骨质疏松知识问卷调查

目的：了解骨质疏松知识的普及程度。方法：对840例昆明市居民进行骨质疏松知识问卷调查。结果：骨质疏松知识不够普及，人们对骨质疏松知识的认识存在一些误区和盲点。结论：应对不同的年龄段人群进行专业化的骨质疏松健康教育。     

Abnormal illness behavior and psychiatric disorders: a study in an outpatient clinic in Japan

Abnormal illness behavior, such as hypochondriacal attitude and inappropriate treatment-seeking, has been associated with various psychiatric disorders in which patients tend to abuse medical services and seek inappropriate treatment in general practice clinics rather than psychiatric clinics. However, the relationship between illness behavior and psychiatric disorders in Japan is yet to be elucidated. We examined the abnormal illness behavior of 243 patients who visited the outpatient department of psychiatry at Saga Medical School Hospital, Saga, Japan, using a Japanese version of the Illness Behavior Questionnaire (IBQ). Multivariate analysis indicated significant association between some of the IBQ scale scores and age, sex and employment status. Patients with anxiety disorder scored higher on five of the seven IBQ scales compared with patients with another major disorder (mood disorder, schizophrenia or somatoform disorder). When compared with the IBQ scale scores reported in Australian patients in a psychiatric hospital, most of the IBQ scale scores differed significantly in our patients; a higher score among Japanese patients on the general hypochondriasis scale was most prominent. A similar trend in IBQ scale scores was also noted among Japanese patients visiting the hospital's general medicine clinic in comparison with Australian patients visiting a general practice clinic. Japanese patients with anxiety disorder may display the most salient abnormal illness behaviors among patients with psychiatric disorders. Sociocultural background may contribute to the characteristic abnormal illness behaviors of Japanese patients.     

麝香保心丸消心痛治疗冠心病心绞痛疗效比较

目的比较麝香保心丸与消心痛治疗冠心病心绞痛的临床疗效.方法选择96例冠心病心绞痛患者,52例给予麝香保心丸治疗,44例给予消心痛治疗,观察其症状缓解情况及心肌耗氧情况.结果麝香保心丸组对心绞痛症状改善作用优于消心痛组,且其降低心率及心肌氧耗量的作用亦优于对照组(P＜0.05,P＜0.01).结论麝香保心丸优于消心痛,是治疗冠心病心绞痛的理想药物.     

新通注射液治疗冠心病心绞痛60例临床研究

目的:观察新通注射液治疗冠心病心绞痛的临床疗效.方法:治疗组应用新通注射液静脉滴注,对照组口服单硝酸异山梨酯,观察临床症状、心电图、动态心电图、血液流变学、血脂等变化.结果:治疗组总有效率为95%,对照组总有效率为65%,两组疗效经统计学处理,差异有显著性(P＜0.01);治疗后治疗组心电图总有效率为76.67%,对照组心电图总有效率为48.33%,两组结果经统计学处理,差异有显著性(P＜0.01);两组缺血性ST-T改变的时间经统计学处理,差异有显著性(P＜0.01);血液流变学的变化情况治疗组治疗前后差异均有显著性(P＜0.01),而对照组差异无显著性(P＞0.05);血脂的变化情况治疗组治疗前后差异均有显著性(P＜0.01),而对照组差异无显著性(P＞0.05).结论:新通注射液治疗冠心病心绞痛疗效确切,临床值得推广应用.     

化瘀祛痰颗粒剂治疗冠心病心绞痛63例

探讨化瘀祛痰颗粒剂治疗冠心病心绞痛的作用及中药治疗的有效方法.方法:筛选冠心病心绞痛患者63例,用化瘀祛痰颗粒剂治疗,观察患者治疗前后症状及心电图的变化.结果:有效率86.7%,其中显效46例,有效8例.治疗后,症状及心电图有明显改善.结论:化瘀祛痰颗粒剂是治疗冠心病心绞痛的有效方药之一.     

Responsiveness and minimal clinically important difference of the Chinese version of the Low Vision Quality of Life Questionnaire after cataract surgery

AIM: To investigate the Chinese version of the Low Vision Quality of Life Questionnaire (CLVQOL) as an instrument for obtaining clinically important changes after cataract surgery. METHODS: Patients underwent cataract surgery in Shanghai General Hospital, Shanghai Jiao Tong University, who fit the inclusion criteria were recruited. Two CLVQOLs were administered, including a preoperative CLVQOL and a CLVQOL at the end of the 3mo follow-up period, and were completed using face-to-face interviews or phone interviews conducted by trained investigators. The minimal clinically important difference (MCID) was calculated using an anchor-based method and a distribution method. In addition, the responsiveness of the questionnaire was measured. RESULTS: A total of 155 residents were enrolled. The average visual acuity (VA) preoperatively was 0.08 (SD=0.05), and it increased to 0.47 (SD=0.28) at the end of follow-up. Statistically significant positive changes in the CLVQOL scores indicated significant improvement of vision related quality of life after cataract surgery. With the larger value between the two results as the final value, the MCID values of the CLVQOL (scores of the four scales as well as the total score) were 8.94, 2.61, 4.34, 3.10 and 17.63, respectively. The CLVQOL has both good internal and external responsiveness. CONCLUSION: CLVQOL scores are appropriate instruments for obtaining clinically important changes after cataract surgery. This study is an effective exploration for establishing cataract surgery efficacy standards, which helps clinical and scientific research workers in ophthalmology to gain a more in-depth understanding when using CLVQOL.     

