Who are your public? A survey comparing the views of a population-based sample with those of a community-based public forum in Scotland.

UNLABELLED: This paper describes a questionnaire survey, carried out in the NHS Grampian area of NE Scotland. It compares responses from 84 members of a community-based public forum (39 of whom were sent questionnaires) and a random sample of 10,000 adults registered with general practices in Grampian (2,449 of whom were sent questionnaires). MAIN OUTCOME MEASURES: differences in demographic profiles and opinions about different feedback mechanisms (patient representative, telephone helpline and NHS feedback website) and their likely effectiveness in three different scenarios. 46% of community forum members consented to take part compared to 24% of the population sample. Younger people and residents in more deprived areas were under-represented in both groups. Community forum members were older (only one under 40 years of age), more likely to be retired and not in employment. Internet access was similar in both groups. Opinions about different systems of feeding back views to the NHS varied but community forum members were more likely to be positive in their opinions about the value of different feedback mechanisms and less likely to think they were 'a waste of NHS money'. Responses to three scenarios revealed similar opinions, but on some issues, there were key differences in the responses from the two groups. Community forum members were more likely to consider writing a letter as a means of getting something done about a problem and were more likely to talk to their GP if experiencing a problem than respondents in the main group. In general their responses were more positive towards the NHS. There is a need to ensure a broad basis for membership of public forums and/or proactively seek the views of groups that are under-represented if public forums are to be used to represent the views of the wider population and inform decision making in the NHS.

Developing consumer-led maternity services: a survey of women's views in a local healthcare setting.

OBJECTIVE: This paper describes a prospective study of women's views and experiences of maternity services. The aim was to examine the way women make choices and decisions about maternity care and the factors which influence decision making, with a view to developing services which best meet the needs of the population. Patient choice issues reviewed included: choice of place of birth, choice of lead professional and choices in labour management. DESIGN, SETTING AND PARTICIPANTS: A cohort of women attending maternity booking clinics, within the catchment area of Peterhead Maternity Unit (PMU) in north-east Scotland, were surveyed by means of postal questionnaires at three stages during their contact with maternity services. A subset of women also took part in in-depth interviews. RESULTS: Not all women were given information about all the available options for place of birth and many women were unclear of the differences between them. Factors influencing choice of place of birth can change, with the medical aspects of maternity care becoming more important as the pregnancy progresses. Women rated the importance of seeing the same staff at antenatal visits highly, but were less concerned with their ability to choose which professional to see. More importance was attached to being able to choose a particular midwife rather than a particular obstetrician. Women's choices with regard to labour management were largely met. Insufficient information, however, was provided about choices in pain relief. CONCLUSIONS: The survey revealed the importance of locally based research, involving all stakeholders, in developing services which best meet the needs of a population.

The requirement for prior consent to participate on survey response rates: a population-based survey in Grampian.

BACKGROUND: A survey was carried out in the Grampian region of Scotland with a random sample of 10,000 adults registered with a General Practitioner in Grampian. The study complied with new legislation requiring a two-stage approach to identify and recruit participants, and examined the implications of this for response rates, non-response bias and speed of response. METHODS: A two-stage survey was carried out consistent with new confidentiality guidelines. Individuals were contacted by post and asked by the Director of Public Health to consent to receive a postal or electronic questionnaire about communicating their views to the NHS. Those who consented were then sent questionnaires. Response rates at both stages were measured. RESULTS: 25% of people returned signed consent forms and were invited to complete questionnaires. Respondents at the consent stage were more likely to be female (odds ratio (OR) response rate of women compared to men = 1.5, 95% CI 1.4, 1.7), less likely to live in deprived postal areas (OR = 0.59, 95% CI 0.45, 0.78) and more likely to be older (OR for people born in 1930-39 compared to people born in 1970-79 = 2.82, 95% CI 2.36, 3.37). 80% of people who were invited to complete questionnaires returned them. Response rates were higher among older age groups. The overall response rate to the survey was 20%, relative to the original number approached for consent (1951/10000). CONCLUSION: The requirement of a separate, prior consent stage may significantly reduce overall survey response rates and necessitate the use of substantially larger initial samples for population surveys. It may also exacerbate non-response bias with respect to demographic variables.

Public knowledge, attitudes and behaviour regarding antibiotics--a survey of patients in general practice.

OBJECTIVE: To assess public knowledge, attitudes and behaviour regarding antibiotics to provide information for a local health education policy. DESIGN: Postal survey to 605 patients registered with two general medical practices in Grampian, North-East Scotland (351 respondents, 59.3%) in February/ March 2000. Questionnaire topics covered attitudes, knowledge and behaviour towards antibiotic use. RESULTS: 326 (93%) had experience of antibiotic use and 319 (81%) were happy to take antibiotics when necessary. 158 (45%) were concerned about antibiotic resistance. Few would expect antibiotics to treat a slight cold or heavy cold, but around half would expect antibiotics for very sore throats and influenza. 262 (75%) indicated they would ask a pharmacist for advice about the treatment of RTI. Most respondents experienced at least one episode of RTI during the review period. 280 (80%) provided details of their most recent episode; most self-treated, 57 consulted a doctor of whom 43 (75%) were prescribed antibiotics. CONCLUSIONS: Antibiotic resistance is a matter of concern for the public. Mixed opinions about the use of antibiotics for common respiratory tract infections were heard. Encouragingly the majority of people suffering an RTI during the review period treated themselves with paracetamol-based products for symptom relief. Those who consulted a doctor were in the minority but were likely to be prescribed antibiotics. Future local health education initiatives should target antibiotic use for sore throats as well as colds and 'flu.