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PubMed1999

Capturing health care utilization after occupational low-back pain: development of an interviewer-administered questionnaire.

The aim of this study was to develop and test the feasibility and validity of a patient questionnaire to assess health care utilization after occupational low-back pain (LBP). Items generated after a literature search were revised and refined on the basis of their face and content validity (judged by a group of practitioners) and pretested with six lay subjects who had LBP. The 73-item questionnaire was then tested in interviews with subjects with acute, subacute, or chronic LBP. Its validity was judged by comparison with a prospective patient diary and with care-provider reports. Chance-corrected agreement was estimated using the kappa statistic. Response rates were 78%, 70%, and 59% for interview, diary, and provider reports, respectively. Eighty of 102 eligible workers completed the interview in an average of 45 minutes (SD = 17.7). Most LBP subjects (90.1%) found it easy to answer. In the opinion of the interviewer, 94.7% of subjects showed adequate comprehension and ability to recall. With a few exceptions, there was moderate to substantial agreement between the interview and the patient diary (most K values between 0.38 and 0.78). Overall, subjects reported more health care services to the interviewer than they recorded in the diary. Owing to the low response rate from providers, comparison with provider reports had to be restricted to 48 subjects and to physicians' reports only. Agreement between interviews and physicians' reports was substantial in use of plain X-rays (kappa = 0.79) and computed tomography scans (kappa = 0.85), but physicians often reported referrals not volunteered by the subjects. Agreement on prescription medications was fair (kappa = 0.29-0.46) with no systematic over reporting or under reporting. Our interviewer-administered questionnaire had better return rate than the patient diary and provider reports. It was easy to administer and understand. On the basis of our comparison with patient diaries and physicians' reports, we conclude that this questionnaire is a sufficiently valid source of health care utilization data in subjects with LBP.

Adult↗

PubMed2000

Assessment of environmental tobacco smoke exposure in children with asthmatic symptoms by questionnaire and cotinine concentrations in plasma, saliva, and urine.

To validate a detailed questionnaire for assessment of environmental tobacco smoke (ETS) exposure by the biomarker cotinine in various media, a population-based study in the urban area of Malmö, Sweden was performed in children aged 8-13 years with and without asthmatic symptoms. There were strong correlations between urinary and saliva cotinine concentrations and also, though to a lesser extent, between these media and plasma. Even a detailed questionnaire gave only a rough picture of the ETS exposure, as indicated by the biomarkers. In a multivariate model, the most significant questionnaire-derived predictor of the cotinine levels was the maternal smoking habits; other questionnaire variables gave only a minimal explained variance. Children with a history of asthmatic symptoms had statistically significantly lower median cotinine levels in urine and saliva compared to referent children, most likely because of the antismoking information to their parents. This should be considered in epidemiological studies of ETS risks.

Adolescent↗

PubMed2002

Development of a new seizure severity questionnaire: initial reliability and validity testing.

PURPOSE: This report describes the initial steps for development of a new scale to assess seizure severity as a treatment response. METHODS: Standard methodology was used to develop the test instrument. Item generation was performed by selecting items from other questionnaires, and asking patients and epileptologists about seizure components. Face and content validity were assessed in a pilot study with patients and observers. The questionnaire was formatted as a structured interview for a reliability study. Construct validity was assessed with three existing questionnaires. Inter-rater reliability and test-retest reliability were performed as two independent ratings on one day, and one re-interview. RESULTS: Based on item generation and pilot testing (33 patients, 28 observers), the Seizure Severity Questionnaire (SSQ) was organized into warning, activity-movement, and recovery (cognitive, emotional, and physical aspects) stages of seizures. Questions reviewed duration, severity, bothersomeness and overall ratings, and the most bothersome aspect of seizures. The mean SSQ Summary Score was 5.78+/-3.24, inter-rater reliability was 0.76 (N=91), and test-retest reliability was 0.74 (N=63). Construct validity showed statistically significant correlations with other scales. CONCLUSION: This study has explored the psychometric properties of the SSQ for face and content validity, inter-rater and test-retest reliability, and construct validity. The Summary Score reliably represents the major components of seizures.

