Methods for questionnaire design: a taxonomy linking procedures to test goals

Satisfaction with Teleophthalmology Services: Insights from Remote Areas of Taiwan

During and after the COVID-19 pandemic, teleophthalmology provided access to eye care for rural populations. This study aimed to assess the efficacy of and satisfaction with an integrated real-time videoconferencing module. This project incorporated ophthalmic instruments and telecommunication devices and provided on-site consultations via videoconferencing. Both patients and healthcare providers completed satisfaction questionnaires. From May 2020 to May 2021, this project provided eye care services to 395 patients (aged 6-90 years). The most frequent eye condition was chronic conjunctivitis (n = 197), followed by senile cataract (n = 163), dry eye (n = 103), and refractive error (n = 95). Among them, 40 (10.1%) patients were referred to secondary or tertiary hospitals for further evaluation or treatment. In total, 181 recruited respondents provided good satisfaction scores in all dimensions, including quality of medical care (4.50 of 5.00), financial aspects of care (4.48), supportive attitude toward the project (4.47), quality of service (4.40), and quality of telecommunication (4.40). Women had a substantially more supportive attitude toward the project, and 25 healthcare providers provided low ratings in areas representing the quality of telecommunication (4.04) and user-friendliness of the instrument (4.00). This teleophthalmology system provided efficient and satisfactory eye care to participants in remote communities. However, better internet access and training in instrument use can reduce obstacles to the future implementation of the project.

Development and evaluation of the Norwegian Fatigue Characteristics and Interference Measure (FCIM) for stroke survivors: cognitive interviews and Rasch analysis

PURPOSE

There is need for a comprehensive measure of post-stroke fatigue with sound measurement properties. This study aimed to develop the Norwegian Fatigue Characteristics and Interference Measure (FCIM) and assess its content validity, structural validity, and internal consistency.

METHOD

This study consisted of three steps: (1) an expert panel developed version 1.0 of the Norwegian FCIM, (2) its content validity was assessed in cognitive interviews with stroke patients (N = 15), (3) a convenience sample of stroke patients (N = 169) completed an online questionnaire with the FCIM, Fatigue Severity Scale, and sociodemographic information; validity and reliability were assessed using Rasch analysis.

RESULTS

FCIM version 1.0 included a 10-item characteristics subscale, a 20-item interference subscale, and two pre-stroke fatigue items. The cognitive interviews revealed content validity issues, resulting in two interference items being removed and five items being flagged but retained for Rasch analysis (version 2.0). Rasch analysis led to removal of four items from the characteristics subscale and six more from the interference subscale. The final six-item characteristics subscale and 12-item interference subscale (version 3.0) both showed adequate fit to the Rasch model with indications of unidimensionality and local independence. The interference subscale had a high person separation index. No significant differential item function (DIF) was found in relation to gender, but one item demonstrated DIF in relation to age.

CONCLUSION

The cognitive interviews and Rasch analysis demonstrated that the Norwegian version of the FCIM has high content validity, structural validity, and internal consistency. Future research should assess its construct validity, reliability, and responsiveness.

A Psychometric Study of a Trait and State Assessment of Sexual Pleasure - The Amsterdam Sexual Pleasure Inventory

We studied the Amsterdam Sexual Pleasure Inventory's (1.0) psychometric properties. The ASPI, a revised self-report battery designed to measure domains of state and trait sexual pleasure in diverse gender, sex, and relationship populations, is based on a recently proposed conceptual framework of sexual pleasure. We collected quantitative (n = 1371) and qualitative data (n = 637) using a cross-sectional multi-method design targeting the general (German-speaking) population. After pre-processing, we conducted analyses on a sample of n = 706 participants. The theory-based 5-factor exploratory structural equation model and the principal component analyses of the two general exploratory index-scales showed good and acceptable structural validity evidence respectively. Measurement invariance was confirmed separately for male and female participants and for those with sexually functional-scoring and dysfunctional-scoring levels. Coefficient omega indicated that all scales, except those of one facet, showed acceptable to very good internal consistency. The ASPI's convergent and discriminant associations with sexological and psychological constructs demonstrated good overall construct validity. Participants understood the items as intended and felt that the ASPI covered relevant facets of sexual pleasure. The ASPI might help understand how individuals differ in experiencing sexual pleasure and how different contexts enable some people to experience pleasure while disadvantaging others.

