Cognitive Interview Methods in PROMIS

Christodoulou et al. (2008) -- Fatigue Items

Irwin et al. (2009)—pediatric item bank (physical functioning, emotional health, social health, fatigue, pain, and asthma-specific symptoms)

	Fatigue	Pediatric
每位受試者訪談題數/問卷總題數	34/136	30/318
受試者	22名 依慢性疾病別與社經地位取樣	28名兒童或青少年 8-17歲，依年齡分布取樣
受試者納入條件	1.      大於18歲 2.      五年內有慢性病就醫的經驗 3.      可以說和讀英文 4.      同意參與研究 5.      沒有可能會影響作答結果的精神疾病 6.      沒有認知上或其他層面(例如：視覺)上的損傷	1.      8-17歲 2.      可以說和讀英文 3.      同意參與研究 4.      家長同意參與研究 5.      沒有精神上、認知上或其他層面，可能會影響作答的損傷。
邀請參與方式	1.      機構依納入條件screen可能的受試者 2.      以電子郵件、電話以及機構內詢問的方式，邀請受試者參與研究	1.      機構依納入條件screen可能的受試者 2.      以郵件方式告知實驗內容，並邀請家長帶其子女參加。 3.      若家長同意參與，研究人員簡單與其子女interview後，確認可進行Cognitive Interview後，與受試者約時間。
Cognitive Interview時間	約1小時	約1小時
Cognitive Interview進行程序	1.      說明訪談內容 2.      受試者填寫問卷 3.      兩位研究人員進行Interview，一位主問並做紀錄，另一位僅作紀錄。 4.      訪談內容包含：題目敘述、選項、回溯時間點、整體評估。	1.      說明訪談內容 2.      受試者填寫問卷 3.      一位研究人員進行interview，並做紀錄。 4.      訪談內容包含：題目敘述、選項、回溯時間點、整體評估。 5.      受試者接受閱讀能力評估測驗 Wide Range Achievement Test-3 Reading Subtest (WRAT)
收案完成要素	每個題目被5-6名受試者評估過。	每個題目被至少5名受試者評估過。
後續動作	1.      整合受試者對於每個題目的看法。 2.      研究人員之間的評分agreement計算。 3.      進行專家會議，進行題目修改與刪除。 4.      將修改之題目再進行一次Cognitive Interview	1.      整合受試者對於每個題目的看法。 2.      專家會議，考量受試者建議進行題目修改與刪除。 3.      將修改之題目再進行一次Cognitive Interview

Reference

1.Christodoulou C, Junghaenel DU, DeWalt DA, Rothrock N, Stone AA. Cognitive interviewing in the evaluation of fatigue items: Results from the patient-reported outcomes measurement information system (PROMIS). Qual. Life Res. Dec 2008;17(10):1239-1246.

2.Irwin DE, Varni JW, Yeatts K, DeWalt DA. Cognitive interviewing methodology in the development of a pediatric item bank: a patient reported outcomes measurement information system (PROMIS) study. Health Qual. Life Outcomes. Jan 2009;7.

Cognitive Interview Questions in PROMIS

Christodoulou et al. (2008) -- Fatigue Items &

Irwin et al. (2009)—Pediatric item bank (physical functioning, emotional health, social health, fatigue, pain, and asthma-specific symptoms)

Directions

How would you make the directions more clear/easy to understand? (P)

What does "in the past 7 days" mean to you? (P)

When you see "the last 7 days", what days did you include? (F, P)

Did you think mostly about your experience on specific days or what was typical for you over the last 7 days (If specific days, “can you tell me more about what made you think about those specific days?”) (F)
Would you have responded to this statement differently if we asked you about what had happened over the last 30 days instead of only the last 7 days? (F)

Items

In your own words, what do you think this question is asking? (F, P)

What does this question mean to you? What did you think of when answering this question? (P)

Was this question easy to understand? Are there any specific words that are difficult to understand? (P)

How would you change the words to make it more clear? (F, P)

Was this item hard to answer? If yes, why? (P)

How did you choose your answer? (P)

Domains

In your own words, what do you think this group of questions is asking about? (P)

How do you think these items are related? (P)

Are there any questions that don't belong in this group? (P)

Response Choices

What do you think about the response choices? (P)

How easy or hard was it to tell the difference between each choice? (F)
You chose (quote their choice) as your answer. What does (quote their choice) mean to you? (F)

How would you make the response choices clearer or easier to understand? (F, P)

Overall Assessment

Are there things that we forgot to ask about that you think are important? (P)

Overall thoughts/opinions of the questionnaire? (P)

Anything you would change in the questionnaire as a whole? (F, P)

Questions that may be applied to evaluating OT quality questionnaire for stroke patients：

