The use of outcome measures to formulate intervention strategies.
To investigate the relative value of the use of open-ended and structured questionnaires in the determination of the most appropriate management of patients in a busy audiological rehabilitation clinic. An open set questionnaire was sent to 56 consecutive patients before clinic attendance, and they were asked to rate the severity of the problems listed on arrival at the clinic. They subsequently were administered the Hearing Disability and Handicap Scale (HDHS), which was not scored until after management decisions had been made. The implications of the results of both questionnaires separately and together for patient management were compared. The Problem Questionnaire highlighted a number of areas in terms of Activity Limitation (Disability) not covered in the HDHS, some of which, such as employment effects, were considered to be of considerable importance to the patients. However, in the field of more general Participation Restriction (Handicap), the structured questionnaire highlighted a number of important areas not volunteered by the patient. Although the open-set Problem Questionnaire approach is valid in the domain of Activity Limitation, it needs to be supplemented by an additional measure of Participation Restriction, either open-set or structured, to ensure optimal patient management.