interval scales, are reviewed. It is concluded that future research and development should devote additional attention to the measurement properties of functional assessment instruments.

Psychometrics↗

Quality of life of living kidney donors: the short-form 36-item health questionnaire survey.

OBJECTIVES: To determine the psychological and social effects of kidney donation on kidney donors by using the short-form 36-item health survey (SF-36) as the quality-of-life questionnaire. METHODS: A total of 104 living donor nephrectomies have been performed at Kobe University Hospital and Nishinomiya Prefectural Hospital. We mailed the questionnaires to donors or handed them out directly at the outpatient clinic. The first part of the questionnaire consisted of the SF-36 (limitations on physical functioning because of health problems) and the second part consisted of 15 questions about donation-related stress, expenses incurred, physical changes, and pre-existing factors such as relationship to the recipients. RESULTS: The SF-36 and the questionnaire about donor satisfaction were completed by 69 donors (48 women and 21 men; mean age 52.1 +/- 8.2 years), only 6 of whom (9%) reported minor complications with the donor operation. The SF-36 scores of our donors were not significantly different from that of the general U.S. population and U.S. donors. In some categories (physical functioning, role-physical, bodily pain, general health, vitality, and mental health), our donors scored slightly higher than the U.S. general population. Although 97% of the donors would make the same choice again, 3% believed that donating had had a negative impact on their health, and 16% reported negative financial consequences. CONCLUSIONS: The quality of life for kidney donors was not affected by donor nephrectomy. Living kidney transplantation seems to be suitable for the rescue of patients with end-stage renal disease. Better psychological and technical preparation for surgery and more consistent follow-up may reduce the negative outcomes even further.

Activities of Daily Living↗