Write A Chronological Report About The Use Of Questionnaires In Determining Environmental Risk Factors For Myopia.

Use Of Questionnaires In Determining Environmental Risk Factors For Myopia

Explain how researchers went from wide range of questions to specific questions, and also focus on specific factors such as time spent outdoors, physical activities and near work.

Background about questionnaires

Questionnaires have their origin from the first United States census in 1790. The U.S. Census Bureau collected data using schedules (questionnaires) which were supplied in paper form with headings having titles such as race, sex, age, and name. The Congress authorized printing of papers to make them uniform for use in the United States (U.S Census bureau, 2016). In 1940, questionnaires were used in counting the population and collecting data on housing. By 1960, the census were combining questions about the population and housing in a single questionnaire. The census taker mailed questionnaires to households and completed them (U.S Census bureau, 2016). Two questionnaires were used by the census bureau used two questionnaires between 1970 and 2000. Households received short-form questionnaires asking minimum questions. Sampled households received long-form questionnaire, which had additional questions about households. The 2010 census involved one questionnaire with only ten questions.

Gault (2012) comments that the larger proportion of current psychological literature is sourced from data obtained through questionnaires. Most people regard questionnaires as a reliable scientific method. Questionnaires take statistics, which begin by enumerating the fighting men in 1835. They studied the social phenomena.

Basic forms of questionnaires

Questionnaires are grouped into structured and unstructured questionnaires.

Structured questionnaire have definite and concrete questions, are prepared in advance and initiate a formal inquiry. They supplement and check previously accumulated data. Structured questionnaire are used in economic studies, social problems, in studying administrative policies and changes. Unstructured questionnaires guide the interviewer when conducting interviews. They are flexible to work with and are used in studying family groups, and personal experiences and beliefs.

Questionnaires can also be classified according to questions.

In open-ended questionnaire, the respondent is free to express his views and ideas. They conduct intensive studies of limited cases. The questionnaire allows raising issues without a structure to be followed by the respondents while replying. The order of questions is pre-determined by nature. The responses are not pre-determined. Interviewers can get extra information and unexpected suggestions. Qualitative questions are open-ended (Kirklees, 2003). Open-ended questions demand feedback and suggestions for improving certain situations.

Close-ended questionnaire has limited responses to stated alternatives. It is not limited but their numbers could be odd or even. They require respondents to choose answers from multiple choices given. The alternatives have yes or no choices leaving the respondent without chance to express their judgment (Singh, 2010). Mixed questionnaire are rarely used. They have pictures to promote the interest of answering questions. They are used to study social attitudes and pre-judice among children. Closed format questionnaires are easy to perform preliminary analysis. The questions are appropriate when calculating statistical data and percentages from known answers. Closed ended questionnaires are asked to different groups at different intervals to track their opinions on certain products.

Strengths and weaknesses–bring out strengths

Questionnaires are written interviews, which are carried by telephone, by post or face-to-face. They are used to research type A personality and asses events in life causing stress in human beings. Questionnaires are preferred because they are cheap, efficient, and quicker ways of obtaining large amounts of information from sampled population (Reja et al., 2003).

Data is quickly collected because they do not require researchers to be present unlike in interviews where researchers have to be present for clarification and explanation (Popper, 2004).

Questions are practical when assessing large populations of people where interviews prove difficult to use. Responses are gathered in standard ways, making questionnaires more objective than interviews. Questionnaires collect potential information from target customers. Questionnaires are cost-efficient especially when compared to telephone interviews (Surrey, 2016). Questionnaires are affordable and reliable when gathering qualitative and quantitative data especially when standard ways are used to gather information. Current advances in technology make questionnaires easily administered through emails and websites to target respondents with little or no cost.

Questionnaires are practical because specific questions can be asked to specific target groups to get accurate information. Open-ended questions are specifically practical when huge data require to be gathered. Speedy results are obtained quickly and easily through mobile and online tools making owners to gain insights in shorter times (Debois, 2016).

