A multi-institutional survey of the quality of life after treatment for uterine cervical cancer: a comparison between radical radiotherapy and surgery in Japan

This study aimed to research the post-treatment quality of life (QOL) between radiotherapy (RT)- and operation (OP)-treated early cervical cancer survivors, using separate questionnaires for physicians and patients. We administered an observational questionnaire to patients aged 20–70 years old with Stages IB1–IIB cervical cancer who had undergone RT or OP and without recurrence as outpatients for ≥6 months after treatment. We divided 100 registered patients equally into two treatment groups (n = 50 each). The average age was 53 and 44 years in the RT and OP groups, respectively. The RT group included 34 and 66% Stage I and II patients, respectively, whereas the OP group included 66 and 34% Stage I and II patients, respectively. The OP group included 58% of patients with postoperative RT. Combination chemotherapy was performed in 84 and 48% of patients in the RT and OP groups, respectively. On the physicians’ questionnaire, we observed significant differences in bone marrow suppression (RT) and leg edema (OP). On the patients’ questionnaire, significantly more patients had dysuria and leg edema in the OP group than in the RT group, and severe (Score 4–5) leg edema was significantly higher in the post-operative RT group than in the OP only group. The frequency of sexual intercourse decreased after treatment in both groups. On the patients’ questionnaire, there were no significant differences between the two groups regarding sexual activity. These findings are useful to patients and physicians for shared decision-making in treatment choices. The guidance of everyday life and health information including sexual life after treatment is important.     

大学生自我表露及其与主观幸福感的关系

目的:探讨大学生自我表露、主观幸福感现况及二者的关系.方法:根据浙江大学164名学生的问卷调查结果对Jourard SM自我表露问卷进行修订,用修订的自我表露问卷和幸福感指数量表对浙江大学的356名学生进行问卷调查.结果:不同信息类别的自我表露评分差异显著(F=50.24,P＜0.001),其中品味和兴趣(1.85±0.41)、学习(工作)(1.87±0.43)的自我表露评分均高于态度和看法(1.70±0.32)(t=7.870、8.256)、金钱(1.60±0.41,t=10.517、11.429)、个性(1.70±0.39)、身体(1.71±0.42)(P均＜0.001).目标人的主效应显著(有男/女朋友者、无男/女朋友者的自我表露问卷评分差异均有显著性,F=21.14、13.88,P＜0.001),信息类别和目标人的交互作用显著(F=76.15,P＜0.001).在金钱、身体、学习或工作方面大学生向父母表露多于向男、女性朋友(如金钱上:母亲1.81±0.59、父亲1.73±0.58,男朋友1.42±0.44,女朋友1.40±0.44;F=116.84,P=0.000).女性的表露程度高于男性(1.79±0.31/1.71±0.32,t=2.03,P=0.044).自我表露与主观幸福感呈正相关(r=0.16,P=0.003).分层回归显示自我表露对预测主观幸福感作出了新的贡献(△R2=0.021,P=0.006).结论:信息类别、目标人、被试性别会影响自我表露的程度,提升表露水平有助于改善主观幸福感.     

《严重过敏反应急救指南》临床问题与结局指标的收集和确定

目的: 确定纳入《严重过敏反应急救指南》的临床问题与结局指标。方法: 由指南指导委员会7位临床医学、药学及护理学专家参考国际指南指导项目组起草、修订拟纳入指南的临床问题与结局指标初稿。临床问题分为背景问题与前景问题,其中背景问题在专家共识组共22位临床专家修订后直接纳入指南范围,前景问题与结局指标将通过三轮德尔菲法对共识组临床专家咨询形成终稿。研究在方法学家全程监督下完成,并通过分析积极系数、变异系数与分值频率等指标进行质量控制。结果: 问题征集初拟共纳入34个前景问题、6个背景问题及6个结局指标,背景问题经专家组修订后直接纳入指南。使用德尔菲法(Delphi method)对前景问题与结局指标的重要程度进行分级后,最终确定28个关键前景问题及6个结局指标纳入指南范围。其中,4个结局指标为关键性结局,其余2个为重要结局,纳入的28个关键前景问题分为严重过敏反应的诊断、救治准备、救治措施及救治后的管理四个部分,另有5个重要问题和1个次要问题此次未纳入指南,供指南修订或更新时参考或讨论。研究中专家响应的积极程度高,积极系数为100%;前景问题的共识程度高,4分及以上的问卷频率均≥0.75;结局指标中,病死率及疾病严重程度的共识程度高,变异系数≤15%。结论: 在全面严谨的信息收集基础上,以德尔菲法的方式确定了需要纳入《严重过敏反应急救指南》的临床问题与结局指标为该指南的后续制定工作奠定了基础。     

Validity of observed differences in dietary surveys by two self-administered questionnaires over a 5-year period: Concordance with self-reported change

Differences observed by comparing the responses to two surveys taken 5 years apart were compared with self-reported changes in dietary habits in the second survey to examine the construct validity of dietary change. That is, when an observed difference about a certain food was consistent with a self-reported change, these two methods seemed to show a high validity regarding dietary change. Both surveys used the same self-administered food intake frequency questionnaire, and subjective changes in food intake were evaluated at the second survey (self-reported change). Eight hundred fifty-five males and one thousand females aged 30-69 years were analyzed. Since results by both methods showed a higher frequency of increased intake of green-yellow vegetables in general, pale- colored vegetables in general, carrots, and squash, these results were thought to be of high validity. However, cabbage, lettuce, and seaweeds showed inconsistent results regarding higher frequencies of intake. Changes among quintiles of lower frequency seemed to show lower validity because the results obtained by the two methods were often inconsistent for dairy foods and some other foods. Thus, self-reported changes may reflect respondents’ attitudes toward foods, not their actual behavior.     

