A comparison of a self-administered dietary questionnaire and a short interview

The reliability of a quick dietary questionnaire developed for epidemiologic purposes was evaluated. Twenty-four hour dietary recall data by self-administered questionnaire were compared with 24-hour requency of consumption of various food items were obtained for 75 subjects. For many food items there was no systematic error between questionnaire and interview data, as the mean frequencies were nearly identical. However, some typical snack foods had higher frequencies in the interview than in the questionnaire. The chance-corrected agreement between the questionnaire and interview data was high for everyday food items such as potatoes and wholemeal bread. The level of agreement was not acceptable for some items including snack food items such as coffee, cakes and buns. However, the disagreement was frequently within one frequency unit of the pair value. It was concluded that the short questionnaire method for 24-hour recall seemed suitable in epidemiologic studies where the diet of large groups is under study. However, if snacks are considered important, it is recommended that the questionnaire be checked in the presence of the subjects when they hand it over.     

Use of medication by Brazilian retirees: 2 - response rate and item completeness in a postal survey in Belo Horizonte, Minas Gerais State, Brazil

This paper reports on the response rate and completeness of item response in a self-administered postal survey questionnaire on use of medication by retirees 60 years or older under the Brazilian Social Security System, in Belo Horizonte, Minas Gerais State, in 2003. Questionnaires were sent in two rounds to 800 postal addresses of subjects selected by simple random sampling. The response rate was 47.8%, and there were no significant differences in the selected characteristics between respondents and non-respondents, or between early and late respondents. For almost all socio-demographic and health variables, item omission was less than or equal to 5% for both the entire sample and early or late responders. For all the medicines used, the dose and laboratory were the main items omitted. The findings indicate that details on drug use should be reevaluated in self-administered questionnaires.     

两水平方差成份模型在评价调查者间变异中的应用

探讨两水平方差成份模型在评价调查者间变异的应用价值。方法针对问题的应答为连续性正态分布的数据,分别拟合了两水平方差成份模进行对比分析。结果：问卷中各个问题存在着一定的调查者间变异,但逐年改进。结论对于问卷项目的应答为连续性正态分布的数据,在拟合重复调查的情形下,可以采用两水平方差成份模评价问卷项目应答的信度。     

多水平logistic模型在问卷信度研究中的应用

目的：探讨离散型反应变量多水平统计模型在问卷信度研究中的应用价值。方法：采用多水平ｌｏｇｉｓｔｉｃ模型对问卷中的三个问题的信度分别进行了分析。结果：问卷中三个问题均存在不同程度的“调查员变异”，且调查员与调查对象特征与问题应答具有联系。结论：在不需要重复调查的情况下，多水平分析技术不仅可评价问卷项目应答的信度，而且可评价调查员和调查对象特征对调查结果的影响     

肿瘤科护士共享决策知信行问卷的编制及信效度检验

目的 编制肿瘤科护士共享决策知识、态度和行为的调查问卷,并检验其信效度。 方法 以知信行理论为指导,通过文献回顾、质性访谈、两轮德尔菲法专家函询确定问卷条目,调查河南省郑州市4所三级综合医院257名肿瘤科护士分析信效度以确定问卷条目。 结果 最终形成共24个条目的问卷,其中知识维度11个条目,态度维度6个条目,行为维度7个条目;问卷探索性因子分析共产生3个因子,累计方差贡献率为57.657%,各条目的内容效度(I-CVI)在0.857～1.000之间,问卷平均内容效度(S－CVI)为0.929,问卷Cronbach’s α系数为0.941,重测信度为0.894。 结论 编制的问卷具有良好信效度,可作为评价肿瘤科护士共享决策知信行现状的研究工具。     

Reverse versus forward order reporting and the accuracy of fourth-graders' recalls of school breakfast and school lunch

BACKGROUND: Do children recall school breakfast and school lunch intake during 24-h recalls more accurately when prompted to report meals and snacks in reverse versus forward order? METHODS: One hundred twenty-one fourth-graders stratified by race (Black, White) and gender were each observed and interviewed twice (once per order) regarding the previous day's intake. Omission and intrusion rates determined accuracy for reporting items. Total inaccuracy determined accuracy for reporting items and amounts. RESULTS: Results failed to indicate significant effects of interviewer, weekday, sequence (first or second recall), or race on omission rates, intrusion rates, or total inaccuracy. A significant order by gender interaction was found for omission rates, which were lower (i.e., better) for males for reverse (53%) versus forward recalls (62%), but not females (61 versus 53%) (P < 0.008). Intrusion rates were acceptable for males for 54% of reverse recalls and 40% of forward recalls (P = 0.095). Means were 57 and 32%, and 6.4 servings for omission rate, intrusion rate, and total inaccuracy for reverse recalls, and 56 and 39%, and 6.9 servings for forward recalls. CONCLUSIONS: Prompting children to report in reverse versus forward order improved omission and intrusion rates for males more so than females. Regardless of reverse or forward order, children reported <50% of items observed; furthermore, >30% of items reported were not observed. Research is needed to enhance accuracy of children's dietary recalls.     

