Average Interview Time Research Articles

The Narrowing of Self as Perceived by People in the Early Stages of Dementia-The Second Report.

The purpose of this study is to shed light on the sense of self that occurs amongst those who have been diagnosed with the early stages of dementia, where the individual attempts narrowing their world. The research was conducted using qualitative induction research methods, and data were collected using semi-structured interview methods. The interviews were conducted between 2017 and 2019. The 15 participants were residents with families in a Japanese city of about 950,000 people. The diagnosis was Alzheimer's disease in all cases. Of the 15 participants, six were male and nine female. The average age was 69.9 years. The average score on the MMSE was 19.8 points. The average period since the first diagnosis was 2 years. The average interview time was 51 minutes. The narrowing self perceived by these people diagnosed with mild dementia was composed of the "neglected self" and "closed self." While living in a safe world in which they had given up on their own possibilities and experienced narrowing, they were unable to give up and harbored regret, anger, resentment, and feelings of absurdity. We believe that this study will help us understand the experiences of people in the early stages of dementia and contribute to providing nursing care that is more tailored to the individuals involved.

간호대학생의 HMD 기반 VR 유치도뇨 교육콘텐츠 실습 경험

Objectives This study aims to figure out the meaning of the practical training experiences of HMD-based VR foley catheterization education content for university nursing students, and look for effective training strategies that utilize VR. Methods The study method involves a focus group interview of 12 university nursing students who have practiced VR foley catheterization education content. Data collection is done from 2023 May to June by three divided groups and the practical training of VR foley catheterization education content is carried out two times per week, a total of 6 times for three weeks, and interviews are conducted after the training. To organize the collected data, the sec-ond interview is conducted after a month. The major question was “what’s the upsides and downsides of the practical training of HMD-based VR foley catheterization education content?” and the average interview time was 50 minutes. The results are derived from the collected data by using content analysis methods. Results The research outcome shows that the collected three topics derived from eight topics are stated as ‘the positive experiences of HMD-based VR foley catheterization education content practical training’, ‘the negative experiences of HMD-based VR foley catheterization education content practical training’, and ‘the double-sided-ness of HMD-based VR foley catheterization education content practical training’. During the practical training of VR foley catheterization education content, participants feel heightened immersion and strengthened core skill capacities of foley catheterization and increased confidence, but their experiences left room for improvement due to physical side-effects such as headache and dizziness, and lack of sense of reality, and participants are also aware of the double-sidedness of it as they feel pride for VR core skill training which is not actively used yet, but also they feel it is hard to be used for providing comprehensive care through interactions. Conclusions In conclusion, as the practical training of HMD-based VR foley catheterization content has both up-sides and downsides, its upsides need strengthening and its downsides need improving. Also, further continuous research is needed to diversely develop HMD-based VR core skill education content and to find effective practical training methods by expanding and applying it in each category.

Etiology, consequences, and solutions of working women’s work-life conflict: a qualitative study

IntroductionWork-life conflict (WLC) is important in organizational behavior research and human resource management. The present research aimed to investigate the underlying causes, consequences, and solutions to WLC in Iranian working women.Materials and methodsThe present qualitative study was conducted through a content analysis method among 19 working married women in Birjand, a city in the east of Iran, from December 2021 to February 2022. To collect the data, semi-structured interviews were held. The average interview time was 45 minutes, and all interviews were recorded upon the participants’ consent. Finally, after coding, the information was analyzed with MAXQDA software.FindingsThe causes of conflict included 4 main categories of individual, interpersonal, organizational, and cultural factors, with seven subcategories: the pressure of the mother’s role at home, personality traits, lack of individual skills, insufficient support, work characteristics, organizational policies, and the traditional role of women in society.The consequences of conflict included 2 main categories, Decreasing quality of life and work problems with 4 subcategories: physical and mental illnesses, forgetting one’s role towards others, limiting social communication, and reducing productivity.Conflict resolution methods included 3 main classes of individual-oriented, other-oriented, and organization-oriented with 8 subclasses: program-oriented, meaning-oriented, emotion-oriented, avoidance, emotional support, instrumental and work support, support work policies, and correct management views.ConclusionTo solve the problem of conflict, different aspects should be considered and help to solve this challenge by influencing each dimension.

