User-friendly Questionnaire Research Articles

HBM4EU feasibility studies: Lessons learned in combining health and human biomonitoring studies

The European Human Biomonitoring Initiative (HBM4EU) is a joint program evaluating humans' exposure to several environmental substances and their potential health effects. One of the main objectives of HBM4EU is to make use of human biomonitoring (HBM) to assess human exposure to chemicals in Europe to better understand the associated health impacts and to improve chemical risk assessment. In parallel to HBM studies, health examination surveys (HESs), nutrition/dietary surveys, and disease specific health surveys are conducted in many European countries. In HESs, information collected by questionnaire(s) is supplemented with physical examinations and analysis of clinical and biological biomarkers in biological samples. HBM and health examination survey (HES) use similar data collection methods and infrastructures hence the feasibility of combining these two is explored in this paper. Within HBM4EU, three feasibility studies (in Finland, Germany, and UK/England) were conducted to evaluate opportunities and obstacles of combining HBM and health studies. In this paper we report lessons learned from these feasibility studies. The Finnish feasibility study called KouBio-KUOPIO study was a new initiative without links to existing studies. The German feasibility study added a HBM module to the first follow-up examination of the LIFE-Adult-Study, a population-based cohort study. The UK feasibility integrates a sustainable HBM module into the Health Survey for England (HSfE), an annual health examination survey. Benefits of combining HBM and HESs include the use of shared infrastructures. Furthermore, participants can receive additional health information from HES, and participation rates tend to be higher due to the potential to obtain personal health information. Preparatory phases including obtaining ethical approval can be time-consuming and complicated. Recruitment of participants and low participation rates are common concerns in survey research and therefore designing user-friendly questionnaires with low participant burden is important. Unexpected events such as the COVID-19 pandemic can cause substantial challenges and delays for such studies. Furthermore, experiences from several countries demonstrated that long-term funding for combined studies can be difficult to obtain. In the future, incorporating HBM modules into existing HESs can provide a feasible and cost-effective method to conduct HBM studies and obtain a wide range of relevant data to support public health policies and research.

EPS1.09 Adapting services during the COVID-19 pandemic – a patient evaluation of physiotherapy telephone reviews within multidisciplinary team virtual clinics

Background: The COVID-19 pandemic forced the evolution of face-to-face cystic fibrosis (CF) multidisciplinary team (MDT) clinics into an entirely remote service. Our virtual clinics included telephone reviews with specialist physiotherapists. Aims: To understand the experiences of our People with CF (PwCF) during their physiotherapy telephone review;to support the collaborative development of our service. Methods: Patient representatives assisted in the development of a user-friendly questionnaire. With patient consent, the questionnaire was distributed via email to patients attending clinics between 28th August–25th September 2020. Results: Of the 142 patients who consented to receiving a questionnaire, 61 (43%) responded. 90% (n = 55) of PwCF were satisfied with their telephone physiotherapy review. 33% (n = 20) of PwCF were not aware they would be called by a physiotherapist. 93% (n = 57) of PwCF found it useful to speak to a physiotherapist, covering the “same (topics) as a face-to-face review.” When stable, some felt a review was not required. PwCF felt good aspects of their review included discussing physiotherapy-related concerns (18%, n = 11) and gaining specialist advice (26%, n = 16). The main area for improvement was providing an allocated appointment time (33%, n = 20). Patient preference for time of call was 26% (n = 16) morning;26% (n = 16) afternoon;49% (n = 29) said call anytime. Conclusions: Feedback was positive for the new entirely remote clinic service. The service now allocates time slots to improve the user experience. Continuing to develop this service with user feedback is an ongoing priority as virtual services will be at the forefront of future CF care.

The validity of the diabetes self-management questionnaire (DSMQ) in Hungarian patients with type 2 diabetes

BackgroundA wide range of measuring instruments are available for diabetes self-management. According to several studies, a relatively new instrument, the diabetes self-management questionnaire (DSMQ), shows a consistent relationship with outcomes of diabetes treatment as well, such as glycated hemoglobin (HbA1c). Furthermore, the questionnaire is short, but covers the main aspects of diabetes management. Given the increasing prevalence of diabetes in Hungary, our goal was to adapt this user-friendly questionnaire and analyze its validity.MethodsAfter the standard translation process, we analyzed a sample of 221 people. The construct validity of the questionnaire was tested with HbA1c and body mass index. Morisky Medication Adherence Scale-8 values were tested via Pearson correlations. Known-groups validity of the DSMQ in relation to groups based on glycemic control levels was investigated using one-way ANOVA.ResultsThe “sum scale” of the questionnaire and the HbA1c values show an inverse relationship (r = − 0.253, p < 0.01). Body mass index was related to the “sum scale” (r = − 0.214, p < 0.01) and to the “physical activity” (r = − 0.219, p < 0.01), while questionnaire results reflecting medication adherence correlated with the “glucose management” (r = − 0.291, p < 0.01), “health-care use” subscale (r = 0.236, p < 0.01) and the “sum scale” (r = 0.281, p < 0.01). A significant difference (F = 6.225, p = 0.002) was found between the DSMQ mean scores of the three groups, defined by good, medium, and poor glycemic control levels.ConclusionsThe Hungarian version of the DSMQ was considered a valid tool for the measurement of diabetes self-management. With its help, problematic areas of self-management could be uncovered, and interventions can be improved.