Development of a quality of life questionnaire for nursing home residents in mainland China

Objective

To develop and validate a quality of life (QOL) questionnaire for nursing home (NH) residents in mainland China.

Methods

A cross-sectional study including a development sample (n?=?176) and validation sample (n?=?371) of NH residents aged 60 and older was conducted between 2015 and 2016 in Jinan, Shandong Province, China. Resident interviews, literature reviews, expert panels, and pilot studies were used to identify QOL domains and items pertinent to NH life. Exploratory and confirmatory factor analysis were used to develop and validate a QOL questionnaire. Reliability (internal consistency, spilt-half reliability, and test–retest reliability) and validity (construct and criterion validity) were evaluated for the questionnaire.

Results

The self-report Chinese NH QOL questionnaire had 9 domains and 38 items including physical health (4 items), food enjoyment (6 items), security (3 items), environmental comfort (5 items), autonomy (2 items), meaningful activity (3 items), interrelationship (6 items), family relationships (3 items), and mood (6 items). The nine-factor model was confirmed with the following fit indices: χ²/df?=?1.872, root mean square error of approximation?=?0.049, comparative fit index?=?0.913, and Tucker-Lewis index?=?0.903. The 38-item NH QOL questionnaire showed satisfactory construct validity, criterion validity, internal consistency (Cronbach’s alpha?=?0.89, spilt-half reliability?=?0.73, test–retest reliability?=?0.76).

Conclusions

The NH QOL questionnaire appears to be a reliable and valid instrument and should be incorporated into a set of quality measures for use with NH residents in mainland China

     

基于改进Kano模型的四川省医养结合型养老机构老年人服务需求分析

目的:调查四川省医养结合型养老机构老年人服务需求属性及特征差异,为医养结合型养老机构实现对老年人服务需求满足的"靶向精准"提供参考。方法:采用便利抽样抽取成都市、攀枝花市、泸州市、自贡市27家医养结合型养老机构内773名老年人为调查对象,采用一般资料调查表,自制《医养结合型养老机构老年人服务需求Kano属性问卷》进行问卷调查。结果:在改进Kano模型划分下,医养结合型养老机构老年人在整体层面对47项养老服务具有一定的需求;64项服务中有30项|DSI|≥0.5,33项SI>|DSI|;重要度矩阵划分结果显示,11项服务划分在第一象限,归属于期望属性,26项服务划分在第二象限,归属于魅力属性,10项服务划分在第三象限,归属于无差异型属性;17项服务划分在第四象限,归属于必备属性。结论:医养结合型养老机构老年人的养老服务需求整体上呈现出"高依赖性"和"高期待性"倾向,据此提出,医养结合型养老机构在持续保障必备型需求服务,稳步提供期望型需求服务,努力丰富魅力型需求服务,客观分析无差异型需求服务的同时还应该采取"必备型需求(M)>期望型需求(O)>魅力型需求(A)>无差异型需求(I)"的需求满足策略。     

Academic and psycho-socio-familiar factors associated to anxiety and depression in university students. Reliability and validity of a questionnaire

BACKGROUND: The high frequency of anxiety and depression in university students is related to social, family factors and academic stress. The aim of this research is to determine the internal consistency and validity of a questionnaire on socio-familiar and academic situations which may be related to psychopathological situations in university students. METHODS: The research was carried out at the Universidad Católica San Antonio de Murcia with 700 students, to whom a questionnaire made by the researchers was given. This questionnaire included items which evaluated academic and socio-familiar aspects. Variables regarding various stressful situations amongst students, and the Goldbergs level of anxiety and depression scale were used as independent facts of research in order to measure the validity of the questionnaire. RESULTS: The reliability of the questionnaire was shown after obtaining an intraclass correlation coefficient of 0.819. The original questionnaire with 19 items was reduced to 15 items after the homogeneity analysis, obtaining a Cronbach alpha of 0.758. The validity of constructio was evaluated with the factor analysis of the questionnaire, with a result of two factors which represented academic aspects and socio-familiar aspects. Those students with a positive anxiety and depression test were the ones who obtained the higher score on the global questionnaire and in both factors, proving the validity of the criteria. CONCLUSIONS: The research questionnaire is an agile and easy to use tool for the assessment and early detection of anxiety and depression in university students.     