The association between COVID-19 preventive strategies, virtual reality exercise, use of fitness apps, physical, and psychological health: testing a structural equation moderation model

Background

Directly or indirectly, individual psychosocial characteristics, motivation, and health consciousness factors help to maintain physical and psychological health through maintaining physical activity.

Objective

In the current study, we investigated how fitness apps moderate the links among COVID-19 preventive strategies, virtual reality exercise, physical health, and psychological health in Chinese society.

Method

A nationwide online survey across China was conducted under a snowball sampling design from February to June 2022. A total of 3,000 questionnaires were distributed across China via online platforms. A total of 2,795 complete detailed replies were included in the final analysis. Structural equation modeling techniques were employed to analyze the collected data through Smart-PLS 3.0.

Results

It has been statically proved that all the scales used in this inquiry to determine the mean scores, standard deviation, excess kurtosis, and skewness values were reliable and produced satisfactory results. The overall results (H1: β = 0.385, t = 15.699, p = 0.000; H2: β = 0.159, t = 7.405, p = 0.000; H3: β = 0.122, t = 5.435, p = 0.000; H4: β = 0.143, t = 6.493, p = 0.000; H5: β = 0.157, t = 6.444, p = 0.000; H6: β = 0.184, t = 9.071, p = 0.000; H7: β = 0.192, t = 9.319, p = 0.000; H8: β = 0.235, t = 11.899, p = 0.000; H9: β = -0.114, t = 4.872, p = 0.000; H10: β = 0.042, t = 2.872, p = 0.004; H11: β = 0.041, t = 2.699, p = 0.007) supported our hypothetical model and explained that using fitness apps and virtual reality exercise benefits physical and psychological health.

Conclusion

The fitness app's primary purpose during and after the pandemic is to motivate users to keep up with their regular at-home workouts. Exercise and active living are helpful in the prevention of risk factors associated with physical inactivity.

Repercussions of Pandemic and Preventive Measures on General Well-Being, Psychological Health, Physical Fitness, and Health Behavior: Mediating Role of Coping Behavior

Background

Pandemic prevention measures increased physical inactivity due to travel restrictions that led to negative physical fitness, health behavior, psychological health, and general well-being. The mediating role of coping behavior must be identified before developing interventional strategies for this pandemic.

Objective

The study investigates the mediating role of coping behavior to mitigate the Coronavirus disease impact on physical fitness, health behavior, psychological health, and general well-being.

Methods

A web-based survey was used under convenience sampling to collect the primary data. Smart-PLS 3.0 was used to analyze the collected data.

Results

All 14 direct correlations (H1-H14) were correct, and coping behavior's mediating impact was shown to be statistically significant (H9a- H14d).

Conclusion

Our study findings indicate that mediating role of coping behavior in mitigating the pandemic impacts was statistically significant. It is concluded that coping behavior is a healthy adaptation to protecting the barrier against COVID-19 adverse effects on health.

Development and early validation of questionnaires to assess system level factors affecting male partners' attendance at childbirth in LMICs

BACKGROUND

There is evidence that a woman who receives continuous labour support from a chosen companion can have shorter labour duration, is more likely to give birth without medical interventions, and report a satisfying childbirth experience. These outcomes result from the beneficial effects of emotional and practical support from the woman's chosen companion, and care provided by health providers. When a woman's chosen companion is her male partner, in addition to the above benefits, his presence can promote his bonding with the baby, and shared parenthood. However, there may be healthcare system barriers, including organisational, management and individual (staff) factors, that inhibit or restrict women's choice of companion. There are currently no suitable survey tools that can be used to assess the system level factors affecting the implementation of male partners' attendance at childbirth in low- and middle- income countries (LMICs).