Medication management of COVID-19 patients during transition to virtual models of care: a qualitative study

IntroductionExpansion of hospital service models was one of the strategies implemented to manage the COVID-19 pandemic through virtual models of care. COVID-19 patients were hospital inpatients transferred to virtual wards and managed outside the hospital. Pharmacists had to provide distance medication management and support services. Virtual care patient support incorporated telehealth consultations by doctors, pharmacists and nurses. This study explored hospital clinicians’ experiences and perspectives on medication management and safety issues of the COVID-19 patients transferred from inpatient units (IPUs) to virtual models of care at the time of transfer.MethodsSemi-structured qualitative interviews were conducted with purposively selected doctors, pharmacists and nurses involved in the management of COVID-19 patients in a virtual model of care (home or hotel). Clinicians were interviewed face-to-face or via MS Teams between March and May 2022. An interview schedule included 13 questions and prompts to explore perceptions of medication management and safety aspects.ResultsTwenty clinicians were interviewed: six doctors, seven pharmacists, and seven nurses. The average interview time was 26 min (SD: 4.7; range 21–39). Four major medication management and safety themes emerged from the data: (1) complexities involved in efficient handover between IPU and virtual models of care; (2) lack of clarity on roles and responsibilities between hospital and primary care clinicians; (3) communication challenges when pharmacists work remotely; and (4) proactive management of specific medication safety risks. A common thread throughout the themes was concerns for potential impact on patient safety.ConclusionOverall, clinicians were supportive of the virtual models although patient safety issues were raised that need to be addressed in the development of future services. The results from this study may inform improvements in medication safety implementation of future virtual models of care.

Smoothing the transition of adolescents with CF from pediatric to adult care: Pre-transfer needs

IntroductionIn France, the cystic fibrosis (CF) care pathway is performed in 45 CF centers, the life expectancy of patients has steadily increased, but to date there are no national recommendations for the transition from pediatric to adult care. The transition to an adult CF center still raises questions about the relevance of its organizational arrangements. The “SAFETIM need” study aimed to identify the organizational needs both of patients and of parents before the transfer to an adult CF center. MethodsThis was a prospective, observational, multicenter study conducted between July 2017 and December 2018, involving the three CF centers of a regional network in southeastern France. Each adolescent registered with the center and his or her parents were interviewed individually, on the same day, during the 6 months leading up to transfer. They participated in semi-structured interviews during one of their routine consultations at the CF center. The interview manual, based on literature reviews and targeting national recommendations, was tested and validated by the national CF therapeutic education group (GETheM). All interviews were transcribed and checked by two different people, and analyzed by two researchers individually. The results were classified by topic according to content categorization. ResultsOverall, 43 adolescents and 41 parents were interviewed, respectively, who were followed up by CF centers: 14% (n=6) in a mixed CF center (pediatric and adult); 19% (n=8) and 67% (n=29), respectively, in two different pediatric CF centers. Adolescents were between 16 and 19 years old. For adolescents, the average interview time was 5.11min. (standard deviation [SD]: 3.8min; minimum: 2.53min; maximum: 17.14min). For parents, the average interview time was 7.99min (SD: 3.56min, minimum: 3.43min; maximum: 22.50min). DiscussionOur study enquired only about the preparation and organization of the transfer. We identified three areas of actions matching the needs of adolescents and parents before transfer. The first one is to anticipate team change to prepare follow-up in their future CF center: acquire new skills, consider the future CF center according to the adolescent's curriculum, be involved in the transition process. The second area is to accompany the upcoming change. The care team could help by providing information and support during the start of teenagers’ transition toward autonomy. And parents were aware that the CF center change will reverse roles. They must provide their own knowledge and manage the ambivalence of this as well as letting go. The third one is to announce the transition process and functioning of the future adult CF center, because the transition would require time to find their place (patients and parents) with the new team. ConclusionThe “SAFETIM needs” pre-transfer study results show that we can identify the main criteria to be developed and strengthened, to promote a smooth, high-quality transition from pediatric to adult CF care for patients in France. For most patients, the transition cannot be prepared at the last minute. Caregivers need to develop specific skills in adolescent and young adult care and follow-up. Each team must consider the transition as a normal part of the patient care cycle. While it must be structured, some flexibility must be allowed so as to give everyone the chance to be prepared and to personalize the care.