Adult↗

PubMed2002

Symptomatology of cancer patients in palliative care: content validation of self-assessment questionnaires against medical records.

To elucidate which symptoms or problems to measure when evaluating palliative care, we assessed the content validity of selected patient self-assessment questionnaires used to evaluate palliative care: the European Organization for Research and Treatment of Cancer-Quality of Life-Core 30 (EORTC QLQ-C30), the Edmonton Symptom Assessment System (ESAS), the Palliative Care Outcome Scale (POS), the McGill Quality of Life Questionnaire (MQOL) and the Memorial Symptom Assessment Scale (MSAS). The content of the questionnaires was compared against the symptoms and problems noted in the medical records of 171 consecutive cancer patients on their first admission to a department of palliative medicine. From the records, 63 different symptoms were listed. Two questionnaires covered almost all of the prevalent symptoms/problems: the EORTC QLQ-C30 covered 10 and the MSAS 11 of the 12 most frequent problems. Researchers selecting instruments for evaluating palliative care may use the present study and other reviews to examine to what degree a given selection of instruments cover the symptoms/problems targeted by palliative care physicians.

Adult↗

PubMed1998

Survey of the Administration of quality of life (QL) questionnaires in three multicentre randomised trials in cancer. The Medical Research Council Lung Cancer Working Party the CHART Steering Committee.

We surveyed centres collaborating in two trials in lung cancer (LU12, LU13) and one in lung and head and neck cancer (CHART) to find out how QL questionnaires were being administered, with the aim of standardising procedures and improving compliance. Dedicated local trials staff were funded for CHART but not for the other trials. In all three trials, patients completed a Rotterdam Symptom Checklist (RSCL) and a Hospital Anxiety and Depression Scale (HADS) at specified times. 17 of 22 LU12 centres, 9 of 11 LU13 and all 10 CHART centres returned survey forms. In LU12 and LU13, the category of staff responsible for questionnaires varied widely; in CHART, only research staff were involved. This led to more consistency in CHART centres in the administration and collection of questionnaires, and more frequent checking of forms. However, even the CHART administration, although better than in the other two trials, could not be regarded as standardised. All centres were equally affected by logistical problems. These embraced organisational deficits (e.g. unavailability of staff, lack of questionnaires) and patient-related factors (e.g. patient deemed to be too ill, had difficulty reading or left before completing the form). Patient refusals were an uncommon reason for non-compliance and patients were considered to be generally in favour of QL assessment. As a result of these findings, a number of measures have been put in place to increase standardisation of procedures and improve compliance. These include publishing guidelines for protocol writing, providing centres with guidelines for QL administration and information leaflets for patients, together with introducing staff training.

Carcinoma, Non-Small-Cell Lung↗

PubMed1999

Fundamental issues in questionnaire design.

The questionnaire is probably the most common form of data collection tool used in nursing research. There is a misconception that anyone with a clear grasp of English and a modicum of common sense can design an effective questionnaire. Contrary to such common belief, this article will demonstrate that questionnaire design is a complex and time consuming process, but a necessary labour to ensure valid and reliable data is collected. In addition, meticulous construction is more likely to yield data that can be utilized in the pursuit of objective, quantitative and generalizable truths, upon which practice and policy decisions can be formulated. This article examines a myriad of fundamental issues surrounding questionnaire design, which encompass question wording, question order, presentation, administration and data collection, amongst other issues.

Data Collection↗

PubMed2004

Factors impacting questionnaire response in a Dutch retrospective cohort study.