Association of smoking behavior and socio-demographic factors, work, lifestyle and mental health of Japanese civil servants

Few studies have examined the individual and social impact of smoking behavior in the Japanese population. The purpose of this study was to clarify the association between smoking behavior and socio-demographic factors, lifestyle, mental health and work characteristics of Japanese civil servants. A self-administered questionnaire survey of 1,439 employees (821 men and 618 women) aged 20-64 yr was conducted in a local government department in 2001. The questionnaire included items on socio-demographic factors, education level, grade of employment, lifestyle, affect balance scale, and work characteristics. Smoking status was divided into current smoker, ex-smoker and never smoked. Multiple logistic regression analysis was performed to evaluate the relationship between smoking and the other items. Men presented a higher smoking prevalence rate than women (53.1% vs. 4.9%). In men, a strong relationship between current smoker and advanced age (40 yr or older), low education level, less physical activity, irregular breakfast and negative affect balance was found. Among men with a low education, the prevalence of smoking cessation was significantly lower in comparison to men with a high education. In women, being young (20-29 yr), unmarried (single or other), having a hobby, and irregular breakfast were associated with smoking behavior. Furthermore, smoking cessation was significantly associated with having a hobby and negative affect balance. The above results suggest that socio-demographic, lifestyle and mental health characteristics are independently associated with current smoking. These factors should be considered in smoking cessation policies as program components.     

Development of the Short Form Endometriosis Health Profile Questionnaire: The EHP-5

OBJECTIVE: To develop and validate a short form version of the Endometriosis Health Profile-30 questionnaire which consists of a 30-item core questionnaire and a 23 item modular questionnaire. METHODS: Three studies were carried out to develop the Endometriosis Health Profile-5. Study 1: a short form version of the Endometriosis Health Profile-30 core questionnaire was developed. Study 2: the results were verified in a new data set. Study 3: a short form version of the 23 item modular questionnaire was produced. The modular questionnaire contains six dimensions which may not be applicable to every woman with endometriosis and is used to supplement the five scales on the core questionnaire when required. RESULTS: The final instrument contained 11 items: five items from the core questionnaire and six items from the modular questionnaire. The 95% confidence intervals for Study 1 indicated that the scale scores overlapped with each item score and were confirmed in the second analysis (study 2). Each item was most highly correlated to its parent scale and less with the remaining four core questionnaire scales which was verified in study 2. In both studies all correlations were significant at the 0.01 level (two tailed test). CONCLUSION: The Endometriosis Health Profile-5 is a reliable and valid short form questionnaire which can also be supplemented with a short form version of the modular questionnaire when required. It will be especially useful in clinical settings where a short and economical endometriosis health status measure is required.     

脑卒中患者健康行为评估工具的构建及信效度检验

目的 编制脑卒中患者健康行为问卷,并测定信效度。方法 在参考文献基础上编制脑卒中健康行为问卷,经过专家咨询确定问卷雏形,采用方便抽样抽取三所三级甲等医院381例住院脑卒中患者为研究对象,进行问卷调查,采用探索性及验证性因子分析对问卷信效度进行评价。结果 问卷总Cronbach’sα系数为0.807,总内容效度指数(S-CVI)为0.97,各条目内容效度指数(I-CVI)在0.8～1之间,经两次探索性因子分析,5因素包含的题项与编制问卷使用的概念框架大致符合,5因素累积方差贡献率为50.833%;模型拟合指数调整卡方(χ2/df)为1.168,近似误差均方根(RMSEA)为0.021,拟合优度指数(GFI)为0.942,比较拟合指数(CFI)为0.992,增量拟合指数(IFI)为0.992,各题项在各自潜变量上的负荷值都达到了显著水平,模型的各拟合指数达到了可接受的统计学标准。结论 该问卷具有较好的效度和信度,可为评估脑卒中患者健康行为提供依据。     

