Skip to main content

01.11.2008 | Regular Article | Ausgabe 6/2008

Environmental Health and Preventive Medicine 6/2008

Development of a questionnaire to assess ‘Hie’ symptoms using an evidence-based analysis

Environmental Health and Preventive Medicine > Ausgabe 6/2008
Takeaki Takeuchi, Mutsuhiro Nakao, Michitaka Kohno, Minoru Hatano, Masanori Niimi, Eiji Yano



Certain symptoms and signs are culturally specific. ‘Hie’ (chill sensation) is a major symptom experienced by Japanese people; however, it is not easily understood by Westerners. Although Hie is not life-threatening, it greatly hampers the quality of life in sufferers. To develop a remedy for Hie, valid and reliable measures are required. This is the first study aimed at developing a standardized questionnaire to quantitatively measure Hie symptom.


This was a cross-sectional study. To identify question items, we conducted a literature search using published books that mention Hie and related symptoms. The first draft of the questionnaire was prepared by selecting 31 items, including three empirically used items, using the Delphi method. A total of 744 Japanese volunteers completed the draft questionnaire. Simple correlation and factor analyses were performed to select items for the final version of Hie questionnaire and for evaluating its test–retest reliability.


The following ten question items were ultimately selected: feeling a breeze, shivery feeling, tolerance, sensitivity to cold, Hie-like sensation in an airplane, dislike of air conditioning, use of gloves, use of an electric blanket, use of heavy clothing and need for heating devices. Of the ten Hie-related question items, five pertained to physical symptoms and the other five to daily behaviours. The internal consistency of the ten-item questionnaire was high, with a Cronbach’s alpha of 0.85. The test–retest reliability of the questionnaire was preserved by the paired two-tailed t test.


A new questionnaire was developed to evaluate the subjective symptom of Hie. This questionnaire demonstrated sufficient reliability and could be used as a tool to assess this symptom.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Interdisziplinär

Für Ihren Erfolg in Klinik und Praxis - Die beste Hilfe in Ihrem Arbeitsalltag als Mediziner

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf

Alle e.Med Abos bis 30. April 2021 zum halben Preis!

Jetzt e.Med zum Sonderpreis bestellen!

Über diesen Artikel

Weitere Artikel der Ausgabe 6/2008

Environmental Health and Preventive Medicine 6/2008 Zur Ausgabe