Validity and comprehensibility of outcome measures in children with shoulder and elbow disorders: creation of a new Pediatric and Adolescent Shoulder and Elbow Survey (Pedi-ASES)

Valid patient-reported outcomes (PROs) for the shoulder and elbow do not exist for children. We assessed children's comprehension of the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire and the American Shoulder and Elbow Surgeons (ASES) standardized shoulder assessment form, identified response errors, and modified items to create a new pediatric shoulder and elbow PRO. We recruited 50 children (aged 10-18 years) with shoulder or elbow disorders from a children's hospital-based orthopedic clinic for this qualitative study. A trained researcher conducted cognitive interviews to identify children's comprehension of PROs. In phase 1, 40 children were purposefully sampled on the basis of age and gender, interviewed, and audiotaped. A behavioral scientist analyzed transcripts, modified items, and created the Pediatric and Adolescent Shoulder and Elbow Survey (Pedi-ASES). In phase 2, 10 children were interviewed to gather feedback on and to refine the Pedi-ASES. The average interview time was 25 minutes (range, 17-44 minutes). There were 242 comments generated about the QuickDASH; 51% of children struggled with complex terminology, and 35% did not understand "tingling." Children generated 309 comments about the ASES, primarily associated with narcotic medications (65%) and shoulder instability (42%). Time frame and format issues were noted. In phase 2, children found the new PRO easier to comprehend and answer. Modifications were needed in general instruction, language, format, and response mapping in the original PROs. Children had few difficulties with the Pedi-ASES. Designing PROs that are specific to children will enable researchers and clinicians to more accurately assess health status and clinical outcomes.

Validity and Comprehensibility of Current Shoulder & Elbow Functional Outcomes Measures in Children

Objectives:To assess the comprehensibility of the Quick Disabilities of the Arm, the Shoulder and Hand Score (Quick DASH) and the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) in children, identify sources of response errors, and modify items, in order to develop an original, age-appropriate, validated pediatric shoulder and elbow patient-reported outcome (PRO) survey.Methods:49 children with shoulder and/or elbow disorders were recruited from a children’s hospital-based orthopedic outpatient clinic. A researcher, who was trained by a behavioral scientist in cognitive interviewing techniques, used a standardized protocol and conducted cognitive interviews to identify children’s comprehension of the QuickDASH and ASES surveys. In Phase One of the study, 39 children (46% female, mean age=15 years; range 10-18) were purposefully sampled based on age and gender, interviewed, and audiotaped. The questionnaires were given in varying sequential order. Interview probes focused on directions, formatting, item content and matching of responses and items. A behavioral scientist analyzed transcripts, modified items accordingly, and created an original pediatric shoulder and elbow PRO. In Phase Two, 10 children (40% female, mean age=15 years) were interviewed to gather feedback specifically on the original pediatric PRO.Results:The average interview time was 26 minutes (range=16 - 44 minutes). 255 comments were generated about the Quick DASH, identifying 60 issues related to item comprehension and 191 issues related to item response format. 51% of children struggled with complex terminology used to describe activities and 41% did not understand symptom-related items such as “tingling”. 294 comments were generated about the ASES, primarily associated with medications (76%) and shoulder instability (47%). Timeframe and format issues were also noted. The resulting original PRO was easy to comprehend, although 40% of children could not interpret a “loose shoulder or elbow”.Conclusion:Item comprehension issues were noted in approximately half of the children completing the Quick DASH and ASES. Specific areas of difficulty included items addressing medication use, activity level and symptoms such as shoulder instability and tingling. Modifications were also needed in general instruction, language, survey and item format, layout, and item response mapping. Based on the results of the cognitive interviews, children had minimal difficulty comprehending items and directions of the newly developed pediatric shoulder and elbow PRO. A subsequent study will assess this original PRO’s psychometric properties in an effort to continue its development and provide more comprehensive, methodologically rigorous validation of its use in this population.