Questionnaires feedback is fast .scalability in questionnaires allows companies to send questions to large audience. Questionnaires are distributed to anyone at any place in the world at a low cost. Specific cities and countries are targeted to answer specific questions. Questionnaires do not require expertise since they are simple to use and easily understood by everybody with little education. It is also easy to analyze information without built-in tools and a background of statistics. Users of information can quickly interpret the results analyze them and turn the data into reports and visualizations (Debois, 2016). Analyzing reports enables users to easily generate predictions, create follow-up questions and benchmark with other organizations.

User anonymity

Online and email surveys permit respondents to maintain anonymity and ensure complete invisibility (Dilman, 2006). Questionnaires do not require the names pf the residents so that they are free to give any information they have in details. Respondents are comfortable answering the questions truthfully. Digital questionnaires give best anonymity and privacy resulting in most honest answers (Couper, 2000). The questionnaires are best for businesses. In addition, results are accurate using online questionnaires.

Email questionnaires have no time limits and no persons waiting for answers from the other end. As a result, the respondents take their time to answer the questions fully (Meadows & Wisher, 2000). Questionnaires have the biggest advantage of not limiting the number of questions asked. Thus, interviewers can ask as many questions as possible mostly covering a whole topic to gather adequate responses from respondents (Ross, 2005). Questions are short and directed to the point to make it easy for answering. They are efficient, and incur least costs when delivering since they can be delivered by hand, and there is no problem of having many inbuilt questionnaires. Questionnaires compare and contrast other types of research and measure changes. Positivists believe that quantitative data create new theories and test existing ones.

Weaknesses of questionnaires

Lacking conscientious

Questionnaires are regarded as weak because they lack validity and interviewer cannot measure the truth of the information given and change of emotions and feelings. It is impossible to measure thoughts put in the questions, and observe facial expression and reactions except when the questions are administered face-to –face (Popper, 2004).

Questions suffer a problem of interpretation because each person answers questions according to their own interpretation. What one person explains as good might be bad or worse to another. The results end up being subjective when there are no persons to explain the questions and give similar meanings. Skewed results are obtained when clarity is a problem and there lacks somebody to clarify the choices and answers asked (Debois, 2016).

Researchers have a disadvantage of asking questions according to their own decisions and assumptions. The assumptions may lead them not to ask various questions that are vital in the research. Respondents might forget important information and fail to answer on information already known. At times respondents chose answers before they have read the question fully, others skip some questions making it difficult to analyze data (Debois, 2016). Other respondents make spilt second choices, which affects data validity.


  Questionnaires are disadvantaged in that they can present dishonest information since some respondents fear getting embarrassed and protect themselves from being tracked. However, respondents can be encouraged to be honest by being assured of their privacy and that they will not be tracked (Reja et al., 2003).

Difficult to analyze

 Questionnaires collect a lot of data. Open-ended questions allow individual answers that cannot be quantified and require humans to review them. Many open-ended questions give more data to be analyzed (Kirklees, 2003).


Respondents may be biased in that some may be interested in your products, services and ideas while others are participate depending on subjects of the questionnaires. As a result, the receiver of the information get inaccurate information and leads to inaccurate data. Imbalanced respondents become overly positive or negative.


Questionnaires may be inaccessible to persons with hearing disabilities and visual impairment. Illiterate respondents are ruled out from answering unless there is an interpreter. LTDL (2016) asserts that questionnaires are standardized making it impossible to explain misinterpreted questions. Some respondents forget vital information since questionnaire are given after occurrence if events. Various respondents fail to reveal important information required with thoughts of getting penalized after availing the right opinion. Evalue (2016) argues that it is impossible to go back to respondents who have not answered various questions, especially in their anonymous nature. Various questions may be answered incorrectly. Since questionnaire are most effective when short, simple and directed to the point, they are not used to answer complex issues.

