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Out-of-body experiences in schizophrenia. A questionnaire survey.

Questionnaires on perceptual distortions, symptoms of schizophrenia, and out-of-body experiences (OBEs) were completed by 71 volunteers with a history of schizophrenia and 40 control subjects (patients in a hospital accident ward). Significantly more of the schizophrenics (42%) than of the control group (13%) answered "yes" to a question about OBEs. However, a follow-up questionnaire showed that only 14% of schizophrenics (i.e., the same as the control group) had had "typical" OBEs, in which a change of viewpoint was reported. Those reporting typical OBEs did not report more perceptual distortions or symptoms of schizophrenia than did those reporting no OBEs, although those reporting other atypical experiences did. On this basis there is no evidence to consider the typical OBE as pathological or as symptomatic of schizophrenia.

Adult

Perceptual changes in schizophrenia: a questionnaire survey.

Questionnaires were completed by 73 volunteers with a history of probable schizophrenia, and by 67 patients admitted to the accident wards of a general hospital. A high incidence of sensory distortions was recorded in the schizophrenic group compared with the controls, distortions of brightness contrast being the most common. Many schizophrenic patients reported that such distortions were reduced or removed early in treatment. Patients who reported visual distortions also tended to report visual hallucinations. The results are discussed with reference to the hypothesis that perceptual malfunction may underlie some other schizophrenic disorders such as delusions or catatonia.

Adult

Management of renal carcinoma--a questionnaire survey.

Questionnaires on the management of renal carcinoma were returned by 134 British urologists. Analysis revealed that ultrasound is used, as a routine investigation, by 93% of the respondents, whereas abdominal CT scanning is used routinely by only 16%. Renal arterial embolisation is used by 60% of respondents; a further 12% indicated that, having tried the technique, they had given it up. Of 81 surgeons using embolisation, 44% were hopeful that it offered systemic benefit to the patient and 54% delay nephrectomy after embolisation. Regression of metastases following treatment was reported by 58 surgeons. Details of metastatic regression in 60 patients revealed that pulmonary metastases were involved in 83%. Embolisation featured in the management of only 11 such patients.

Embolization, Therapeutic

Suture materials currently used in obstetric-gynecologic surgery in the United States: a questionnaire survey.

Questionnaires on the material and the size of sutures used in obstetric-gynecologic surgery were sent to the directors of 110 residency programs in the specialty in medical schools in the United States. Replies were received from 80 (73%) programs. The findings indicate that the use of chromic catgut still predominates, but that the newer synthetic absorbable materials such as polyglycolic acid and polyglactin 910 are becoming popular for some procedures, including certain steps in abdominal closure and in reconstructive tubal surgery. The increasing use of these materials for hysterectomy and cesarean section, heretofore exclusively the domain of chromic catgut, suggests that there is possibly under way a reorientation of attitudes about the materials used for sutures in obstetric-gynecologic surgery. The characteristics of catgut and of synthetic absorbable materials are herein described and compared in relation to their current use.

Abdomen

Psychosocial adjustment in a large cohort of adults with growth hormone deficiency treated with growth hormone in childhood: summary of a questionnaire survey. Committee for the Study Group of Adult GH Deficiency.

The quality of life of adult patients with growth hormone (GH) deficiency, who ceased GH therapy before the age of 20 years, was surveyed. Questionnaires were sent to 1116 patients and their physicians, asking about socioeconomic status and for medical information, respectively. Response rates were 64% and 69%, respectively. The final height of the patients was about -2 SD in 61% of those surveyed. The distributions of occupation and income were similar to those in the general population. Patients with a final adult height below 155 cm (men) and below 140 cm (women) felt disadvantaged in terms of obtaining employment and finding partners. Slight psychological problems in these patients were revealed by the Cornell Medical Index health questionnaire.

Adult

Treatment of terminal cancer pain in Finland. A questionnaire survey.

A questionnaire concerning current practice in the treatment of cancer pain was sent to 783 Finnish physicians. This study is based on the replies from 421 physicians who stated that they at least sometimes see cancer patients. Three simulated patient cases were presented in the questionnaire, and the adequacy of the treatment suggestions was evaluated. The results indicated that drugs predominate in the treatment of cancer pain. The suggested doses of narcotic analgesics were well below the minimum effective daily doses. As many as half of the physicians failed to use the therapeutic modalities correctly, irrespective of the frequency of their seeing cancer patients. Education in effective pain treatment should therefore be intensified to ascertain that all physicians involved in clinical practice have satisfactory knowledge of the treatment of cancer pain.

Analgesics, Opioid

The pediatric prenatal visit: a questionnaire survey.

A questionnaire was sent to 83 pediatricians to determine which issues they considered important in the pediatric prenatal visit. Of the 64 respondents, 58 do prenatal interviews. Approximately half of the mothers of newborns entering these practices had prenatal visits. Most respondents indicated that the prenatal visit focused on meeting the family and discussing practical aspects of infant care. The finding that few respondents focused the interview on psychological aspects of parenthood raises questions about the role of the prenatal visit in pediatric care.