PURPOSE: To study questionnaire length, type of consent, approach to recruitment, and subject characteristics on participation in epidemiologic studies. METHODS: As part of a health survey among Dutch subjects treated for ear, nose, and throat disorders in childhood, we conducted a pilot study of 200 individuals who were randomly assigned to one of four categories, defined by length of questionnaire (long vs. short) and type of consent form (basic vs. multi-option). In addition, among 8402 subjects eligible to be in the main study (average age 41 years in 1997), we examined the effect of approach to recruitment and subject characteristics on participation rates. RESULTS: The pilot study showed a non-significant 10% increase in participation rate using the shorter questionnaire, but no differences by type of consent form. In the full survey, the participation rate was 49% after the first mailing. Response increased by 15% after a written reminder and by 10% after a telephone survey. The total participation rate was 74%. Attained age, sex, exposure status, age at exposure, and response to an earlier survey were determinants of participation rates. Among male non-participants, outright refusal was less frequent than non-response. The refusal rate, unlike the non-response rate, was positively associated with older age at time of survey. CONCLUSIONS: Health survey participation is influenced by questionnaire length, frequency of contact, and subject characteristics.

Adult↗

PubMed2004

Development and validation of school-based asthma and allergy screening questionnaires in a 4-city study.

BACKGROUND: Asthma and allergies are commonly undiagnosed in children. Schools provide settings for potentially accessing almost all children for asthma and allergy screening. OBJECTIVE: To evaluate the feasibility and validity of using a questionnaire-based screening tool to identify undiagnosed asthma and respiratory allergies in children in kindergarten to grade 6. METHODS: A student questionnaire (SQ) and a parent questionnaire (PQ) were developed, administered in 4 diverse communities, and validated against standardized clinical assessments. Children without diagnosed asthma and representing a range of symptoms participated in a validation study that consisted of independent, standardized, clinical assessments. Sensitivity, specificity, and predictive values for questionnaire items were evaluated against expert consensus designations. RESULTS: A total of 190 children (age range, 7-13 years) completed the validation study. Affirmative responses to individual questions from either the SQ or PQ regarding asthma and allergy were modestly to moderately predictive of the clinical assessments (odds ratios, generally 2.5-5.0). When considering a positive asthma screen as affirmative responses to 3 of the best 7 SQ asthma questions, the odds ratio for asthma was 9.3 (95% confidence interval, 4.1-21.1), with 80% sensitivity and 70% specificity. Considering the allergy screen as positive based on affirmative response to either of the 2 SQ allergy questions yielded 81% sensitivity and 42% specificity. CONCLUSIONS: Either a 9-item SQ or a 10-item PQ can be used in diverse settings to screen for asthma and respiratory allergies. The SQ, obtained by directly screening students, may provide a sensitive approach for detecting children with previously undiagnosed asthma and allergies.

Adolescent↗

PubMed2006

Questionnaire evaluation and risk factor identification for nonallergic vasomotor rhinitis.

BACKGROUND: Chronic rhinitis, a prevalent primary care disorder associated with significant comorbidities, is often incorrectly diagnosed. As a result, inappropriate treatment leads to higher health care costs and poor clinical outcomes. OBJECTIVE: To verify whether responses to specific questions may help in the diagnosis of nonallergic vasomotor rhinitis (NAVMR). METHODS: A questionnaire listing allergic and nonallergic triggers was blindly distributed to 100 random new patients with chronic rhinitis in an allergist's office. Questionnaire and physician diagnoses were compared. Allergic triggers included cat, dog, feathers, other furry animals, and symptoms during the spring, summer, and fall seasons. Nonallergic triggers included temperature changes, diesel and car exhaust, tobacco smoke, perfumes and fragrances, incense, cleaning products, newsprint, hairspray, and alcoholic beverages, spicy foods, or eating. RESULTS: The construct validity and internal consistency indicated that the questionnaire was a good tool for diagnosing NAVMR. Multivariate analysis revealed that the absence of outdoor symptoms in the spring (odds ratio [OR], 7.76; 95% confidence interval [CI], 1.18-51.22; P = .03), no parental history of allergy (OR, 5.16; 95% CI, 1.05-25.20; P = .04), no symptoms around cats (OR, 3.82; 95% CI, 0.59-24.83; P = .16), the presence of symptoms around perfumes and fragrances (OR, 4.875; 95% CI, 1.05-22.60; P = .04), and age at symptom onset (OR, 1.08; 95% CI, 1.02-1.14; P = .008) were predictive of NAVMR. CONCLUSIONS: Specific questionnaire responses may help primary care physicians accurately diagnose NAVMR. Questions asked of patients by physicians to diagnose allergic rhinitis do not correlate well with physician diagnosis.

