ABSTRACT
INTRODUCTION: Pyrosis symptoms and their impact on the quality of life related with health (QLRH) are frequently evaluated in clinical trials. When a questionnaire is translated into a language other than the original, it is necessary to have a linguistic validation, although this is not sufficient unless the psychometric characteristics have been verified. This study aims to document the psychometric characteristics of the translation to Spanish of the gastrointestinal symptoms rating scale (GSRS) and quality of life in reflux and dyspepsia (QOLRAD). MATERIAL AND METHOD: One hundred fifty eight patients with pyrosis symptoms (age: 51.0; SD: 16.3 years; men: 42.4%) completed the translation to Spanish of the GSRS, the pyrosis version of the QOLRAD, the Short-Form-36 (SF-36) and the hospital of anxiety and depression (HAD) scale. Seventy six patients were given an appointment for a second visit after one week, to fill out the GSRS and QOLRAD again. RESULTS: The reliability of the internal consistence of the GSRS was 0.59-0.83 and that of the QOLRAD: 0.87-0.95, and test-retest reliability of the GSRS was 0.44-0.63 and QOLRAD: 0.77-0.85. Score of the important domains of the GSRS "reflux", "abdominal pain" and "indigestion" and above all those of the QOLRAD correlated significantly. The domain "abdominal pain" of the GSRS had a strong correlation (negative) with the relevant domains of the SF-36. The QOLRAD domains significantly correlated with all the related domains of the SF-36. CONCLUSIONS: The psychometric characteristics of the translation to Spanish of the GSRS and QOLRAD were good, with satisfactory reliability and validity. However, the test-retest reliability of the "reflux" domain of the GSRS was not optimum.
Subject(s)
Dyspepsia/psychology , Gastroesophageal Reflux/psychology , Sickness Impact Profile , Adult , Dyspepsia/physiopathology , Female , Gastroesophageal Reflux/physiopathology , Humans , Language , Male , Middle Aged , Psychometrics , Quality of Life , SpainABSTRACT
INTRODUCTION: The clinical and socioeconomic burden of gastroesophageal reflux disease (GERD) is considerable. AIM: The aim of this study was to describe the impact of heartburn on patients' health-related quality of life (HRQL) in Spain, using validated generic and disease-specific instruments to measure patient-reported outcomes. PATIENTS AND METHODS: Patients with symptoms of heartburn completed the Spanish versions of the Gastrointestinal Symptom Rating Scale (GSRS), the Quality of Life in Reflux and Dyspepsia questionnaire (QOLRAD), the Short Form-36 (SF-36) and the Hospital Anxiety and Depression (HAD) scale. The frequency and severity of heartburn in the previous 7 days were also recorded. RESULTS: One hundred fifty-eight patients completed the assessments (mean age: 51 years, SD = 16; 58% female). Sixty-one percent of the patients had moderate symptoms and 73% had symptoms on three or more days in the previous week. Patients were most bothered by symptoms of reflux (mean GSRS score of 3.8 on a scale of 1 [not bothered] to 7 [very bothered]), abdominal pain (3.1) and indigestion (3.1). As a result of their symptoms, patients experienced problems with food and drink (mean QOLRAD score of 4.5 on a scale of 1 to 7, where 1 represents the most severe impact on daily functioning), impaired vitality (4.7) and emotional distress (4.8). This led to impaired overall HRQL across all domains (mean SF-36 score of this heartburn population compared with a general population in Spain). The HAD scale showed that 28% of patients were anxious and 13% were depressed. CONCLUSION: There is consistent evidence that GERD substantially impairs all aspects of HRQL.
Subject(s)
Gastroesophageal Reflux/complications , Quality of Life , Adult , Aged , Female , Humans , Male , Middle Aged , Spain , Surveys and QuestionnairesABSTRACT
BACKGROUND: The clinical and socioeconomic burden of gastro-esophageal reflux disease (GERD) is considerable. The primary symptom of GERD is heartburn, but it may also be associated with extraesophageal manifestations, such as asthma, chest pain and otolaryngologic disorders. AIM: To describe the impact of heartburn on patients' Health-Related Quality of Life (HRQL) in Germany, using validated generic and disease-specific instruments to measure patient-reported outcomes. METHOD: Patients with symptoms of heartburn completed the German versions of the Gastrointestinal Symptom Rating Scale (GSRS), the Quality of Life in Reflux and Dyspepsia questionnaire (QOLRAD), the Short Form-36 (SF-36) and the Hospital Anxiety and Depression (HAD) scale. Frequency and severity of heartburn during the previous 7 days were also recorded. RESULTS: 142 consecutive patients completed the assessments (mean age of 47.5 years, SD = 14.6; 55.6 % female). 70 % of patients had moderate symptoms. Over half (68 %) had symptoms on more than 4 days in the previous week. Patients were most bothered by symptoms of reflux with a mean GSRS score, (ranges from 1 [not bothered] to 7 [very bothered]), of 3.9, indigestion of 3.3 and abdominal pain of 3.0, respectively. As a result of their symptoms, patients experienced problems with food and drink. The mean QOLRAD score (ranges from 1 to 7; the lower the value the more severe the impact on quality of life) of daily functioning was 4.4, impaired vitality 4.6, emotional distress 5.0 and sleep disturbance 5.1, respectively. This led to impaired overall HRQL across all domains (mean SF-36 score of this heartburn population compared to a general population in Germany). Using HAD, 25 % of patients were anxious and 8 % were depressed. CONCLUSION: There is consistent evidence that heartburn substantially impairs all aspects of health-related quality of life.