Development and proposal of a reference tool for semi-structured interviews for the characterization of the management in mental health networks

In 2011, Brazil’s mental health care networks were instituted; nevertheless, standardized arrangements or indicators for network evaluation and management were not established. Hence, a proposed model to evaluate municipal and regional management of such networks was elaborated. One of its steps consists of semi-structured interviews aiming the network management knowledge. Therefore, this paper aimed the development and validation of a reference tool for conducting interviews focusing on assessment of mental health care network management. Methods comprised definition of interest topics, questions elaboration for each topic, preliminary script preparation, script validation, script adequacy and definition of final script. Thus, the developed script consisted of 29 questions and 8 follow-up questions divided over 8 topics (interviewee characterization, legislation, decision-making processes, network structure, management participants, information systems, indicators, and knowledge of external experiences). The script also added individualized field reports and interview planning and execution guidelines. After validation, it was concluded that chosen topics were relevant and appropriate, despite minor modifications; and estimated average interview time remained close to prior established. Therefore, the developed tool can assist collecting information to help managers evaluate the network and improving population health. Moreover, the tool could be used in other localities or adapted for other networks.

Validity of the progress notebook in supporting patients with higher cortical dysfunction

Sonoda S, Shirayama Y, Tanabe S, Shimomura K, Suzuki S. Validity of the progress notebook in supporting patients with higher cortical dysfunction. Jpn J Compr Rehabil Sci 2014; 5: 93-96. Purpose: To validate the usefulness of a progress notebook (p-notebook) in supporting patients with higher cortical dysfunction by analyzing the difference in interview time in a new hospital or facility with and without the p-notebook. The p-notebook was created to assist those with higher cortical dysfunction, which is not well understood by non-experts. Methods: Interview times with and without the p-notebook (notebook group: n=34, non-notebook group: n=32) were compared when patients with higher cortical dysfunction went to a new hospital or facility. Impressions of the families and support coordinators of patients in the notebook group were evaluated using visual analogue scales. Results: The average interview time was 32.4 ± 10.7 minutes in the notebook group and 57.2 ± 28.9 minutes in the non-notebook group, and this difference was significant (p<0.0001). Regarding the impressions of family and support coordinators, the length of explanation was shorter and understandability was improved when using the p-notebook. These tendencies were dominant in families compared with support coordinators. Conclusion: Our p-notebook is useful since it decreases the interview time and lowers the burden of giving explanations.

“Think Different”: A Qualitative Assessment of Commercial Innovation for Diabetes Information Technology Programs

This study reviews the state of diabetes information technology (IT) initiatives and presents a set of recommendations for improvement based on interviews with commercial IT innovators. Semistructured interviews were conducted with 10 technology developers, representing 12 of the most successful IT companies in the world. Average interview time was approximately 45 min. Interviews were audio-recorded, transcribed, and entered into ATLAS.ti for qualitative data analysis. Themes were identified through a process of selective and open coding by three researchers. We identified two practices, common among successful IT companies, that have allowed them to avoid or surmount the challenges that confront healthcare professionals involved in diabetes IT development: (1) employing a diverse research team of software developers and engineers, statisticians, consumers, and business people and (2) conducting rigorous research and analytics on technology use and user preferences. Because of the nature of their respective fields, healthcare professionals and commercial innovators face different constraints. With these in mind we present three recommendations, informed by practices shared by successful commercial developers, for those involved in developing diabetes IT programming: (1) include software engineers on the implementation team throughout the intervention, (2) conduct more extensive baseline testing of users and monitor the usage data derived from the technology itself, and (3) pursue Institutional Review Board-exempt research.