METHODS

We designed two questionnaires to help to address that gap: the Male Partners' Attendance at Childbirth-Questionnaire for Heads of Maternity Units (MPAC-QHMUs); and the Male Partners' Attendance at Childbirth-Questionnaire for Maternity Staff (MPAC-QMS). We carried out an extensive review to generate initial items of the two questionnaires. We assessed the content and face validity of the two questionnaires in a three-round modified Delphi study.

RESULTS

The Male Partners' Attendance at Childbirth-Questionnaire for Heads of Maternity Units (MPAC-QHMUs) focused on organisational and management factors. The Male Partners' Attendance at Childbirth-Questionnaire of Maternity Staff (MPAC-QMS) focused on individual staff factors. The final MPAC-QHMUs and MPAC-QMS included items which garnered over 80% content relevance according to the experts' rating. After all three consensus rounds of the Delphi study, 43 items were retained for the MPAC-QHMUs and 61 items were retained for the MPAC-QMS.

CONCLUSIONS

The MPAC-QHMUs and the MPAC-QMS may help understanding of barriers affecting male partners' attendance at childbirth in LMICs in order to devise implementation strategies to enable wider availability and to maximize women's choices during labour and childbirth. The MPAC-QHMUs and the MPAC-QMS as newly-developed questionnaires require further validation of their acceptability and feasibility in different cultural contexts, and languages.

A Questionnaire Survey on Chinese Translation and Interpreting Scholars' Publication Pressure and Its Impact on Research Quality and Publishing Ethics

The issue of publishing ethics has been drawing attention from scholars of various fields, and this study focuses on the situation in translation and interpreting (T&I) studies. It surveys Chinese T&I researchers' publication pressure and its impact on their research quality and publishing ethics via an online questionnaire and follow-up telephone interviews. Altogether, 124 respondents filled out the questionnaire, and 14 of them took part in the interviews. Data analyses reveal that the pressure caused by the limited number of T&I journals is the highest, there is significant correlation between this type of pressure and publishing ethics, and there is also significant association between publication pressure and research quality. The follow-up interviews confirmed the findings, and the discussions with interviewees suggest that using alternative evaluation methods such as the representative work method might be a way out of the current publishing dilemma.

Patients' awareness regarding the quality of their oral hygiene: development and validation of a new measurement instrument

BACKGROUND

The present research aimed to develop and validate a standardised survey instrument for the assessment of patients' awareness of the quality of their oral hygiene performance.

METHODS

A digital questionnaire was developed that assesses both patients' naïve self-perceptions of oral cleanliness (SPOC_n) after tooth brushing and patients' perceptions after being informed how oral cleanliness may be captured in dentistry (SPOC_d). Three studies (N = 56 adults, N = 66 adolescents and one of their parents, N = 24 university students) assessed the instrument's feasibility (patient reports), reliability (internal consistency), validity (correlation with other constructs; sensitivity to manipulation of actual tooth brushing), and the correlation with actual oral cleanliness after tooth brushing.

RESULTS

All study groups accepted the questionnaire well; average answering times were less than 5 min. Cronbach's α exceeds 0.90; correlational analyses support the discriminant validity regarding oral hygiene related self-efficacy expectations and stages of change; manipulation of oral hygiene behaviour results in the expected changes of SPOC scores. Patients' SPOC correlate only moderately with actual oral cleanliness. The comparison between SPOC_d scores and actual oral cleanliness indicate that they considerably overestimate their oral hygiene performance.

CONCLUSIONS

The SPOC questionnaire is an easy-to-use, well-accepted, reliable and valid instrument for the assessment of patients' awareness of the quality of their oral hygiene for research and clinical purposes. The results of the questionnaire may help to reveal unrealistic self-perceptions of patients regarding their oral hygiene. It can raise their awareness of the need to improve their skills and/or efforts in this regard. Trial registration The third study was an interventional study and was registered in the appropriate national register ( www.drks.de ; ID: DRKS00018781; date of registration: 12/09/2019).