Subject(s)
Cost of Illness , Gastroesophageal Reflux , Heartburn , Quality of Life , Adult , Aged , Data Interpretation, Statistical , Female , Gastroesophageal Reflux/psychology , Heartburn/psychology , Humans , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
The aim of this study was to investigate the factor structure of the 15-item Dental Beliefs Survey (DBS) in a population of dental phobic patients (n=362). Exploratory (EFA) and confirmatory (CFA) factor analyses were used. The EFA indicated three factors: 'communication', 'trust', and 'fear of negative information'. However, the EFA further suggested a general factor with all 15 items. By using the CFA, five factors were found based on the EFA solution and the original DBS dimensions. A general factor, 'social interaction distress in dental treatment', and four more narrow dimensions, 'communication', 'trust', 'fear of negative information' (originally labelled 'belittlement'), and 'lack of control', was the most adequate result with regard to theoretical and statistical properties. However, some items in the factors were partly different from the original version of the DBS. In conclusion, the DBS attempts to measure a complex phenomenon with regard to patients' perceptions and attitudes to dental care. This study has revealed psychometric properties of the DBS in a population of dental phobic patients. The important finding was a general dimension, which suggests the use of DBS as an overall measure of dental beliefs. However, more research is needed in epidemiological and clinical studies with non-phobic individuals.
Subject(s)
Attitude to Health , Dental Anxiety/psychology , Dental Care/psychology , Personality Tests/statistics & numerical data , Adult , Aged , Attitude of Health Personnel , Chi-Square Distribution , Communication , Dentist-Patient Relations , Factor Analysis, Statistical , Female , Humans , Internal-External Control , Interpersonal Relations , Male , Middle Aged , Psychometrics , Statistics as Topic , Stress, Psychological/psychologyABSTRACT
Thirty semi-structured interviews were conducted with 5 dentists (3 male and 2 female) after first and second consultations with 15 newly enrolled dental phobic patients (2 male and 13 female) in a clinic specializing in the treatment of odontophobia. Analysis of the transcribed interviews was influenced by the principles of grounded theory. Five concepts/higher-order categories were grounded in the data: 1 core category: 'Relatedness, based on affective resonance and concordant roles' and 4 additional higher-order categories: 'the dental phobic patient's emotions'; 'the patient's verbal and non-verbal cues'; 'the dentist's role as a clinician: professional interpersonal skills'; and 'the dentist's role as a fellow-being: general interpersonal skills'. The model developed describes the dynamics of the dentist patient interaction and has a theoretical application.
Subject(s)
Dental Anxiety/psychology , Dental Care/psychology , Dentist-Patient Relations , Adult , Affect , Clinical Competence , Communication , Cues , Dental Anxiety/prevention & control , Female , Humans , Interpersonal Relations , Interviews as Topic , Male , Middle Aged , Models, Psychological , Nonverbal Communication , Reproducibility of Results , Stress, Psychological/psychology , Videotape RecordingABSTRACT
In this article we report on how 64 dentists working in a big city in southern Sweden view their profession. The dentists ranged in age from 30 to 70 years (as it was indicated in intervals of 10 years). Their professional experience ranged from 2 to 44 years (mean, 23 years). We collected their views on the ideal skills of a good dentist by means of a questionnaire. From this material we identified three categories: 1) interpersonal skills; 2) clinical skills; and 3) others, such as self-confidence, stress tolerance, and managerial and administrative skills. Next, they rated the relative importance of a number of listed attributes in dentistry in this order: contact with patients, communication skills, empathy, manual skills, and theory. Finally, they described a number of aspects of their profession. We conclude that the importance of interpersonal skills, as well as stress tolerance and administrative skills, is emphasized by experienced practitioners but that these skills are not focused on in the dental curriculum.
Subject(s)
Attitude of Health Personnel , Dentist-Patient Relations , Dentistry , Dentists , Adult , Aged , Clinical Competence , Communication , Curriculum , Education, Dental , Empathy , Female , Humans , Interpersonal Relations , Male , Middle Aged , Motor Skills/physiology , Occupational Diseases/prevention & control , Practice Management, Dental/organization & administration , Professional Competence , Self Concept , Stress, Psychological/prevention & control , Surveys and Questionnaires , Sweden , Time Factors , Urban PopulationABSTRACT
In 21 patients the treatment described in an original communication by Bousquet for chronic anteromedial anterolateral instability of the knee was applied. The basic components of treatment were static-dynamic substitution of the anterior crucial ligaments by the proximally pedunculated gracilis tendon, tightening of the dorsomedial capsule, bypass of the popliteal tendon, revision of the joint, treatment of medial instabilities with conservation of the menisci if possible, postoperative treatment without plaster and mobilization without weight-bearing until active bending at 90 degrees was attained. Of the 21 patients treated between April 1983 and December 1984, 18 were examined again an average of 52.5 months after treatment. According to a postoperative examination checklist, results were found to be excellent in 8 cases, good in 9, moderate in 1 and poor in another case. In spite of the good results a definite opinion of the method cannot be given.
