The usefulness of the RSTC medical questionnaire in pre-participation health risk assessment of recreational scuba divers in Hong Kong

Abstract

Introduction: The current practice in Hong Kong is to have potential recreational divers complete a Recreational Scuba Training Council self-declared medical statement (RSTC form) prior to participation in diving. There are no reports in the literature on the usefulness of the Chinese version of the form. Methods: The Professional Association of Diving Instructors (PADI) RSTC form (Chinese version) was completed by 117 research participants who were then individually interviewed (without examination) to establish whether relevant information was not captured by the form. Any discrepancies or problems identified were recorded for further analysis. Results: Among participants, 15.4% expressed difficulty in completing the RSTC form. Less than one-third (28.2%) replied ‘all negative’ to the questions. Some health conditions that could impose diving risks were not elicited by the questionnaire alone. Nevertheless, there was good sensitivity, specificity, positive predictive value and negative predictive value with the exception of a few questions. However, significant discrepancies were identified when comparing the English and Chinese versions. There was also uncertainty with aspects of implementation, including attitudes of the user and provider, reliability of self-declaration answers and the handling of completed questionnaires. Conclusions: Health screening with a questionnaire for recreational divers remains practical and acceptable. Full revision of the RSTC form in Chinese is recommended in view of problems with the construct validity and translation. People should be informed about the non-prescriptive approach of health assessment for recreational divers. Further research on the implementation of the form may help to improve the screening strategy in the future.