Female

New Zealand obstetricians' management of hypertension in pregnancy. A questionnaire survey.

A questionnaire about the management of hypertension in pregnancy was sent to the 150 members of the Royal New Zealand College of Obstetricians and Gynaecologists. Sixty five out of a total of 77 replies were suitable for analysis. There was a wide variation in the criteria for diagnosis and the outpatient and inpatient investigation and treatment. The commonest drugs prescribed in imminent eclampsia were hydralazine as an anti-hypertensive, and diazepam or phenytoin as anticonvulsants. All clinicians practised aggressive management with induction of delivery if significant proteinuria complicated hypertension in pregnancy. Glucocorticoid therapy for the premature induction of fetal lung maturity in mothers and severe hypertension was considered beneficial by some, yet contraindicated by others.

Adult

Voiding patterns in men evaluated by a questionnaire survey.

A questionnaire on obstructive and irritative voiding symptoms was sent to 572 men aged between 20 and 79 years, selected at random from the National Register; 337 questionnaires were completed. None of the responders had consulted a doctor because of voiding symptoms. There was a significant increase in voiding symptoms and in the obstructive, irritative and total symptom scores between the sixth and seventh [corrected] decades, whereas the increases in the other decades were small. Only the prevalence of terminal dribbling was uniform. The prevalence of single obstructive and irritative voiding symptoms in men aged 60 to 79 years without subjective prostatism was the same as in patients admitted with prostatism, although most of the men had milder symptoms. Only nocturia and urge incontinence were more prevalent in patients admitted with prostatism. About 20% of men in the oldest decades had symptoms equal in severity to those found in men undergoing prostatectomy; 29% and 11% of men in the eighth decade [corrected] had nocturia twice and 3 times or more respectively; 19% complained of urge incontinence. More information on possible treatment is needed.

Adult

Somatoform disorders in different cultures--a mail questionnaire survey.

A mail questionnaire survey was organized by WHO to obtain expert opinion on the cross-cultural applicability of ICD-10 definitions of somatoform disorders. A response was obtained from 42 experts in 23 countries representing all five continents. The results showed that the ICD-10 concept of somatoform disorders was generally acceptable for use across cultures. However, a number of culture-specific symptoms, characteristics and terms that do not appear in ICD-10 were found to be common and important for the diagnosis of somatoform disorders in particular cultures. Pointing out the relative restrictiveness of ICD-10 criteria for somatization disorder, the experts emphasized the usefulness of having the more inclusive category of undifferentiated somatoform disorder. The survey was organized as the starting point of the WHO International Study of Somatoform Disorders. The major goal of the study is to improve understanding of the somatic presentation of psychological disorders in different cultures.

Cross-Cultural Comparison

Ethnic minorities in British diabetic clinics: a questionnaire survey.

A questionnaire was sent by the British Diabetic Association to hospital consultant physicians caring for diabetic patients in the UK to estimate the number of ethnic minority patients attending British Diabetic clinics, and the availability of special facilities for their care. Sixty-two clinics were estimated to have at least 50 Asian patients, and 25 had at least 200 Asian patients. For Afro-Caribbeans the corresponding figures were 33 and 14 clinics, respectively. Clinics serving a relatively high proportion of these patient groups were situated primarily in Greater London, the Midlands and the North West. Approximately 40% of clinics with over 50 Asians had no specifically adapted diet sheets, and 34% had no hospital interpreter service. Tapes, slides or video presentations were available in only eight clinics. There is an urgent need to improve the provision of special facilities to clinics with substantial numbers of ethnic minority patients.

Adult

[A group of homosexuals change their sex habits after information about AIDS. A questionnaire survey].

A questionnaire investigation to which 144 homosexual persons replied anonomously revealed alterations in the sexual habits after information about AIDS. Significant reduction in the annual number of partners and significantly fewer employ the more dangerous sexual practices which now occur particularly in more permanent partnerships are among the alterations started. An unchanged number still employ active anal and orogenital coitus. Employment of condoms has increased significantly, particularly in anal coitus and "casual" partners (from 3% to 82%). The majority accept the use of condoms and state that they employ more "safe sex" than prior to information about AIDS. 12% stated that they had sex with both sexes and the possibility of spread of infection from homosexual to heterosexual groups is present. The intensive informative work from the homosexuals own organisation and from public health authorities appear to have had some effect but further information and influencing are necessary if the spread of HIV infection is to be stopped.

Acquired Immunodeficiency Syndrome

Nonresponse bias to mail survey questionnaires within a professional population.

Mail survey questionnaires are often used in dental research. In most instances, results depend on a single mailing and an incomplete return rate. The possible bias resulting from excluding nonresponders in tabuling data from mail survey questionnaires in a dentist population was investigated. Two different questionnaires, one soliciting attitudes, the other knowledge, were sent to randomly selected dentists. The differences between the responders and the nonresponders were analyzed with respect to the dentists' demographic data, attitudes, and knowledge. It was concluded that: (1) subject matter does affect dentist response rates to mailed survey questionnaires, (2) there are no differences in demographic data between dentist responders and nonresponders, and (3) nonresponse bias does not affect the results of dental surveys on a typical dentist response rate.