Uses of closed and open-ended questions

Open format questions

Open format questions allow respondents to include their opinions in the answers in details. There are no predetermined set of responses, thus respondents are free to answer whatever they feel is right. Open-ended questions are used to get feedback and sourcing for extra information for improvements of certain areas (Ross, 2005).

Flatworld solutions (2016) explains that closed ended questions are divided into

Leading questions

Leading questions force the audience to give particular answers. Leading questions have equally likely answers. Choices in leading questions include excellent, superb, great, fair, good, and poor. The questions get opinions from audience using limited words (Mathers et al., 2007).

Importance questions

Importance questions ask respondents to rate the importance of particular issue, from given rating scale of 1 to 5. The questions help to understand significant things to the respondents and allow making critical business decisions.

Likert questions

Likert questions are used to ascertain the strength of respondents while agreeing to particular statement. The questions are used in ascertaining how customers feel on certain issues, services, and products. Likert questions offer choices such as strongly agree, agree, neither agree or disagree, disagree and strongly disagree (Reja et al, 2003).

Dichotomous questions

Dichotomous questions are simple and demand respondents to answer with a yes or no. the disadvantage is that they questions cannot analyze answers since there lacks a middle perspective. Closed ended questions only have yes and no choices (Graf, 2002).

Bipolar questions

Closed-ended bipolar questions have two extreme answers written at the opposite ends of the scale. The respondents are required to mark responses between the two. Examples

How would you describe XYZ corporation?

Efficient……..       …x…..     ……. Inefficient

Fast………..       ……x….      …………    slow

Rating scale questions

Rating scale questions rate particular issues on scales ranging between poor and good. Rating scale have even choices that excludes respondents from selecting the middle option. Respondent’s choices include such as good, fair, poor, and very poor (Reja et al., 2003).

Buying propensity questions

Buying propensity questions attempt to vary the intentions of future customers and determining the buying intention of respondents. The questions ask respondents their wishes on buying particular products, types of requirements they need and their will to buy similar products in the future. Choices given to respondents include definitely, probably, probably not, not sure and definitely not (Meadows, 2003).

Using questionnaires to asses risk factors for myopia

Saxena et al. (2015) explains that myopia is a common cause of visual impairment in the world. Myopia prevalence varies by age, country, ethnic group, and backgrounds. High prevalence of myopia is reported in East Asia especially in Japan, Singapore, Taiwan, China, and Hong Kong. Lower rates are reported in India and South Asia (Dandona, Dandona, Srinivas, Sahare, 2002). The group conducted a study to assess the rates of myopia among school going children in Delhi and associated factors.

Explain how researchers went from wide range of questions to specific questions, and also focus on specific factors such as time spent outdoors, physical activities and near work.

Saxena et al. (2015) began by delivering participant information sheet to all parents for signing. The sheet explained the objectives and aims of the study, the detailed procedure of the research and adverse effects of dilatation. The researchers asked for permission to examine the eye, take vision, and administer questionnaires asking demographic questions, children habits. Eye dilation for refraction was required. Ten schools were randomly selected from two randomly selected districts. Structured questionnaires were presented to the schools using vernacular languages for easy understanding of parents and children. The answers were recorded in English. Questionnaires were directly filled from children details, while others were filled from interviews conducted through telephoning one parent. Time spent on various activities was asked individually each day of the week. Total hours spent engaging in each activity was recorded per week. Time spent at home and in school was recorded differently in each activity. Details were confirmed through cross checking them with their teachers and conducting telephone interviews with their parents.

Vision of the right eye was recorded as the smallest line read with or without errors using letter E from early treatment diabetic retinopathy study (ETDRS) vision chart under ambient room lighting. Visual acuity was tested in the right eye followed by the left eye. A risk factor questionnaire was filled foe children unable to read six out of nine letters. Other questionnaires were filled for normal vision (non myopic group).

