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At least 19 recordsLinked to original sources

Fundamental issues in questionnaire design.

The questionnaire is probably the most common form of data collection tool used in nursing research. There is a misconception that anyone with a clear grasp of English and a modicum of common sense can design an effective questionnaire. Contrary to such common belief, this article will demonstrate that questionnaire design is a complex and time consuming process, but a necessary labour to ensure valid and reliable data is collected. In addition, meticulous construction is more likely to yield data that can be utilized in the pursuit of objective, quantitative and generalizable truths, upon which practice and policy decisions can be formulated. This article examines a myriad of fundamental issues surrounding questionnaire design, which encompass question wording, question order, presentation, administration and data collection, amongst other issues.

Data Collection↗

Cognitive laboratory approach to designing questionnaires for surveys of the elderly.

Data from surveys of the elderly are used by policy analysts to design health services programs. Consequently, the quality of survey data on elderly respondents has important implications for this growing segment of society: improving the quality of data should result in more cost effective programs for the elderly. However, studies suggest that the quality of responses from the elderly may be less than that for other respondents. Moreover, the increasing needs of policy analysts and health researchers for data have resulted in more complex survey questions that place a high cognitive burden on respondents. New methods for improving the design of these questionnaires are needed. This project investigated whether new techniques of questionnaire design, adapted from the theories and methods of cognitive psychology, could be effectively used in interviewing older respondents. The techniques used in this study, concurrent think-aloud interviews with followup probe questions, have been shown recently to be effective with younger respondents. Problems that elderly respondents have in comprehending survey questions, retrieving relevant information from memory, and using decision processes to estimate and provide answers were investigated. Questions on functional ability and social support were taken from the 1984 Supplement on Aging to the National Health Interview Survey. Analysis of respondents' think-aloud protocols and responses to probes suggest that the cognitive interview procedures were effective in identifying problems with the survey questions that would result in data of poorer quality and in suggesting the wording of questions that would be likely to result in answers of greater validity and reliability. Implications of these results for survey design and validation studies are discussed.

Activities of Daily Living↗

Evaluation of computerised questionnaires designed for patients referred for gastrointestinal endoscopy.

The aim of this prospective study was to assess the applicability of a computerised medical history system at the open-access endoscopy unit of a University Hospital during routine clinical practice. We studied feasibility, acceptability and reproducibility of computerised questionnaires designed for patients referred for endoscopy of either the upper or lower gastrointestinal (GI) tract, partly in comparison with almost identical paper questionnaires. In the first period of the study 1134 patients were referred of whom 73% answered the paper questionnaire, and during the second period 537 patients were referred of whom 64% answered the computerised questionnaire (P less than 0.001). There was no sex dependency regarding the ability to answer both types of questionnaires. A significant age dependency regarding the ability to answer the paper questionnaires was observed for patients referred for upper and lower GI endoscopy (P less than 0.0001 and P less than 0.0001). Corresponding with this observation, the ability to answer the computerised questionnaires significantly decreased with increasing age for both groups of patients (P less than 0.0001 and P less than 0.0001). The average completion times of both computerised questionnaires, designed for the upper and lower GI tract, were 11 min. The completion times did not depend on sex, but there was a slight positive correlation with age (P less than 0.0001 with multiple R = 0.27 and P = 0.0593 with multiple R = 0.12). Answering our computerised questionnaires was consistently reported to be interesting and easy, and did not last too long according to the respondents. After patients had answered the computerised history system, the insight into their complaints had increased in 40%, and 45% could put their complaints into words more easily. Only 25% of the patients were unable to express all their complaints. A reproducibility of medical history data of 85% was observed between paper and computerised questionnaires. Our computerised questionnaires can provide us with a detailed and uniformly acquired medical history of most patients referred for GI endoscopy. They are well accepted by the patients and can be completed during the normal waiting period. The medical history data obtained with these questionnaires are quite reproducible.

Adult↗

A time to pregnancy questionnaire designed for long term recall: validity in Oxford, England.

STUDY OBJECTIVE: To establish the degree of validity of data on time to pregnancy, derived retrospectively using a short questionnaire. DESIGN: Information from the questionnaire was compared with data that had been collected concurrently from the same individuals. SETTING AND PARTICIPANTS: Questionnaires were mailed to 1647 women who continue to be followed up by the Oxford Family Planning Association contraceptive study, and a further 424 were approached for personal interview. Response rates were 91% and 79% respectively. MAIN RESULTS: Matching was successful in 91% of pregnancies. Median recall time was 14 years (interquartile range, 11-16 years). At the group level, remarkably good agreement was found between the two sources of information, presented as cumulative percentage distributions of live births. The findings were at least as good with longer recall (> 14 years) as with shorter recall. Digit performance was present to a limited degree. At the individual level, some misclassification was evident, which has implications for statistical power. For detection of clinical infertility (no conception within 12 months), the sensitivity was in the range 67%-91%, and the specificity was 92%-96%. Variations with format, duration of recall, age at delivery, year of birth, parity, social class, smoking habit, last contraceptive method, and outcome (live birth or not) were generally small, and were not statistically significant. CONCLUSIONS: Time to pregnancy is a sensitive way of assessing reproductive function in either sex. Valid data at a group level can be derived retrospectively, with a long duration of recall, using a short questionnaire.

Adult↗

The partial questionnaire design for case-control studies.