Attitude of Health Personnel

Methicillin-resistant Staphylococcus aureus in the UK and Ireland. A questionnaire survey.

The results of a questionnaire survey of the distribution of methicillin-resistant Staphylococcus aureus (MRSA) in the UK and Ireland between 1982 and 1983 are reported. Information was obtained about the geographical distribution of MRSA, the units affected, the sites of isolation and the preventive measures employed. Serious clinical problems were confined to a small number of hospitals with high isolation rates of MRSA.

Cross Infection

[Sleep disturbances complicated by surgical stress; a questionnaire survey of 50 patients].

A questionnaire survey of sleep disturbances was undertaken in 50 adult surgical patients to examine the prevalence of insomnias complicated with surgical stress. The survey about nocturnal sleep conditions was performed for consecutive four nights from two days before surgery. Defining early awakenings, difficulty of initiating or maintaining of sleep as manifestations of insomnias, the incidence of insomnias amounted to 72.9% on the night of two days before surgery, 72.0% on the night before surgery, 86.0% on the night of surgery, and 86.6% on the first night after surgery. High incidence of sleep disturbances complicated with surgical stress is noteworthy in the field of perioperative care.

Adult

Management of acute leukemia during pregnancy: from the results of a nationwide questionnaire survey and literature survey.

In March, 1993, a questionnaire was sent to 362 gynecological and obstetric offices of national, prefectural and municipal hospitals and private university hospitals with 250 beds or more. Answers were collected from 260 institutions. Thus, this study analyzed 39 patients with acute leukemia during pregnancy collected by the questionnaires survey and 64 cases reported in the Japanese literatures during 1975-1993 (total 103 patients). The weeks of pregnancy were defined as the 1st (< 15th week), 2nd (16th-27th week), and 3rd (> 28th week) trimesters. The time of diagnosis of leukemia during pregnancy changed from 25% in the 2nd trimester and 62% in the 3rd trimester during 1975-1984 to 39% and 48% after 1985, respectively. After 1985, the remission rate was 72% in the questionnaire group and 75% in the group from literatures. There was no statistical difference. The 50% survival period was 12 months in the group during 1975-1984, but 25 months in the group after 1985. The survival was significantly longer in the patients whose induction therapy was started before delivery than in those treated after delivery. The results suggest that the treatment for acute leukemia during pregnancy should be initiated as soon as possible after the diagnosis of leukemia, with carefully selected regimens. It is important that the time of delivery should be selected considering the maternal and fetal conditions after consultation with an obstetrician.

Adult

[Adequacy of translating health survey questionnaires for cross-cultural surveys--the case of the Todai Health Index].

The adequacy of the language translation of self-administered questionnaire items was examined in a comparative study of adolescent mental health between Japan and the United States. As a screening instrument to be used in both countries, the Todai Health Index (THI) questionnaire had been translated from original Japanese into English. The original version was administered to 570 Japanese adolescents and the translated version was given to 295 middle school students in the United States (aged 12 to 15). The equivalence of the two versions was re-examined based on the results of the surveys by a team of researchers from both countries including a bilingual investigator. For the items which produced a statistically significant different response pattern between the two samples, the investigators attempted to determine whether the observed difference could be attributed to an inadequate translation or to a real cultural difference. For those items judged to suffer from inadequate translation, modifications were made to improve cross-cultural equivalence. The above methodological procedure, though not perfect, proved to be relatively simple but very useful in resolving many practical issues in cross-cultural studies and produced interesting findings. For example, the phrase "worry about" was found to not adequately capture the Japanese meaning of "ki-ni-naru" and instead the phrase "concern about" or "care" was suggested as a more appropriate substitute. Very little is known and insufficient attention has been given to the effect of translation in cross-cultural surveys. These investigations suggest the benefit of more extensive studies and focused discussions of reliability of the translated survey instruments by public health researchers involved in international comparisons.

Adolescent

Voiding patterns and prevalence of incontinence in women. A questionnaire survey.

A detailed questionnaire on the occurrence of irritative and obstructive voiding symptoms, incontinence and the number of childbirths was sent out to 600 women aged between 20 and 79 years, randomly selected from the National Register; 432 (72%) returned the questionnaire and 414 (69%) were evaluable. The frequency of obstructive symptoms such as hesitancy, intermittency and decreased stream was low. Diurnal frequency with voiding intervals less than 3 h were recorded by more than 50% of the women and about 10% voided more frequently than every second hour. Nocturia increased significantly with age; 54 (13.6%) voided at least twice per night. About 40% complained of incontinence but this was troublesome in only 6%; 15.3, 13.3 and 11.5% had stress, urge and mixed incontinence respectively. More than 8% wore nappies or sanitary towels every day to protect against urinary leakage. Although the tendency to wear nappies or sanitary towels increased with age, the increase was not statistically significant. There was a positive correlation between the occurrence of stress incontinence and childbirth in the group as a whole.

Adult