Adult↗

PubMed2003

Development of the obstructive sleep apnea knowledge and attitudes (OSAKA) questionnaire.

STUDY OBJECTIVES: To develop and validate a questionnaire that assesses physicians' knowledge and attitudes about obstructive sleep apnea (OSA): the Obstructive Sleep Apnea Knowledge and Attitudes (OSAKA) questionnaire. DESIGN: Questionnaire study. SETTING: Physicians associated with the Washington University Physicians Network. PARTICIPANTS: Twenty physicians in the pilot testing and 115 physicians in the final testing of the instrument. INTERVENTIONS: Physicians completed the OSAKA questionnaire containing sections regarding knowledge about OSA (18 items), attitudes about OSA (five items), and demographics of the study participants. MEASUREMENTS AND RESULTS: Knowledge scores ranged from 0 to 18 (mean+/-SD=13.3+/-2.8). Individual knowledge items did not differ significantly by gender or by whether or not respondents had completed subspecialty training. The five attitude items were significantly correlated with one another. Knowledge scores correlated with the 5-item attitude scale. There was a negative correlation between age and knowledge (r=-0.368, P<0.001) and between age and the single attitude item pertaining to physicians' confidence in managing patients with OSA (r=-0.198, P=0.036); thus, the older the respondent, the lower the knowledge score and the less confident they were in managing patients with OSA. CONCLUSIONS: The OSAKA appears to be a useful instrument to measure physicians' knowledge about OSA, their views on its importance as a clinical disorder, and their confidence in identifying and managing patients with this disorder.

Adult↗

PubMed2002

A questionnaire: will plateletpheresis donors accept multicomponent donation?

BACKGROUND AND OBJECTIVES: New technological developments make it possible to collect red blood cells (RBC) by apheresis which provides standardised products and has the potential for improved RBC quality. The purpose of this study was to evaluate the donors' opinion about the multicomponent donation procedure. MATERIAL AND METHODS: For evaluating the donors' opinion about this new apheresis technique we compiled a questionnaire. The questionnaire was given to all single needle actual plateletpheresis donors (n = 133) that donated platelets in our Institute during February-March 2001. The questionnaire contained 12 questions related to: (1) general information about previous donations of our donors and (2) donors' opinion about multicomponent donation. After implementation of multicomponent donation in December 2001 the data of the questionnaire were compared with the actual opinions of the donors about the procedure. RESULTS: The mean age of the donors was 38.1 +/- 9.1 years. The median number of previous platelets donations of the interviewed donors was 30. The majority of donors (92.4%) were willing for multicomponent donation. In the same time the majority of donors (74.8%) were willing to donate multicomponents four times per year. The different donation time was not an argument for the donors for the multicomponent donation, while the reduction of incidence of transfusion transmitted diseases was a motivation for them. The decrease of hemoglobin and the side effects caused by possible iron-supplementation therapy were found acceptable from most of our donors. Approximately 74% of the donors thought that the donation of a second component should result in better remuneration whereas 20% of them believed that the remuneration should be unchanged. Seventy-five RBC units were concurrently collected with platelets since December 15th, 2001. Six donors (7.4%) were unwilling to donate an additional RBC unit. CONCLUSION: Acceptance and disacceptance rates were almost equal after the implementation of multicomponent donation and at the time point when the interview was performed. The majority of donors was highly motivated to donate multicomponents, by these means we were able to increase our RBC supply and to improve standardization of our products.