We propose an alternative to a long questionnaire that may increase quality while reducing the cost and effort of participants and researchers. In the 'partial questionnaire design', information about the exposure of interest is obtained from all subjects, while zero, one, or more disjoint subsets of questions about possible confounders are asked to randomly selected subgroups. The proposed analyses exploit the fact that the uncollected data can be considered to be missing at random. We show that it is possible to obtain high efficiency for estimating the effect of exposure of interest, adjusted for confounding, while substantially shortening average questionnaire length.

Bias↗

How to avoid the pitfalls of questionnaire design.

This article discusses how questionnaires are constructed and used. Question choice and construction plus the allocation of codes to analyse answers are discussed. A second article on this subject, due to appear in Nursing Times on June 4, will examine questionnaire layout, issues of reliability and validity and questionnaire piloting.

Data Interpretation, Statistical↗

Questionnaire design and surveys.

Surveys provide powerful means for systematic collection of information to test hypotheses and quantify the extent and nature of phenomena. This article discusses survey types and questionnaire design, and outlines 10 steps for planning a survey.

Humans↗

Development and validation of a questionnaire designed to measure foot-health status.

The aim of this study was to apply the principles of content, criterion, and construct validation to a new questionnaire specifically designed to measure foot-health status. One hundred eleven subjects completed two different questionnaires designed to measure foot health (the new Foot Health Status Questionnaire and the previously validated Foot Function Index) and underwent a clinical examination in order to provide data for a second-order confirmatory factor analysis. Presented herein is a psychometrically evaluated questionnaire that contains 13 items covering foot pain, foot function, footwear, and general foot health. The tool demonstrates a high degree of content, criterion, and construct validity and test-retest reliability.

Adult↗

The effects of questionnaire design on the determination of end results in lumbar spinal surgery.

Two hundred and seven patients followed a minimum of 10 years after a single lumbar disc operation were evaluated using 14 different questionnaires that measure surgical outcomes. Dependent on the questionnaire design, the satisfactory outcomes for this population ranged from 97% to 60%, which is statistically significant. The authors conclude that the reported outcomes for lumbar spinal surgery are significantly manipulated by the criteria selected for the assessment of end results.

Follow-Up Studies↗

Health complaints and job stress in Norwegian physicians: the use of an overlapping questionnaire design.

An extensive research program has been undertaken in Norway on physician health, sickness, working conditions and quality of life. Data are collected from cross-sectional and longitudinal prospective and retrospective surveys, qualitative studies, and vital statistics. This paper presents findings on subjectively experienced health problems, emotional distress, experienced job stress and job satisfaction, based on an extensive cross-sectional postal questionnaire study in 1993. An overlapping questionnaire design was used to allow many relationships to be estimated without exhausting the recipients. 9266 active physicians were included, which comprises close to the total Norwegian physician work-force minus a representative sample of 2100, used for other studies. The primary questionnaire was returned by 6652 (71.8%), the great majority of which also returned three secondary questionnaires. The results indicate that health complaints were significantly more frequent in female physicians and decreased with age. Low job satisfaction, high job stress, and emotional distress were all found to be significant predictors of subjective health complaints, as measured by the Ursin Health Inventory.

Adult↗

Effect of questionnaire design on recall of drug exposure in pregnancy.

Case-control studies of antenatal drug exposure and birth defects often rely on maternal recall of drug use in pregnancy. Differential recall among mothers of cases and controls can lead to information bias ("maternal recall bias"), and the opportunity for such bias increases as ascertainment of drug exposure diminishes. The effect of questionnaire design on the ascertainment of drug use in pregnancy was examined in two studies. In a pilot interview study of 532 women in obstetric/gynecologic practices, information on drug use in the past year was obtained by means of three questions asked in sequence: The first question was open-ended, the second asked about drug use for selected indications, and the third asked about use of specifically named drugs. Among obstetric patients who reported use of any of five drugs, less than 50% did so in response to the open-ended question, and approximately 20-40% reported use only when the specific drug name was asked. In a case-control Birth Defects Study of 5,435 mothers of malformed children, information on drug use in pregnancy was obtained by asking questions in sequence about indications and specifically named drugs. Among the women who reported use of any of 11 drugs, 6-40% did so only when asked about the specific drug by name. These findings suggest that completeness of ascertainment of antenatal drug exposure varies according to how the mother is questioned and is directly related to the specificity of the questions asked.

Abnormalities, Drug-Induced↗

Reproducibility and validity of a food-frequency questionnaire designed for use in girls age 7 to 12 years.

This study focused on a food-frequency questionnaire (FFQ) designed to measure nutrient intake in girls aged 7 to 12 years, inclusive. The instrument's reproducibility and validity were assessed using food records (FRs) as gold standards of measurement. Log-transformed nutrient intake estimates were compared from two FFQs and between FFQs and FRs. Intraclass correlation coefficients measuring the reproducibility of the FFQ ranged from 0.11 (starch) to 0.69 (fiber). Intraclass correlation coefficients measuring agreement between FFQ and 14l-day FR data varied between 0.15 (starch) and 0.68 (vitamin B2) for the first, and between 0.06 (starch) and 0.95 (vitamin B1) for the second FFQ. FFQs were in the best agreement with FRs for the following nutrients: fiber, vitamin B1, vitamin B2, vitamin C, and beta-carotene. Joint classifications revealed that overall, 36% of subjects were similarly categorized by FFQ and FR, and 70% of those in the lowest or highest FR quartiles were were found in the lowest or highest FR quartiles were found in the lowest or highest two FFQ quartiles, respectively.

Ascorbic Acid↗

Questionnaire design.

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Surveys and Questionnaires↗