Exploring the efficiency of the Tilburg Frailty Indicator: a review

Due to rapidly aging human populations, frailty has become an essential concept, as it identifies older people who have higher risk of adverse outcomes, such as disability, institutionalization, lower quality of life, and premature death. The Tilburg Frailty Indicator (TFI) is a user-friendly questionnaire based on a multidimensional approach to frailty, assessing physical, psychologic, and social aspects of human functioning. This review aims to explore the efficiency of the TFI in assessing frailty as a means to carry out research into the antecedents and consequences of frailty, and its use both in daily practice and for future intervention studies. Using a multidimensional approach to frailty, in contexts where health care professionals or researchers may have no time to interview or examine the client, we recommend employing the TFI because there is robust evidence of its reliability and validity and it is easy and quick to administer. More studies are needed to establish whether the TFI is suitable for intervention studies not only in the community, but also for specific groups such as patients in the hospital or admitted to an emergency department. We conclude that it is important to not only determine the deficits that frail older people may have, but also to assess their balancing strengths and resources. In order to be able to meet the individual needs of frail older persons, traditional and often fragmented elderly care should be developed toward a more proactive elderly care, in which frail older persons and their informal network are in charge.

Support Needs and Coping Strategies as Predictors of Stress Level among Mothers of Children with Autism Spectrum Disorder.

This study examined maternal stress, coping strategies, and support needs among mothers of children with Autism Spectrum Disorder (ASD). A convenience sample of 70 mothers completed the Parent Stress Index Short Form (PSI-SF), Coping Health Inventory for Parents (CHIP), and Modified Family Needs Questionnaire (FNQ). PSI-SF scores reflected clinically significant levels of stress for 77% of mothers, and mothers identified 62.4% of important needs as unmet. The five most frequently reported important unmet needs were (1) financial support; (2) break from responsibilities; (3) understanding of other after-school program children; (4) rest/sleep; (5) help remaining hopeful about the future. Most coping strategies (81%) were identified as helpful. Additionally, both coping strategies and support needs served as predictors for maternal stress. Maternal stress scores decreased by .402 points for each percent increase in helpful coping strategy, and stress scores increased by .529 points with each percent increase in unmet needs. Given large variation in questionnaire responses across participants and studies, utilization of user-friendly questionnaires, such as the PSI-SF, CHIP, and FNQ, is advocated to determine the evolving important needs unique to each family over the child's lifetime as well as guide prioritization of care, compilation of resources, and referrals for additional services.

Therapeutic Alliance in Patients With Schizophrenia: Introduction of a New Rating Instrument.

The quality of the patient-psychiatrist relationship can be seen as a cornerstone of adherence to medications in patients with chronic psychiatric disorders. Although therapeutic alliance in psychotherapy has been investigated broadly, it has received little attention in the context of medication adherence. The goal of this study was to develop and validate a user-friendly questionnaire for the assessment of therapeutic alliance in clinically stable outpatients with schizophrenia. The "Brief Questionnaire on Therapeutic Alliance" (BQTA) addresses both the physician and the patient, each of whom responds to 5 items that focus on important domains of the therapeutic alliance. Psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS) and patients' attitudes toward the illness and medication were assessed using the Drug Attitude Inventory (DAI). A total of 61 patients who met ICD-10 criteria for schizophrenia spectrum disorders and their treating psychiatrists were included in the study. Overall, patients and psychiatrists gave high (ie, favorable) ratings on all BQTA items. The 5 patient-related items showed high internal consistency (Cronbach α=0.77), whereas physician-related items showed slightly less internal consistency (Cronbach α=0.68). The concordance between patient and physician ratings was fair, although statistically significant (κ=0.33, P=0.007). Physicians' total score on the BQTA was moderately correlated with patients' PANSS total score and with the DAI total score and its compliance subscale, whereas patients' total score on the BQTA did not correlate with DAI or PANSS scores. The BQTA was found to cover crucial aspects of the doctor-patient relationship in chronically ill individuals with schizophrenia. Further validation will shed more light on the usefulness of this questionnaire.