Adult↗

PubMed2006

[Validation study of the Spanish adaptation of the satisfaction with inhaled asthma treatment questionnaire].

OBJECTIVE: Although satisfaction with asthma treatment is an important variable, it has received little attention and few validated measurement instruments are available. The aim of this study was to assess the psychometric properties and the feasibility of the Spanish adaptation of the Satisfaction With Asthma Treatment Questionnaire (SATQ) for inhaled medication. PATIENTS AND METHODS: This cross-sectional study to validate the adapted SATQ included 239 patients (67.8% women) with stable asthma (mean age, 43.3 years; forced expiratory volume in 1 second, 89% of predicted) and a median time since diagnosis of 10 years. Intermittent asthma was reported in 23.0% of the patients and severe persistent disease in 15.9%. Patients filled out the questionnaire twice. RESULTS: A 4-dimensional factorial structure could be discerned. These dimensions were similar to the validation of the original questionnaire and explained 55.1% of the variance. Internal consistency was acceptable (Cronbach alpha, 0.880 for the overall score and 0.600-0.866 for subscales), as was reliability (intraclass correlation coefficient, 0.912 for the overall score and 0.841-0.916 for subscales). A significant moderate correlation was observed between the overall score and physician--and patient--reported satisfaction (rho=0.295 and 0.507, respectively). Three of the 4 subscales were able to discriminate between categories of the Global Initiative for Asthma. The questionnaire was completed in less than 10 minutes by 92.5% of the patients, and 93.7% left no field blank. CONCLUSIONS: The Spanish adaptation of the SATQ is a useful, user-friendly instrument for measuring satisfaction with inhaled treatment.

Administration, Inhalation↗

PubMed2005

Developing a family function questionnaire for families with developmentally delayed children.

The purpose of this study was to develop a "Family Function Questionnaire for Families with Developmentally Delayed Children". The questionnaire was created by sampling 300 parents with developmentally delayed children. Initially, families and early intervention services were observed and a qualitative interview with the child's family was conducted. The researchers created a family function database reflecting these steps and by referral to relevant literature. The final version of the questionnaire consisted of 42 items in 11 categories: cohesion, education, problem solving, affective involvement, independence, action participation, family support, recreation, rules implementation, collaboration, and financial management. The questionnaire had a Cronbach's alpha of 0.9326.

Child↗

PubMed1989

The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): socio-demographic correlates, reliability, validity and some norms.

The IQCODE is a questionnaire which asks an informant about changes in an elderly person's everyday cognitive function. The questionnaire aims to assess cognitive decline independent of pre-morbid ability. In the present study, the IQCODE was administered to a sample of 613 informants from the general population. In addition, the questionnaire was administered to informants of 309 dementing subjects who had filled it out one year previously. A principal components analysis, using the general population sample, confirmed that the IQCODE measures a general factor of cognitive decline. The questionnaire was found to have high internal reliability in the general population sample (alpha = 0.95) and reasonably high test-retest reliability over one year in the dementing sample (r = 0.75). The total IQCODE score, as well as each of the 26-items, was found to discriminate well between the general population and dementing samples. The correlation with education was quite small (r = -0.13), indicating that contamination by premorbid ability is not a problem.

Aged↗

PubMed1980

Experience with the Bortner questionnaire as a measure of Type A behaviour in a sample of UK families.

The self-administered, 14-item Bortner questionnaire was used to characterize the Type A behaviour of the members of a group of families selected from 3 general practice registers. The questionnaire was found to be easy to complete and showed no systematic variation on repeat administration. The rank order of the 14 items was similar in the men, women and children of the study (and in a sample of Belgian men where the Bortner questionnaire had been validated against other measures of Type A behaviour). There was a social class gradient among the men but not among the women or children, and there was no correlation of this behaviour characteristic between parents and their children. This simple questionnaire may thus be an acceptable way of characterizing Type A behaviour which, it is suggested, might develop during adult life in response to occupational experiences.