Validation of the repetitive behaviour questionnaire for use with children with autism spectrum disorder

The repetitive behaviour questionnaire (RBQ) (Turner, 1995) is one of the three most commonly used interview/questionnaire measures of repetitive behaviour (Honey et al., in preparation). Despite this there is a scarcity of information concerning its structure, reliability and validity. The psychometric properties of the RBQ were examined when used with children with an autism spectrum disorder, children of typical development and children with a learning disability. The questionnaire was found to examine two valid and reliable factors of repetitive behaviour and to have good levels of concurrent and construct validity. This novel study provides researchers and clinicians with information necessary to make decisions about the RBQ's utility and for the evaluation of conclusions drawn from existing research, which has used the RBQ.     

Reliability of a multidimensional questionnaire for adults with treated complete cleft lip and palate

The purpose of this study was to evaluate the reliability of a multidimensional questionnaire for Swedish adults with treated complete unilateral or bilateral cleft lip and palate (CLP). The questionnaire was designed to be used in the evaluation of adults with treated CLP after treatment. Before any conclusions were drawn from the results of the study we assessed the test-retest reliability of the questionnaire. The questionnaire included 168 questions and assessed the following domains: aesthetics, functions associated with CLP, satisfaction with treatment and perceived need for treatment, quality of life, depression and non-specific physical symptoms, body image, and jaw function. The subjects answered the questionnaire twice at a 2-3-week interval. Sixty-one adults (38 men, 23 women) mean age 24 years (range 20-29) participated in the study. The response rate for the questionnaire was acceptable at 75%. The test-retest reliability varied among the different domains. The reliability of questions regarding aesthetics, functions associated with CLP, and treatment satisfaction was good to excellent (intraclass correlation coefficient (ICC) = 0.51 to 0.89). Good to excellent (ICC = 0.61 to 1.0) reliability was also found for the quality of life in various life domains and the wellbeing scales. The reliability of the body image scale was moderate (kappa = 0.43-0.60) for most items and lower than that of other scales used in this study. The reliability of the mean depression symptom score (ICC = 0.93) and the mean non-specific physical symptoms score (ICC = 0.85) were excellent. The reliability of the mandibular function impairment was good (ICC = 0.67). The conclusion of the study is that an overall reliability was good for the multidimensional questionnaire.     

Surveying general practitioners: a new avenue

SUMMARY

Background: The validity of opinions expressed in questionnaire surveys diminishes with lower response rates. Recent research suggests that general practitioners (GPs) are more likely to respond to questionnaire surveys if they are motivated to do so because the subject of the survey is perceived as relevant to the practitioner at the time of the survey, and there is an opportunity to respond without encroaching on existing obligations or interests.

Aim: To compare the results of a questionnaire survey administered by two routes: a postal survey with reminders and after an educational meeting with no reminders.

Methods: A validated questionnaire with 19 questions using a Likert scale seeking views about the ideal contents of a referral letter to colorectal surgeons was administered to GPs attending a monthly educational meeting in one locality in the UK and by post to a different group in a second locality. The response rate and demographic characteristics of the GPs were compared for respondents, non-respondents, attenders and non-attenders to the educational meeting. The mean responses to the questions on the Likert scale were used to produce a schedule to score the contents of referral letters. The schedules produced by the two methods (postal/educational meeting) were used to score 551 referral letters at one district general hospital. Mean scores calculated using the two schedules derived by the postal and educational routes were compared. Cases diagnosed with 'significant organic pathology' as defined in a previous study were identified. The predictive value of the scores in identifying these cases was compared.

Results: 88% (138/157) of GPs in the locality attended the educational meeting and were invited to participate in the survey. Non-attenders were more likely to be assistants, locums or part-time practitioners. Overall 71% (98) of the GPs responded to the survey. There were no significant demographic differences between the respondents and non-respondents to the survey. Response rates to the survey conducted by the two routes were similar. Referral letter 'quality' scores derived via the two alternative routes were equally valuable in predicting which patients had significant organic pathology.

Conclusions: Responses to questionnaire surveys are equally valid when administered via an educational meeting or by post. The value of the educational meeting approach was the relative ease of administering the questionnaire and the rapid turn around of replies. However this method may exclude the views of part-time practitioners who were more likely to fail to attend. These practitioners may need to be targeted by alternative routes in questionnaire surveys.     

Impact of Guidelines for Antihypertensive Treatment on Clinical Practice

Many Guidelines and Consensus Statements were published in 1993 and 1994. The pressure to produce these guidelines comes from clinicians faced with rapid change, from a wish to provide an independent authoritative view rather than rely on commercial promotion of particular treatments, and from governments seeking assistance with the allocation of scarce resources.

Evaluation of the impact that guidelines exert on clinical practice is notoriously difficult, but has been attempted using the self-report questionnaire, or the more reliable but expensive analysis of actual practice data, before and after publication of the guidelines.