Influence of hearing aids on monosyllabic test score and subjective everyday hearing

Pure tone and speech audiometry are essential methods for examining the indication for hearing aids, as well as for hearing aid evaluation. Additionally, the subjective benefit of hearing aids has to be evaluated with appropriate questionnaires. The aim of the present study was to investigate the correlation between speech audiometry data and the results of asimple and user-friendly questionnaire, as well as to provide normative data for subjective benefit. Data from 136hearing aid users with bilateral sensorineural hearing loss were analyzed retrospectively. Pure tone thresholds and Freiburg monosyllabic speech perception in the binaural situation were measured at 65dB in quiet and in noise (signal-to-noise ratio, SNR= +5dB), with and without hearing aids. Additionally, subjective hearing in everyday life was recorded using the 12-item Oldenburg Inventory. Improvement of speech perception with hearing aids for the Freiburg monosyllabic test in quiet was 32.0percentage points on average; in noise, there was an average improvement of 16.4percentage points. There was astrong correlation between the results of pure tone and speech audiometry. With hearing aids, patients scored their everyday hearing using the Oldenburg Inventory on average 1.4scale points better than without hearing aids. Results of the Oldenburg Inventory correlate with both pure tone and speech audiometry. Hearing aid evaluation should include both speech audiometry and systematic measurement of the subjective benefit using asuitable questionnaire. In combination, the Freiburg monosyllabic test and the Oldenburg Inventory allow for quick and comprehensive evaluation.

Development of a Pre- and Postnatal Bonding Scale (PPBS)

Objectives: Bonding is a major topic in the field of developmental psychology, due to its importance for adequate child’s development. Studies investigating the relationship between prenatal and postnatal bonding show moderate correlations. However, an important limitation is that no similar instrument was used to measure bonding pre- and postnatally. For the current study, a user-friendly questionnaire was developed to assess maternal bonding during pregnancy and postpartum. Psychometric properties were investigated. Methods: In a large sample of 1,050 pregnant women, 14 positive items, based on the literature, were used to construct a pre- and postnatal bonding questionnaire. The sample was randomly split into two equal subsamples: group I was used for reliability and Exploratory Factor Analysis, group II for Confirmatory Factor Analysis. The bonding scale was assessed at 32 weeks’ pregnancy and at eight and 12 months postpartum. The Edinburgh Depression Scale (EDS) and the subscale Partner Involvement of the Tilburg Pregnancy Distress Scale (TPDS) were used to assess construct validity. Results: After CFA, a five-item bonding scale remained with excellent model fit (CFI: 0.97, TLI: 0.97, NFI: 0.98; RMSEA: 0.06, lower bound 0.03. Cronbach alpha’s at 32 weeks’ gestation and at eight and 12 months postpartum were: 0.87, 0.80 and 0.79, respectively. Test-retest correlations of the PPBS at 32 weeks’ gestation and at eight and 12 months postpartum were high: 0.42 and 0.41, and 0.67 between eight and 12 months postpartum, respectively. At 32 weeks’ gestation, the PPBS correlated significantly with partner support (TPDS): 0.38. and depression (EDS): -0.24. Similar correlations with depression were found at eight and 12 months postpartum. Conclusion: The five-item PPBS seems to be a user-friendly self-rating scale with good psychometric properties and construct validity, both pre- and postnatally.

Systematic content evaluation and review of measurement properties of questionnaires for measuring self-reported fatigue among older people.

The assessment of fatigue in older people requires simple and user-friendly questionnaires that capture the phenomenon, yet are free from items indistinguishable from other disorders and experiences. This study aimed to evaluate the content, and systematically review and rate the measurement properties of self-report questionnaires for measuring fatigue, in order to identify the most suitable questionnaires for older people. This study firstly involved identification of questionnaires that purport to measure self-reported fatigue, and evaluation of the content using a rating scale developed for the purpose from contemporary understanding of the construct. Secondly, for the questionnaires that had acceptable content, we identified studies reporting measurement properties and rated the methodological quality of those studies according to the COSMIN system. Finally, we extracted and synthesised the results of the studies to give an overall rating for each questionnaire for each measurement property. The protocol was registered with PROSPERO (CRD42013005589). Of the 77 identified questionnaires, twelve were selected for review after content evaluation. Methodological quality varied, and there was a lack of information on measurement error and responsiveness. The PROMIS-Fatigue item bank and short forms perform the best. The FACIT-Fatigue scale, Parkinsons Fatigue Scale, Perform Questionnaire, and Uni-dimensional Fatigue Impact Scale also perform well and can be recommended. Minor modifications to improve performance are suggested. Further evaluation of unresolved measurement properties, particularly with samples including older people, is needed for all the recommended questionnaires.