世界卫生组织健康调查资料的结构方程模型

目的 探索2002年世界卫生组织(WHO)健康调查数据中,人群自述健康水平、实际健康水平、社会人口学特征、危险因素之间的潜在关系,及各调查指标对自述健康和自述健康对实际健康水平的影响程度.方法 数据来源于WHO提供的2002年包含印度、巴西、布基纳法索、匈牙利、尼泊尔、俄罗斯、西班牙、突尼斯、越南等9个国家在内的健康调查数据(包括自我评价部分和健康情景部分)(29 971例).本研究利用健康情景资料对自我评价资料进行校正和消除切点位移偏倚后,用自我评价资料构建自述健康水平、实际健康水平、社会人口学特征、危险因素之间关系的结构方程模型.结果 最终结构方程模型:实际健康水平=0.80×自述健康水平+(-0.04)×社会人口学特征+(-0.08)×危险因素(R2=0.66),自述健康水平=(-0.70)×社会人口学特征+0.10×危险因素(R2=0.55);自述健康水平对实际健康水平的标准化总效应达0.80,人口学特征对自述健康水平和实际健康水平的标准化总效应分别为-0.70与-0.60;自述健康水平的16项指标含8个维度,按照对其影响程度由大到小依次为:活动能力、疼痛不适、睡眠情况、认知、情绪、自理能力、视觉能力、交际活动能力.结论 实际健康水平与自述健康水平之间、自述健康水平与社会人口学特征之间均有较强的线性关系,自述健康水平对实际健康水平有较大影响,2002年WHO健康调查所用16项指标在人群健康评价中占有重要的地位.     

不同年龄段儿童功能性构音障碍临床特征分析

目的 分析不同年龄段儿童功能性构音障碍的临床特征,为其干预治疗提供依据和参考。方法 将153例患儿分为4岁、5岁、6~9岁组,对其进行语音评估及治疗,分析错误特点及治疗效果。结果 4岁、5岁、6~9岁组患儿辅音错误平均个数分别为9.3、7.8、6.5个。舌尖后音错误率最高为90.8%;舌尖中音化及舌尖前音化错误常见,错误率分别为74.5%和46.4%;替代、歪曲及省略的错误率分别为98.0%、62.7%、7.2%。不同年龄间患儿功能性构音障碍程度,唇音、唇齿音、舌尖中音、舌根音、舌尖前音的发音错误,以及对舌面音化、塞音化、塞擦音化、不送气化和省略错误比较,差异均有统计学意义(P<0.05)。结论 构音障碍程度受年龄影响,且年龄的增长有利于改善辅音发音,但多数错误发音特点和治愈率不受年龄影响。儿童存在构音问题时,无论年龄大小都应及时就医诊治。     

Validation of the General and Sport Nutrition Knowledge Questionnaire (GeSNK) in Spanish Adolescents

The General and Sport Nutrition Knowledge Questionnaire (GeSNK) is an instrument that has been developed and validated to assess the level of nutrition knowledge in adolescents and young adults. The aim of the present study was to validate the GeSNK questionnaire in a group of Spanish adolescents in the framework of a Nutrition Education Programme in Secondary Schools in Andalusia, Spain. This cross-sectional questionnaire validation study was developed in two phases: translation-cultural adaptation and validation. A total of 305 adolescents aged 11 to 17 years, studying from the first to the third year of compulsory secondary education, participated on a voluntary basis. The GeSNK questionnaire consists of 62 items: 29 items for the General Nutrition section and 33 items for the Sports Nutrition section. Cronbach’s alpha coefficient for the complete questionnaire (GeSNK Total) was: 0.934; for the GeSNK General Nutrition section it was 0.918; and for the GeSNK Sports Nutrition section it was 0.856. The stability measured by the correlation coefficient for the General Nutrition section was 0.406 (p = 0.000); for the Sports Nutrition section it was 0.198 (p = 0.017); and for GeSNK Total the stability was 0.545 (p = 0.000). The questionnaire also demonstrated adequate construct validity. We therefore conclude that the Spanish version of the GeSNK questionnaire is a valid instrument to measure the level of knowledge in general nutrition and sports nutrition in adolescents.     

Systolic blood pressure in relation to occupation and perceived work stress

This paper outlines the methods used in a five-year prospective study of 4,607 Australian government employees and presents initial cross-sectional results examining associations between systolic blood pressure, occupation, and subjects' perceptions of work stress as ascertained in a questionnaire survey. The questionnaire items were grouped by means of principal component analysis into six factors representing adverse job characteristics. There were appreciable occupational differences in the mean scores for all six factors and in systolic blood pressure. The differences in systolic blood pressure among men from different occupational categories could not be explained by variation in the level of occupational stress perceived and reported by the subjects. Age, occupation, body mass index, and level of perceived stress arising from financial problems were significantly associated with systolic blood pressure level. A multiple linear regression model was used to determine the relationship between systolic blood pressure, age, and occupation after adjustment for the effects of the other variables.     