Perception and Information Behaviour of Institutional Repository End-Users Provides Valuable Insight for Future Development

Perception and Information Behaviour of Institutional Repository End-Users Provides Valuable Insight for Future Development

The brand‐wagon: emerging art markets and the Venice Biennale

PurposeThe purpose of this paper is to investigate whether and how participating in a branded Biennale (Venice) may legitimate and promote selected artists from the emerging markets of Venezuela and Thailand alongside art market leaders.Design/methodology/approachResearch was conducted at the 53rd International Art Biennale in Venice, Italy, in June 2009. Underpinned by a constructivist approach, qualitative data were collected via participant observation, illustrative photography and semi‐structured interviews (average interview time 55 minutes) with curators and participating artists from two emerging markets: Venezuela and Thailand.FindingsThis research indicates that merely attending the Venice Biennale does not mean automatic branding for success: each artist's signature style must stand out within its cultural context for the branding effect to succeed. The conclusion compares and contrasts the effective relationship between identification and success for the two emerging economies within the world‐leader arts event in Venice.Originality/valueThis study contributes to the growing body of knowledge on arts management and events management, focusing on the until now unexplored area of contemporary arts marketing for the emerging economies of Venezuela and Thailand. The paper may aid emerging market art professionals in their strategy and planning to better benefit from the Venice Biennale's branding opportunity, as well as guiding scholarly research to a better understanding of the area.

Unbearability of suffering at the end of life: the development of a new measuring device, the SOS-V

BackgroundUnbearable suffering is an important issue in end-of-life decisions. However, there has been no systematic, prospective, patient-oriented research which has focused on unbearable suffering, nor is there a suitable measurement instrument. This article describes the methodological development of a quantitative instrument to measure the nature and intensity of unbearable suffering, practical aspects of its use in end-stage cancer patients in general practice, and studies content validity and psychometric properties.MethodsRecognizing the conceptual difference between unbearability of suffering and extent or intensity of suffering, we developed an instrument. The compilation of aspects considered to be of importance was based on a literature search. Psychometric properties were determined on results of the first interviews with 64 end-stage cancer patients that participated in a longitudinal study in the Netherlands.ResultsThe instrument measures five domains: medical signs and symptoms, loss of function, personal aspects, aspects of environment, and nature and prognosis of the disease. Sixty nine aspects were investigated, and an overall score was asked. In 64 end-stage cancer patients the instrument was used in total 153 times with an average interview time varying from 20-40 minutes. Cronbachs alpha's of the subscales were in majority above 0.7. The sum scores of (sub)scales were correlated strongly to overall measures on suffering.ConclusionThe SOS-V is an instrument for measuring the unbearability of suffering in end-stage cancer patients with good content validity and psychometric properties, which is feasible to be used in practice. This structured instrument makes it possible to identify and study unbearable suffering in a quantitative and patient-oriented way.