Les questionnaires recommandés en médecine sexuelle

Screening, diagnosis and assessment of the management of male and female sexual dysfunctions have been greatly improved by the scientific development of self-administered questionnaires. Their use became the rule in clinical trials and epidemiological surveys. Nevertheless, their routine use has not yet become part of daily urological practice. Even if these tools replace neither the patient interview and medical history and the psychological and social context of the sexual behavior, nor clinical examination, they are of great assistance for determining management and are also highly reliable.Medical literature was reviewed and combined with expert opinion of the author.We present here several questionnaires which have been validated in their French version with the methodology for the calculation of the scores. The International Index of Erectile Function (15 items) and two abbreviated versions, the Erectile Function domain (six items) and the Sexual Health Inventory for Men (five questions) are mainly of use for patients with erectile dysfunction. They provide a robust classification of the severity of the condition. The Premature Ejaculation Profile (four questions) is used for patients with premature ejaculation. It describes premature ejaculation with the following criteria: time to ejaculation, control over ejaculation, the level of distress. The Male Health Sexual Questionnaire (25 questions) provides with a wider and more comprehensive approach to male sexuality of male sexuality including: erection, ejaculation, desire and satisfaction. This questionnaire is particularly useful to investigate ejaculatory disorders. Lastly, the Female Sexual Function Index (19 questions) is the tool of choice for female sexuality with questions regarding desire, arousal, lubrication, orgasm, satisfaction and pain.Validated, user-friendly questionnaires are available in French language for the diagnosis and the follow-up of sexual dysfunctions in both men and women.

Combining the qualitative and quantitative with the Q2 scenario technique — The case of transport and climate

Two recent trends in scenario making are the starting point of this study: the combination of qualitative and quantitative materials, and inclusion of many kinds of experts. We propose a new scenario technique Q2 that answers to these calls, and describe it step-by-step. Q2 scenarios consist of Delphi, cluster analysis of numerical material, qualitative content analysis of interviews, and a futures table. Most of the required tools and methods are well documented and commonly used, but their combination is original, particularly the explorative and disaggregative way both types of material are analysed and compressed into a futures table and further developed into scenarios. We demonstrate the methodology through a case: the growing Finnish transport sector that faces severe pressure to cut CO2 emissions. Finnish experts were asked about their views of the future up to 2050, using an interactive and user-friendly questionnaire, and interviews. An expertise matrix was formed in order to achieve a comprehensive coverage in terms of key expertise, education, organisation, age, and gender. By widening the concept of expertise, it is possible to get a large variety of viewpoints. The resulting scenarios reveal that reaching the CO2 targets will require a palette of technical, infrastructural, and behavioural changes.

Validity and reliability of the TED-QOL: a new three-item questionnaire to assess quality of life in thyroid eye disease

AimTo develop and test a user-friendly questionnaire for rapidly assessing quality of life (QOL) in thyroid eye disease (TED).MethodsA three-item questionnaire, the TED-QOL, was designed and compared to the 16-item...

Development and Psychometric Evaluation of the Knowledge Scale for Adults With Congenitally Malformed Hearts

Adults with congenitally malformed hearts have knowledge gaps regarding their heart condition, and their level of knowledge is not routinely assessed during follow-up. One reason for this is that there are few validated, user-friendly questionnaires to assess knowledge about congenital heart disease and its effects on daily life. Failure to identify low levels of knowledge could lead to less motivated and insecure individuals not actively involved in treatment and care of their heart condition. Therefore, the objective of this study was to develop and test a knowledge scale for adults with congenitally malformed hearts. The development and psychometric evaluation of the Knowledge Scale for Adults With Congenitally Malformed Hearts (KnoCoMH) followed 2 phases: (1) development and evaluation of the initial version, with face validity and content validity assessed by experts and adults with congenitally malformed hearts, and (2) evaluation and refinement of the KnoCoMH in adults with congenitally malformed hearts, including item difficulty level, internal consistency, and test-retest reliability. The development and evaluation of a knowledge scale for adults with congenitally malformed hearts resulted in the KnoCoMH including 46 items in 4 domains: General Knowledge, with a Kuder-Richardson formula 20 (KR-20) value of 0.68; Medical Treatment, with a KR-20 value of 0.74; Endocarditis Prophylaxis, with a KR-20 value of 0.90; and Contraceptives and Pregnancy, with a KR-20 value of 0.65. Test-retest evaluation showed significant correlations between 0.50 and 0.67 (P < .01) in all 4 domains. There was good variation in item difficulty, with a mean value of 0.56 in General Knowledge, 0.62 in Medical Treatment, 0.33 in Endocarditis Prophylaxis, and 0.48 in Contraceptives and Pregnancy. The KnoCoMH has acceptable psychometric properties for most of the knowledge domains included. It can be used for evaluating knowledge among adults with congenitally malformed hearts and its associations with other outcomes. However, further studies are advisable to test construct validity, predictive validity, and responsiveness.