An exploration of the attitudes, personality and performance of dental students

This study investigates (1) the behavioural patterns, performance and attitudes to dentistry and (2) the personality traits, in male and female dental students (n = 219) studying at Cardiff Dental School. The first part deals with the results of a questionnaire investigating aspects of the students' training course, interests in various fields of dentistry, the level of frustration, anxiety and fatigue felt, the overall feelings of satisfaction and dissatisfaction produced in their dental course, their reasons for entering dentistry and their hopes for a future career, as well as their various leisure and spare-time activities. The second part examines the personality traits of clinical stage students (n = 123) based on Cattell's personality questionnaire, the 16 PFQ form C. The results were correlated with students' 'A' level grades, interview grades, clinical examination results and responses to some items of the general questionnaire. It was possible to identify certain characteristics in dental students which implied likely success in their dental examinations. This may have a useful implication for the initial selection of those wishing to practise dentistry.     

Validation of core medical knowledge by postgraduates and specialists

BACKGROUND: Curriculum constructors and teachers must decide on the content and level of objectives and materials included in the medical curriculum. At University Medical Centre Utrecht it was decided to test relatively detailed knowledge at a regular level in study blocks and to design a progress test aimed at the medical core knowledge that every graduating doctor should possess. This study was conducted to validate the level of knowledge tested in this progress test. AIM: We designed a questionnaire to investigate whether postgraduate trainees and experienced specialists agree with item writers on what is required core knowledge. METHODS: Postgraduates and specialists received a questionnaire with 80 items designed to test core knowledge. Respondents were asked to indicate to what extent the items actually represented the core knowledge required of a recently graduated medical student. RESULTS: Of the clinical questions, 82.4% were judged to reflect core knowledge, whereas only 42.4% of the basic science questions were judged to reflect core knowledge. There was a strikingly high correlation on the mean judgements per item of postgraduate trainees versus medical specialists (r = 0.975). CONCLUSION: Many items, written to reflect core knowledge, appear to be judged by postgraduates and clinicians as pertaining to non-core knowledge. Postgraduate trainees appear to be as capable as experienced specialists of making judgements regarding core knowledge. Fewer basic science items are regarded as core knowledge than clinical items. This may suggest that, specifically, basic science teachers do not agree with physicians on what is to be considered medical core knowledge for graduating doctors.     

Fourth-grade children are less accurate in reporting school breakfast than school lunch during 24-hour dietary recalls

OBJECTIVE: To compare reporting accuracy for breakfast and lunch in 2 studies. DESIGN: Children were observed eating school meals and interviewed the following morning about the previous day. In Study 1, 104 children were each interviewed 1 to 3 times with >or=25 days separating any 2 interviews. In Study 2, 121 children were each interviewed once in forward (morning-to-evening) and once in reverse (evening-to-morning) order, with these interviews separated by >or=29 days. SETTING: 12 schools. PARTICIPANTS: Fourth-grade children. MAIN OUTCOME MEASURES: For each meal, food-item variables (observed number, reported number, omission rate, intrusion rate, total inaccuracy) and kcal variables (observed, reported, correspondence rate, inflation ratio). ANALYSIS: General linear mixed models. RESULTS: For each study, observed and reported numbers of items and kcal, and correspondence rate (reporting accuracy), were greater for lunch than for breakfast; omission rate, intrusion rate, and inflation ratio (measures of reporting error) were greater for breakfast than for lunch. In Study 1, for each meal over interviews, total inaccuracy decreased and correspondence rate increased. In Study 2, for each meal for boys for reverse and for girls for forward order, omission rate was lower and correspondence rate was higher. CONCLUSIONS AND IMPLICATIONS: Breakfast was reported less accurately than lunch. Despite improvement over interviews (Study 1) and differences for order x sex (Study 2), reporting accuracy was low for breakfast and lunch.     

Do economic cycles have a permanent effect on population health? Revisiting the Brenner hypothesis

The Brenner hypothesis is essentially that economic cycles, characterized by unemployment and fluctuations in per capita income can have profound negative implications for population health. A number of subsequent studies have identified shortcomings in Brenner's model and have reported results that for the most part contradict his results. This paper argues that the failure to account for the time-series properties (i.e. the potential for unit root behaviour) of macro level data is a key omission in Brenner's and other subsequent studies. To address this omission an error correction model specification was applied to American data for the period 1948-1996. The findings suggest that economic cycles do have a permanent effect on population health. Paradoxically, they also suggest that economic growth and increases in unemployment reduce aggregate mortality risk. A need for measures of economic change that are perhaps more sensitive to the effects of economic cycles on groups that may be at greater risk of unemployment was identified.