Abstract
Goals of work
The authors describe the use of cognitive interviewing methodology in the development of a new supportive and palliative care screening measure to identify the specialist supportive and palliative care needs of patients with an advanced illness.
Materials and methods
A draft screening measure was developed by literature reviewing and consultation with patients, carers and health and social care professionals. Using this draft, cognitive interviews were conducted with six professionals and one consumer using the ‘thinking aloud technique’ to assess the perception, usefulness and interpretation of each question on the measure. The focus of these interviews was to identify unclear words or phrases and to explore how the questions worked in eliciting a response. A content analysis of the interviews was used to identify problems with the text, phrasing and format of the questions and accompanying responses.
Main results
The authors found the technique to be useful in identifying jargon or confusing questions. A number of perspectives were taken into account by speaking to health and social care professionals in primary care and secondary care who would be offering the measure to future patients.
Conclusions
The most sensitive questions were highlighted, and this enabled the researchers to consider how these should be asked and responded to in subsequent versions of the measure. The measure was re-drafted in light of these comments.
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References
Ahmed N, Bestall JC, Ahmedzai SH, Payne SA, Clark D, Noble B (2004) Systematic review of the problems and issues of accessing specialist palliative care by patients, carers and health and social care professionals. Palliat Med 18(6):525–542. doi:10.1191/0269216304pm921oa
Bestall JC, Ahmed N, Ahmedzai SH, Payne SA, Noble B, Clark D (2004) Access and referral to specialist palliative care: patients’ and professionals’ experiences. Int J Palliat Nurs 10(8):381–389
Chang MW, Nitzke S, Brown RL, Baumann LC, Oakley L (2003) Development and validation of a self-efficacy measure for fat intake behaviours of low-income women. J Nutr Educ Behav 35(6):302–307. doi:10.1016/S1499-4046(06)60344-8
Collins D (2003) Pre-testing survey instruments: an overview of cognitive methods. Qual Life Res 12:229–238. doi:10.1023/A:1023254226592
Drennan J (2003) Cognitive interviewing: verbal data in the design and pretesting of questionnaires. J Adv Nurs 42(1):57–63. doi:10.1046/j.1365-2648.2003.02579.x
Groenvold M, Petersen MA, Aaronson NK, Arraras JI, Blazeby JM, Bottomley A et al (2006) The development of the EORTC QLQ-C15-PAL: a shortened questionnaire for cancer patients in palliative care. Eur J Cancer 42(1):55–64. doi:10.1016/j.ejca.2005.06.022
Havens GAD (2001) A practical approach to the process of measurement in nursing. Clinical Nurse Specialist 15:146–152, http://www.nursingcenter.com
Hearn J, Higginson IJ (1999) Development and validation of a core outcome measure for palliative care: the palliative care outcome scale. Qual Health Care 8(4):219–227
Jobe JB (2003) Cognitive psychology and self reports: models and methods. Qual Life Res 12:219–227. doi:10.1023/A:1023279029852
Knafl K, Deatrick J, Gallo A, Holcombe G, Bakitas M, Dixon J et al (2007) The analysis and interpretation of cognitive interviews for instrument development. Res Nurs Health 30(2):224–234. doi:10.1002/nur.20195
Lauren HK, Jackson FF, Julie AB, Jenny AS, Sheri FS (1999) The use of cognitive testing to develop and evaluate CAHPS TM 1.0 core survey items (Consumer Assessment of Health Plans Study). Med Care 37(3):MS10–MS21. doi:10.1097/00005650-199903001-00002
Memon A (1999) Interviewing witnesses: the cognitive interview. In: Memon A, Bull R (eds) Handbook of the psychology of interviewing. John Wiley, Chichester, pp 343–355
McHorney CA, Rust J, Golombok S, Davis S, Bouchard C, Brown C et al (2004) Profile of female sexual function: a patient-based international, psychometric instrument for the assessment of hypoactive sexual desire in oophorectomized women. Menopause 11(4):474–483. doi:10.1097/01.GME.0000109316.11228.77
Murtagh FE, Addington-Hall JM, Higginson IJ (2007) The value of cognitive interviewing techniques in palliative care research. Palliat Med 21(2):87–93. doi:10.1177/0269216306075367
National Institute for Clinical Excellence Improving supportive and palliative care for adults with cancer. National Institute for Clinical Excellence, London (March 2004); (http://www.nice.org)
Richardson A, Tebbit P, Brown V, Sitzia J, Cancer Action Team (2006) Assessment of supportive and palliative care needs for adults with cancer. King’s College London, London
Rosal MC, Carbone ET, Goins KV (2003) Use of cognitive interviewing to adapt measurement instruments for low-literate Hispanics. Diabetes Educ 29(6):1006–1017. doi:10.1177/014572170302900611
Sofaer S (2002) Qualitative research methods. Int J Qual Health Care 14(4):329–336. doi:10.1093/intqhc/14.4.329
Ware NC, Dickey B, Tugenberg T, McHorney CA (2003) A measure of continuity of care in mental health services. Ment Health Serv Res 5(4):209–221. doi:10.1023/A:1026276918081
Willis GB (1999) Cognitive interviewing a “how to guide”. Reducing survey error through research on the cognitive and design processes in surveys. Short course presented at the 1999 meeting of the American Statistical Association. Research Triangle Institute
Acknowledgements
This project was funded by the Elizabeth Clark Charitable Trust (Sainsbury Family Charitable Trust). The authors would like to thank all the participants who agreed to be interviewed for their time and commitment to this study.
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Ahmed, N., Bestall, J.C., Payne, S.A. et al. The use of cognitive interviewing methodology in the design and testing of a screening tool for supportive and palliative care needs. Support Care Cancer 17, 665–673 (2009). https://doi.org/10.1007/s00520-008-0521-2
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DOI: https://doi.org/10.1007/s00520-008-0521-2