Adolescent↗

PubMed2007

The heritability of cluster A personality disorders assessed by both personal interview and questionnaire.

BACKGROUND: Personality disorders (PDs) as assessed by questionnaires and personal interviews are heritable. However, we know neither how much unreliability of measurement impacts on heritability estimates nor whether the genetic and environmental risk factors assessed by these two methods are the same. We wish to know whether the same set of PD vulnerability factors are assessed by these two methods. METHOD: A total of 3334 young adult twin pairs from the Norwegian Institute of Public Health Twin Panel (NIPHTP) completed a questionnaire containing 91 PD items. One to 6 years later, 1386 of these pairs were interviewed with the Structured Interview for DSM-IV Personality (SIDP-IV). Self-report items predicting interview results were selected by regression. Measurement models were fitted using Mx. RESULTS: In the best-fit models, the latent liabilities to paranoid personality disorder (PPD), schizoid personality disorder (SPD) and schizotypal personality disorder (STPD) were all highly heritable with no evidence of shared environmental effects. For PPD and STPD, only unique environmental effects were specific to the interview measure whereas both environmental and genetic effects were found to be specific to the questionnaire assessment. For SPD, the best-fit model contained genetic and environmental effects specific to both forms of assessment. CONCLUSIONS: The latent liabilities to the cluster A PDs are highly heritable but are assessed by current methods with only moderate reliability. The personal interviews assessed the genetic risk for the latent trait with excellent specificity for PPD and STPD and good specificity for SPD. However, for all three PDs, the questionnaires were less specific, also indexing an independent set of genetic risk factors.

Adult↗

PubMed1995

Evaluating translations of health status questionnaires. Methods from the IQOLA project. International Quality of Life Assessment.

There is growing demand for translations of health status questionnaires for use in multinational drug therapy studies and for population comparisons of health statistics. The International Quality of Life Assessment (IQOLA) Project is conducting a three-stage research program to determine the feasibility of translating the SF-36 Health Survey, widely used in English-speaking countries, into other languages. In stage 1, the conceptual equivalence and acceptability of translated questionnaires are evaluated and improved using qualitative and quantitative methods. In stage 2, assumptions underlying the construction and scoring of questionnaire scales are tested empirically. In stage 3, the equivalence of the interpretation of questionnaire scores across countries is tested using methods that closely approximate their intended use, and empirical results are compared. Data analyses from Sweden and the United Kingdom, as well as other research cited, support the feasibility of cross-cultural health measurement using the SF-36.

Activities of Daily Living↗

PubMed1993

Zygosity diagnosis of twins by questionnaire for twins' mothers.

Subjects were 74 twin pairs, 61 MZs and 13 same-sexed DZs who entered the High School affiliated with Tokyo University, Japan. Their mothers also participated. The twins' zygosity was previously identified by many genetic markers. This study aimed at clarifying the effectiveness of zygosity diagnosis by questionnaires distributed to twins' mothers. The questionnaire consisted of three questions concerning the degree of similarity of twins at one year of age; whether they were confused, and if so, by whom. It was slightly modified from that reported earlier by Ooki et al [11] for twins themselves. According to the degree of similarity of the twins, points were allotted thus: from 1 to 3 points for answers to questions (1) and (2) and from 1 to 4 points for answers to questions (3). The sum of the points was calculated, then ranged from 3 to 10. Zygosity was determined by the sum of these points. If the sum was 3-6, the twin pairs were considered MZ and if the sum was 7-10 DZ. It was revealed that more than 90% of twins were identified correctly as MZ or DZ by applying this cutting point and this result was in accordance with that obtained by use of discriminant function analysis. Moreover, the accuracy of the mothers' responses was nearly the same as that obtained by the questionnaire for twins themselves. It was concluded, therefore, that the information from twins' mothers is as correct as that from twins themselves. This questionnaire is simple, practical and especially useful when twins are still too young to participate personally.

Diagnosis↗