題目相關

1. In your own words, what do you think this question is asking? (F, P)

請問您認為這個問題是在問甚麼？

2. Was this question easy to understand? Are there any specific words that are difficult to understand? (P)

您認為這個問題的敘述容易理解嗎？有沒有哪些詞看起來不知道是甚麼意思？

3. How would you change the words to make it more clear? (F, P)

對於那些比較難理解的詞，您認為可以更換成甚麼更簡單的詞？

向度相關

1.      In your own words, what do you think this group of questions is asking about? (P)

對您來說，這部分的題目都是在問哪一方面的問題？

2.      Are there any questions that don't belong in this group? (P)

您認為有那些題目，不符合您剛剛所說的「那一方面」？

選項相關

1.      How easy or hard was it to tell the difference between each choice? (F)

您認為區分每個選項之間的差異是否容易？

2.      You chose (quote their choice) as your answer. What does (quote their choice) mean to you? (F)

在這一題中，您選擇了(受試者的作答)，請問您選擇這個選項的原因為何？

3.      How would you make the response choices clearer or easier to understand? (F, P)

您認為這些選項要如何修改以變得更清楚易懂？

整體評估

1.      Are there things that we forgot to ask about that you think are important? (P)

在整份問卷中，您認為有哪些問題是我們沒有問但您認為重要的？

2.      Anything you would change in the questionnaire as a whole? (F, P)

對於整份問卷，您認為還有哪些可以修改的部分？

QAS-99 Categories -- Checklist of Cognitive Interview

STEP 1 READING:
  Determine if it is difficult for the interviewers to read the question uniformly to all respondents.

STEP 2 INSTRUCTIONS:
  Look for problems with any introductions, instructions, or explanations from the respondent’s point of view.

STEP 3 CLARITY:
  Identify problems related to communicating the intent or meaning of the question to the respondent.

STEP 4 ASSUMPTIONS:
  Determine if there are problems with assumptions made or the underlying logic.

STEP 5 KNOWLEDGE/MEMORY:
  Check whether respondents are likely to not know or have trouble remembering information.

STEP 6 SENSITIVITY/BIAS:
  Assess questions for sensitive nature or wording, and for bias.

STEP 7 RESPONSE CATEGORIES:
  Assess the adequacy of the range of responses to be recorded.

STEP 8 OTHER: Look for problems not identified in Steps 1 - 7.

*      : Steps that really applied by PROMIS for cognitive interviewing in the evaluation of fatigue items.


Reference
Christodoulou C, Junghaenel DU, DeWalt DA, Rothrock N, Stone AA. Cognitive interviewing in the evaluation of fatigue items: Results from the patient-reported outcomes measurement information system (PROMIS). Qual. Life Res. Dec 2008;17(10):1239-1246.

Measure of Process of care (MPOC)

    由加拿大McMaster University所成立的CanChild Centre for Childhood Disability Research，其中的一項計畫。內容主要是請家長評估孩子所接受的健康照護服務是否是"family -centred"。


相關連結如下


MPOC量表




MPOC量表主要關注於醫療提供者與家屬之間的互動情形，原先的量表是針對孩童，目前已有關注於中風病人的量表產生(請見部落格文章)。這個研究，對於未來我們將設計有關主要照護者的題目，具有參考價值。

SASC-19

Note

1. 出院的部分，談及居家環境的情況，與職能治療照護連結較低，發展台灣量表時相關題目考慮不採用。
2. 談到出院之後的內心感受部分，並無明確指涉職能治療師，發展台灣版量表時應進行主語的修改。

Satisfaction with Stroke Care questionnaire (SASC-19)
  
 Satisfaction with inpatient stroke care (Hospital-subscale)
1) I have been treated with kindness and respect by the staff at the hospital.
2) The staff attended well to my personal needs while I was in hospital (for example, I was able to get to the toilet whenever I needed).
3) I was able to talk to the staff about any problems I might have had.
4) I have received all the information I want about the causes and nature of my illness.
5) The doctors have done everything they can to make me well again.
6) I am happy with the amount of recovery I have made.
7) I am satisfied with the type of treatment the therapists have given me (e. g. physiotherapy, speech therapy, occupational therapy).
8) I have had enough therapy (e. g. physiotherapy, speech therapy, occupational therapy).

Satisfaction with stroke care after discharge (Homesubscale)
9) I was given all the information I needed about allowances or services I might need after leaving hospital (e. g. home help, district nursing, meals on wheels).
10) Things were well prepared for my return home (i. e.aids such as a wheelchair or adaptations in my house, like grab handles in the lavatory or the shower, had been organised).
11) I get all the support I need from services such as meals on wheels, home help, district nursing, etc.
12) I am satisfied with the outpatient services provided by the hospital (e. g. day hospital or appointments with  doctors or therapists).
13) I am satisfied with the practical help I have received since I left hospital.
14) I have received enough information about recovery and rehabilitation after stroke.
15) Somebody has really listened and understood my needs and problems since I left hospital.
16) I have felt neglected since I left hospital.
17) I have had enough emotional support since I left hospital.
18) I have received enough special equipment (e. g.wheelchair, commode,adaptations in my house, like grab handles in the lavatory or the shower, etc.).
19) I know who to contact if I have problems relating to my stroke.

Response categories: 0=strongly disagree, 1=disagree, 2=agree, and 3=strongly agree.