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Validation of an asthma questionnaire for use in healthcare workers.

ABSTRACT: Previous studies have described increased occurrence of asthma among healthcare workers, but to our knowledge there are no validated survey questionnaires with which to study this occupational group.To develop, validate, and refine a new survey instrument on asthma for use in epidemiological studies of healthcare workers.An initial draft questionnaire, designed by a multidisciplinary team, used previously validated questions where possible; the occupational exposure section was developed by updating health services specific chemical lists through hospital walk-through surveys and review of material safety data sheets. A cross-sectional validation study was conducted in 118 non-smoking subjects, who also underwent bronchial challenge testing, an interview with an industrial hygienist, and measurement of specific IgE antibodies to common aeroallergens.The final version consisted of 43 main questions in four sections. Time to completion of the questionnaire ranged from 13 to 25 minutes. Test-retest reliability of asthma and allergy items ranged from 75% to 94%, and internal consistency for these items was excellent (Cronbach's alpha > or = 0.86). Against methacholine challenge, an eight item combination of asthma related symptoms had a sensitivity of 71% and specificity of 70%; against a physician diagnosis of asthma, this same combination showed a sensitivity of 79% and specificity of 98%. Agreement between self-reported exposures and industrial hygienist review was similar to previous studies and only moderate, indicating the need to incorporate more reliable methods of exposure assessment. Against the aerollergen panel, the best combinations of sensitivity and specificity were obtained for a history of allergies to dust, dust mite, and animals.Initial evaluation of this new questionnaire indicates good validity and reliability, and further field testing and cross-validation in a larger healthcare worker population is in progress. The need for development of more reliable occupational exposure assessment methods that go beyond self-report is underscored.

SUBMITTER: Delclos GL

PROVIDER: S-EPMC2078145 | biostudies-literature | 2006 Mar

REPOSITORIES: biostudies-literature

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Validation of an asthma questionnaire for use in healthcare workers.

Delclos G L GL Arif A A AA Aday L L Carson A A Lai D D Lusk C C Stock T T Symanski E E Whitehead L W LW Benavides F G FG Antó J M JM

Occupational and environmental medicine 20060301 3

<h4>Background</h4>Previous studies have described increased occurrence of asthma among healthcare workers, but to our knowledge there are no validated survey questionnaires with which to study this occupational group.<h4>Aims</h4>To develop, validate, and refine a new survey instrument on asthma for use in epidemiological studies of healthcare workers.<h4>Methods</h4>An initial draft questionnaire, designed by a multidisciplinary team, used previously validated questions where possible; the occ ...[more]

PMID: 16497858

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Project description:BACKGROUND:A valid and efficient stress measure is important for clinical and community settings. The objectives of this study were to translate the English version of the Perceived Stress Questionnaire (PSQ) into Chinese and to assess the psychometric properties of the Chinese version of the PSQ (C-PSQ). The C-PSQ evaluates subjective experiences of stress instead of a specific and objective status. METHODS:Forward translations and back translations were used to translate the PSQ into Chinese. We used the C-PSQ to survey 2798 medical students and workers at three study sites in China from 2015 to 2017. Applying Rasch analysis (RA) and factor analysis (FA), we examined the measurement properties of the C-PSQ. Data were analyzed using the Rasch model for item fit, local dependence (LD), differential item functioning (DIF), unidimensionality, separation and reliability, response forms and person-item map. We first optimized the item selection in the Chinese version to maximize its psychometric quality. Second, we used cross-validation, by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), to determine the best fitting model in comparison to the different variants. Measurement invariance (MI) was tested using multi-group CFA across subgroups (medical students vs. medical workers). We evaluated validity of the C-PSQ using the criterion instruments, such as the Chinese version of the Perceived Stress Scale (PSS-10), the Short Form-8 Health Survey (SF-8) and the Goldberg Anxiety and Depression Scale (GADS). Reliability was assessed using internal consistency (Cronbach's alpha, Guttman's lambda-2, and McDonald's omegas) and reproducibility (test-retest correlation and intraclass correlation coefficient, [ICC]). RESULTS:Infit and/or outfit values indicated that all items fitted the Rasch model. Three item pairs presented local dependency (residual correlations >?0.30). Ten items showed DIF. Dimensionality instruction suggested that eight items should be deleted. One item showed low discrimination. Thirteen items from the original PSQ were retained in the C-PSQ adaptation (i.e. C-PSQ-13). We tested and verified four feasible models to perform EFA. Built on the EFA models, the optimal CFA model included two first-order factors (i.e. constraint and imbalance) and a second-order factor (i.e., perceived stress). The first-order model had acceptable goodness of fit (Normed Chi-square?=?8.489, TLI?=?0.957, CFI?=?0.965, WRMR?=?1.637, RMSEA [90% CI]?=?0.078 [0.072, 0.084]). The second-order model showed identical model fit. Person separation index (PSI) and person reliability (PR) were 2.42 and 0.85, respectively. Response forms were adequate, item difficulty matched respondents' ability levels, and unidimensionality was found in the two factors. Multi-group CFA showed validity of the optimal model. Concurrent validity of the C-PSQ-13 was 0.777, -?0.595 and 0.584 (Spearman correlation, P <?0.001, the same hereinafter) for the Chinese version of the PSS-10, SF-8, and GADS. For reliability analyses, internal consistency of the C-PSQ-13 was 0.878 (Cronbach's alpha), 0.880 (Guttman's lambda-2), and 0.880 (McDonald's omegas); test-retest correlation and ICC were 0.782 and 0.805 in a 2-day interval, respectively. CONCLUSION:The C-PSQ-13 shows good metric characteristics for most indicators, which could contribute to stress research given its validity and economy. This study also contributes to the evidence based regarding between-group factorial structure analysis.

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Validation of an asthma questionnaire for use in healthcare workers.

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Validation of an asthma questionnaire for use in healthcare workers.

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