Nichol K L, Korn J E, Baum P
Section of General Internal Medicine, VA Medical Center, Minneapolis, MN 55417.
Am J Prev Med. 1991 Jul-Aug;7(4):199-203.
As part of an effort to evaluate the effectiveness of a multifaceted, institution-wide influenza vaccination program, we mailed a self-administered postcard questionnaire to 500 randomly selected outpatients following both the 1987-1988 and 1988-1989 immunization seasons. The postcard asked if the patients received influenza vaccine, where they were immunized, whether they had any high-risk medical illnesses, their age at their last birthday, and their name. To assess the validity of the questionnaire, following the 1988 survey, we selected a 25% systematic sample of respondents and compared survey responses with medical record documentation. Response rates for the surveys were 77.6% for the 1988 survey (two mailings) and 86.5% for the 1989 survey (three mailings). Ninety-four percent (n = 89) of charts selected for audit were successfully reviewed. Agreement between questionnaire responses and medical records was excellent, with greater than 90% agreement and kappas of .8 to .9 for classifying patients as high-risk and receipt of vaccine at the Department of Veterans' Affairs Medical Center. For other data, agreement ranged from 84% to 96% with kappas of .6 to .75. Responses to the 1989 survey also demonstrated the importance of sample frame definition and response wave on estimates of risk characteristics and vaccination rates. A self-administered postcard questionnaire is a valid tool for estimating outpatient risk characteristics and influenza vaccination rates.
作为评估一项多方面、全机构范围流感疫苗接种计划有效性工作的一部分，我们在1987 - 1988年和1988 - 1989年免疫季节之后，向500名随机挑选的门诊患者邮寄了一份自行填写的明信片调查问卷。明信片询问患者是否接种了流感疫苗、在哪里接种、是否有任何高危疾病、他们上一个生日时的年龄以及他们的姓名。为了评估问卷的有效性，在1988年调查之后，我们从受访者中选取了25%的系统样本，并将调查回复与病历记录进行比较。1988年调查（两次邮寄）的回复率为77.6%，1989年调查（三次邮寄）的回复率为86.5%。选定进行审核的病历中有94%（n = 89）得到了成功审查。问卷回复与病历之间的一致性非常好，在将患者分类为高危以及在退伍军人事务医疗中心接种疫苗方面，一致性超过90%，kappa值在0.8至0.9之间。对于其他数据，一致性在84%至96%之间，kappa值在0.6至0.75之间。1989年调查的回复还表明了样本框定义和回复轮次对风险特征和疫苗接种率估计的重要性。自行填写的明信片调查问卷是估计门诊患者风险特征和流感疫苗接种率的有效工具。