Bayoumy and Saad (2007) and Muhamedagic et al., 2015) gave structured questionnaires to students, which covered medical, personal and environmental data. Personal data asked about sex, school level, age, and area of resident. Environmental data asked about sources of pollution on the resident area. Pollution nearing their houses such as bread ovens, workshops that manufacture ceramic tiles, heavy traffic, refuse burning and carpenters. The questionnaires included questions on types of cooking fuels used and use of pesticides at home. Medical questionnaire asked about manifestations of eye strains ad previous ophthalmic problems.

Questions about reddening of eyes, headaches, difficulties in reading the blackboard at school were included in medical questionnaires. Family history questionnaire asked about consanguinity and family histories of RE. Children were given questionnaires asking about whether their parents belonged to the same family, or from different families. Wearing of glasses within families was asked. Economic questionnaires asked about social economic status of the family with choices such as highly educated with occupations reasonable for their education levels, and high or secondary educated with occupations below their education levels, and low level and illiterate with casual and semi-permanent employments. The questionnaires included questions about how much near work the child practiced in activities such as reading, watching television and reading. Authors of the questionnaires trained social workers who could assist each child to complete the structured questionnaires. Accuracy was ensured by having the social workers fill the questionnaires from information availed by each child and the authors revising the questionnaires.

Sherwin et al. (2012) undertook an ophthalmic epidemiological research on Norfolk Island. The area was chosen because of its minute population and inherent genetic and geographical population. Respondents filled Sun-exposure questionnaire. The questionnaires contained questions about the history of sun exposure and sun-protective strategies. Response categories included never, seldom, half of the time, usually and always. Questions on time spent outdoors when awake were included. The parts of the day spent outside during summer. Possible responses included none, quarter of the day, approximately half, three quarter of the day, none, and a quarter of the day. Categories were later combined since there were low numbers in the none category. UVAF photos were taken using cameras developed by colleagues and coroneo. The photographs taken used both reflected and visible light (control) and UV-induced fluorescent aided by two photograph systems that were portable.

Huang, Chang, and Wu (2015) conducted 12 cohort studies and 15 cross-sectional studies including 25,025 children aged 6 to 18 years, to assess myopia in relation to work activities. Questionnaires were designed with questions such as myopia, short sighted, near sighted and refractive errors. More questions included near work, studying, reading distance, and working distance. There were no restrictions on language. Two authors screened the studies after deletion of duplicate articles. Questionnaires asked personal information such as race/ethnicity of study population, age, and last name of first author. Near work, activity was determined through assessing reading, use of computers, playing video games, writing, and myopia development. Responses included three times reading, two times computer use, two times video games in hours per day.

Yingyong (2010) and Hsu et al., 2016). Conducted a cross-sectional analysis on population between October 2008 and September 2009 in Nakhon Pathom. He used questionnaires to assess refractive error, parental refractive status, hours per week of near activities (studying, reading books, watching television, playing with video games, and working on computer). The study was conducted among 377 children who participated in the study.

Dandona et al. (2002) conducted a random selection of village-based clusters to identify causes of myopia in children aged between seven to fifteen years of age. A door-to-door survey was used to enumerate 25 clusters. Examination included retinoscopy, autorefraction, occur motility evaluation, and visual acuity measurements. Examination of anterior segment, fundus, and media was done and filled in the questionnaires.

Wu et al. (2015) used a detailed questionnaire to conduct a study on factors associated with myopic shifts among primary school children. The first part of the questionnaire concentrated on near-work activities such as amount of time spent studying, watching television, computer activities each day. The average reading distance was assessed. Question son outdoor activities were also included such as time spent by children in outdoor activities for leisure (playing outdoors and walking), time spent on outdoor activities for leisure after school and during weekends. Time spent in sports during the week and weekends.

Vannas, et al. (2003) studied two conscript cohorts where garrisons were required to complete written questonnaires about their vision and risk factors associated. The questionnaires assessed risk factors such as demographic, habits, health status, and conscript families.

Questionnaire on light exposure asked questions on birth date, sunglasses, community, wearing habits, eye color, and community of residence. Two indices were used such as daily hours of darkness in each month and region and daily global irradiance (in KJ/m2)


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