Self-Reported Medical Errors in 7 Countries: Implications for Pharmacy

Purpose The purpose of this study was to determine the rate of self-reported errors in Canada compared with other countries, and to identify risk factors for medical error. Methods In 2007, the Commonwealth Fund surveyed a sample of adults in 7 industrialized nations: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom and the United States. The surveys were conducted by telephone by Harris Surveys and country affiliates, with an average interview time of 17 minutes. Data from this source was used to perform a bivariate analysis comparing those individuals who reported having experienced a medical error to those who had not, followed by a logistic regression model in order to delineate the relationship between medical error and several explanatory variables. The goodness of fit of the final model was assessed, as was the possible presence of multicollinearity. All data analysis was performed using SPSS Version 16.0. Results Overall, 11,910 respondents from 7 countries were included in the analysis. The rate of self-reported medical error ranged from 12%– 20% in the 7 nations. Approximately 1 in 6 (17%) Canadians reported having experienced at least 1 error in the previous 2 years, which translates to 4.2 million adult Canadians. Several variables were found to have a statistically significant relationship to self-reported medical errors in the final regression model, including high prescription drug use (4 or more medications), presence of a chronic condition, lack of physician time with the patient, age under 65, lack of patient's involvement in care, perceived inadequate nursing staffing and absence of a regular doctor. Conclusions This study has demonstrated that medical error is a commonly occurring problem from the perspective of patients in 7 industrialized countries. The risk factors for self-reported medical error that have been identified in this study should aid clinicians, including pharmacists, in the design and implementation of targeted strategies to address this issue. By proactively identifying patient, provider and system-related risk factors for medical error, the opportunity for improving the safety of Canada's health care system could be greatly enhanced. While not all of the errors identified in this study are related to medications, there are implications for pharmacy practice. More specifically, our results suggest that pharmacists should be extra vigilant with patients with high prescription drug use and chronic conditions and ensure that patients are given the opportunity to be involved in their care.

The reliability and validity of the forensic Camberwell Assessment of Need (CANFOR): a needs assessment for forensic mental health service users.

No instrument exists that measures the individual needs of forensic mental health service users (FMHSUs). The aim of this study was therefore to develop a valid and reliable individual needs assessment instrument for FMHSUs that incorporated staff and service user views and measured met and unmet needs. The Camberwell Assessment of Need was used as a template to develop CANFOR. Consensual and content validity were investigated with 50 forensic mental health professionals and 60 FMHSUs. Both were found to be satisfactory. Concurrent validity was tested using the Global Assessment of Functioning and a five-point needs scale, and again was found to be satisfactory. Reliability studies were carried out with 77 service users and 65 staff in high and medium security psychiatric services in the UK. Inter-rater reliability, rating whether a need was present or not, was high for service users (0.991) and staff (0.998). Similarly high reliability was found for unmet needs (0.985 and 0.972, respectively). Test-retest reliability was found to be moderately high for service users (0.795) and staff (0.852) when ratings were made two weeks apart. Similar levels were found for ratings of unmet needs (0.813 and 0.699, respectively). The average interview time was 23 minutes. CANFOR has good validity and reliability, and is suitable for further testing with other service user groups.

Factors affecting study efficiency and item non-response in health surveys in developing countries: the Jamaica national healthy lifestyle survey

BackgroundHealth surveys provide important information on the burden and secular trends of risk factors and disease. Several factors including survey and item non-response can affect data quality. There are few reports on efficiency, validity and the impact of item non-response, from developing countries. This report examines factors associated with item non-response and study efficiency in a national health survey in a developing Caribbean island.MethodsA national sample of participants aged 15–74 years was selected in a multi-stage sampling design accounting for 4 health regions and 14 parishes using enumeration districts as primary sampling units. Means and proportions of the variables of interest were compared between various categories. Non-response was defined as failure to provide an analyzable response. Linear and logistic regression models accounting for sample design and post-stratification weighting were used to identify independent correlates of recruitment efficiency and item non-response.ResultsWe recruited 2012 15–74 year-olds (66.2% females) at a response rate of 87.6% with significant variation between regions (80.9% to 97.6%; p < 0.0001). Females outnumbered males in all parishes. The majority of subjects were recruited in a single visit, 39.1% required multiple visits varying significantly by region (27.0% to 49.8% [p < 0.0001]). Average interview time was 44.3 minutes with no variation between health regions, urban-rural residence, educational level, gender and SES; but increased significantly with older age category from 42.9 minutes in the youngest to 46.0 minutes in the oldest age category. Between 15.8% and 26.8% of persons did not provide responses for the number of sexual partners in the last year. Women and urban residents provided less data than their counterparts. Highest item non-response related to income at 30% with no gender difference but independently related to educational level, employment status, age group and health region. Characteristics of non-responders vary with types of questions.ConclusionInformative health surveys are possible in developing countries. While survey response rates may be satisfactory, item non-response was high in respect of income and sexual practice. In contrast to developed countries, non-response to questions on income is higher and has different correlates. These findings can inform future surveys.