A questionnaire to assess the generic and disease-specific health outcomes of patients with chronic hepatitis C

A 69-item questionnaire measuring generic functioning and well-being and disease-specific health outcomes was developed and tested using the pre-treatment data from patients with chronic hepatitis C (CHC) participating in two randomized trials of interferon -2b (n = 157). The questionnaire included all eight scales from the SF-36 and measures of nine other generic and disease-specific health concepts. Psychometric tests confirmed the assumptions underlying the construction and scoring of all generic and disease-specific scales. Cross-sectional tests of known groups validity showed that CHC patients scored worse on the generic scales than patients with other chronic conditions and worse than a healthy general population. The generic and disease-specific scale scores were lower in the presence of physical findings of CHC, as hypothesized, but only the physical functioning and bodily pain scales were linked to cirrhosis or extreme alanine aminotransferase (ALT) ratios. This instrument will be useful in studies of health outcome among patients with CHC, a condition whose health burden appears to have been underestimated in studies to date.     

Convergent and Discriminant Validity of the Perinatal PTSD Questionnaire (PPQ): A Preliminary Study

We evaluated the validity of the Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ) as a measure of posttraumatic stress symptomatology. Mothers of high-risk infants (N = 91) and healthy, full-term infants (N = 51) answered the PPQ and two other convergent measures of posttraumatic stress disorder symptoms, the Impact of Event Scale (IES) and the Penn Inventory (PI). The Need for Cognition Scale (NCS) was used as a divergent measure. Correlations among the convergent measures were significantly greater than the correlation between the PPQ and NCS. High-risk mothers also scored higher than normal mothers on the PPQ and IES. The results support the validity of the PPQ.     

Repeatability and validity of an upper limb and neck discomfort questionnaire: the utility of the standardized Nordic questionnaire

The repeatability and validity of a questionnaire for upper limb and neck complaints were assessed in a population of 105 hospital outpatients with a range of upper limb and neck disorders (including cervical spondylosis, adhesive capsulitis, lateral epicondylitis, carpal tunnel syndrome and Raynaud's phenomenon). Subjects were asked to complete a modified Nordic-style upper limb and neck discomfort questionnaire on two occasions closely spaced in time. The repeatability of their responses was assessed by calculating a kappa coefficient (kappa), and the sensitivity and specificity of component items in the questionnaire were determined for specific diagnostic categories of upper limb and neck disorder. Symptom reports for pain in the upper limb and neck, pain interfering with physical activities, neurological symptoms and blanching were all found to be highly repeatable (kappa = 0.63-0.90). A number of regional pain reports proved to be very sensitive in relation to specific upper limb disorders, but, with the exception of reported finger blanching in patients with Raynaud's phenomenon, none proved to have a good specificity (range = 0.33-0.38). We conclude that a modified Nordic-style questionnaire is repeatable and sensitive, and is likely to have a high utility in screening and surveillance. However a complementary examination schedule of adequate specificity and repeatability is essential to establish a clinical diagnosis.     

A Kiswahili version of the SF-36 Health Survey for use in Tanzania: translation and tests of scaling assumptions

The objective of the study was to translate and adapt the SF-36 Health Survey for use in Tanzania and to test the psychometric properties of the Kiswahili SF-36. A cross-sectional study was conducted as part of a household survey of a representative sample of the adult population of Dar es Salaam, Tanzania. The IQOLA method of forward and backward translation was used to translate the SF-36 into Kiswahili. The translated questionnaire was administered by trained interviewers to 3,802 adults (50% women, mean (SD) age 31 (13) years, 50% married and 60% with primary education). Data quality and psychometric assumptions underlying the scoring of the eight SF-36 scales were evaluated for the entire sample and separately for the least educated subgroup (n=402), using multitrait scaling analysis. Forward and backward translation procedures resulted in a Kiswahili SF-36 that was considered conceptually equivalent to the US English SF-36. Data quality was excellent: only 1.2% of respondents were excluded because they answered less than half of the items for one or more scales; ninety percent of respondents answered mutually exclusive items consistently. Median item–scale correlations across the eight scales ranged from 0.47 to 0.81 for the entire sample. Median scaling success rates were 100% (range 87.5–100.0). The median internal consistency reliability of the eight scales for the entire sample was 0.81 (range 0.70–0.92). Floor effects were low and ceiling effects were high on five of the eight scales. Results for n=402 people without formal education did not differ substantially from those of the entire sample. The results of data quality and psychometric tests support the scoring of the eight scales using standard scoring algorithms. The Kiswahili translation of the SF-36 may be useful in estimating the health of people in Dar es Salaam. Evidence for the validity of the SF-36 for use in Tanzania needs to be accumulated.     

Prevalence of nocturia among Japanese adults

The prevalence of nocturia among Japanese community-dwelling adults was associated with insomnia, taking into account other correlates of insomnia.     

Reliability of the Dominic-R: A Young Child Mental Health Questionnaire Combining Visual and Auditory Stimuli

Reliability of the Dominic-R, a. questionnaire combining visual and auditory stimuli, was tested in 340 community children aged 6 to 11 years. Test-retest reliability of symptoms of, and of symptom scores of, DSM-III-R disorders including simple phobias, separation anxiety disorder, overanxious disorder, depression/dysthymia, attention deficit/ hyperactivity disorder, oppositional defiant disorder, and conduct disorder was assessed. Most symptoms yielded kappas greater than .40, and ICCs ranged from .74 to .81. In conclusion, reliability of the Dominic-R compares favourably with that of other child assessment questionnaires.