Screening for Complicated Grief Among Project Liberty Service Recipients 18 Months After September 11, 2001

Screening for Complicated Grief Among Project Liberty Service Recipients 18 Months After September 11, 2001

The reliability of the Brazilian version of the Composite International Diagnostic Interview (CIDI 2.1)

The objective of the present study was to determine the reliability of the Brazilian version of the Composite International Diagnostic Interview 2.1 (CIDI 2.1) in clinical psychiatry. The CIDI 2.1 was translated into Portuguese using WHO guidelines and reliability was studied using the inter-rater reliability method. The study sample consisted of 186 subjects from psychiatric hospitals and clinics, primary care centers and community services. The interviewers consisted of a group of 13 lay and three non-lay interviewers submitted to the CIDI training. The average interview time was 2 h and 30 min. General reliability ranged from kappa 0.50 to 1. For lifetime diagnoses the reliability ranged from kappa 0.77 (Bipolar Affective Disorder) to 1 (Substance-Related Disorder, Alcohol-Related Disorder, Eating Disorders). Previous year reliability ranged from kappa 0.66 (Obsessive-Compulsive Disorder) to 1 (Dissociative Disorders, Maniac Disorders, Eating Disorders). The poorest reliability rate was found for Mild Depressive Episode (kappa = 0.50) during the previous year. Training proved to be a fundamental factor for maintaining good reliability. Technical knowledge of the questionnaire compensated for the lack of psychiatric knowledge of the lay personnel. Inter-rater reliability was good to excellent for persons in psychiatric practice.

Development of a Screening Tool to Assess Folate Intake from Food

Adequate folate intake (≥400 μg/d) in women of childbeanng age may decrease the risk of neural tube defects. Assessing folate intake through dietary records is time intensive. Therefore, we designed and conducted initial validity testing on the Folate Intake Tool (FIT). The FIT is a food frequency survey comprised of top folate sources as assessed by frequency of consumption and amount per serving. The original FIT contained 72 items. Twenty-nine females (childbearing aged, mixed ethnic background) were recruited from a university community. Each completed the FIT and a 3-day food record (FR). The FIT was telephone interviewed and subjects reported usual intake over the previous year (average interview time: 12–13minutes). Total intake for FIT and FR was estimated with the 1998 folate fortification levels. For the FIT, total folate intake was calculated from frequency of intake and serving size; for the FR, with the Food Processor (version 7.2). Data were analyzed with nonparametric statistics (significance criterion: p<.05). Mean folate intake from the FIT (437.36±40.31 μg (SE)) did not differ significantly from that of the FR (381.02±30.98 μg). Grouping folate intake as adequate/inadequate (above/below 400 μg/d) identified 19 of 29 inadequate from the FR, 12 of 29 from the FIT. The FIT correlated significantly with the FR (rho=0.58, p=.001). Of the 72 FIT items, 24 were primary contributors to estimated folate intake. These items included the fortified cereals, breads, grains, and some fruits and vegetables. The calculated mean intake from these 24 items (302.53±19.89 μg) was less than that from the 72 items. However, the 24-item FIT continued to correlate significantly with the FR (rho=.67, p<.0001). The 24-item FIT classified more subjects with inadequate intakes (25 of 29). Thus the sensitivity (correctly identifying inadequate intake) reached 95% while specificity (correctly identifying adequate intake) was only 30%. These preliminary analyses suggest that the FIT can identify those with inadequate intakes of folate with as few as 24 items.

A computer interview for emergency room patients

A patient-conducted computer interview for emergency room use has been developed and its feasibility tested. The history of present illness and brief medical history data is collected directly from patients. Average interview time is 13 minutes and patients found the experience interesting and not difficult. Comparisons of the computer-generated summary and the emergency room record showed the computer summary to be more standardized, complete and as accurate as the emergency room record. Less than one minute of staff time is required per interview and a legible and organized summary is available for clinical use within two minutes after the patient completes the interview.