Using validity theory and psychometrics to evaluate and support expanded uses of existing scales

BACKGROUND

Scale development is a complex activity requiring significant investments of time and money to produce evidence of a scale's ability to produce reliable scores and valid inferences. With increasing use of clinical outcome assessments (COAs) in medical product development, evidentiary expectations of regulatory bodies to support inferences are a key consideration. The goal of this paper is to demonstrate how existing methods in measurement science can be used to identify and fill evidence gaps when considering re-purposing an existing scale for a new use case (e.g., new patient population, altering the recall period), rather than creating a new COA tool.

METHODS

We briefly review select validity theory and psychometric concepts, linking them to the nomenclature in the COA/regulated space. Four examples (two in-text and two in online supplemental materials) of modifications are presented to demonstrate these ideas in practice for quality of life (QOL)-related measures.

RESULTS

Each example highlights the initial process of evaluating the desired validity claims, identifying gaps in evidence to support these claims, and determining how such gaps could be filled, often without having to develop a new measure.

CONCLUSIONS

If an existing scale, with minimal modification or additional evidence, can be shown to be fit for a new purpose, considerable effort can be saved and research waste avoided. In many cases, a new instrument is simply unnecessary. Far better to recycle an "old" scale for a new use-with sufficient evidence that it is fit for that purpose-than to "buy" a new one.

The Employee Relationship Analysis on Innovation Behavior of New Ventures Under the Organizational Psychology and Culture

The study aims to explore the psychology and behavior of employees in organizations in enterprise innovation. Based on the human resource management system (HRMS), organizational psychological ownership, and other related theories, the transformational leaders and their advice behavior in start-ups are taken as the research object. The data obtained from the questionnaire as the research samples. Second, the influence and intermediary effect of employees' organizational psychological ownership on colleagues, leaders, and the whole enterprise are discussed, and the corresponding conclusions are drawn. The results show that the path coefficients of transformational leaders of start-up enterprises for employees' advice to their superiors and their peers are 0.28 and 0.31, respectively, and p < 0.01. Therefore, transformational leadership has a positive impact on both elements. In the relationship between organizational psychological ownership and employee creativity, the r value is 0.34 and p < 0.01. This shows that organizational psychological ownership positively correlates with employees' creativity. In addition, corporate support can mediate employees' behavior and psychological ownership in the organization and has a positive correlation in support, identity, and care. Therefore, the impact of organization-employees relations on employees' innovation behavior is discussed based on organizational psychology and culture, which can improve employees' subjective initiative for work and provides ideas for the management and development of start-ups.

Method of preparing a document for survey instrument validation by experts

Validation of a survey instrument is an important activity in the research process. Face validity and content validity, though being qualitative methods, are essential steps in validating how far the survey instrument can measure what it is intended for. These techniques are used in both scale development processes and a questionnaire that may contain multiple scales. In the face and content validation, a survey instrument is usually validated by experts from academics and practitioners from field or industry. Researchers face challenges in conducting a proper validation because of the lack of an appropriate method for communicating the requirement and receiving the feedback. In this Paper, the authors develop a template that could be used for the validation of survey instrument. In instrument development process, after the item pool is generated, the template is completed and sent to the reviewer. The reviewer will be able to give the necessary feedback through the template that will be helpful to the researcher in improving the instrument.

Examining instruments used to measure knowledge of catheter-associated urinary tract infection prevention in health care workers: A systematic review

BACKGROUND

Catheter-associated urinary tract infection (CAUTI) is the most frequently occurring health care-associated infection among hospitalized patients. Adequate knowledge of CAUTI in health care workers supports effective prevention and control of the infection. This systematic review assesses instruments used to assess knowledge of CAUTI prevention in health care workers to inform future research. The catheter lifecycle model was used to evaluate the conceptual framework upon which the measurement instruments were based. Finally, the psychometric quality of these instruments was evaluated.

METHODS

Five electronic databases were searched for published studies and instruments. The COnsensus-based Standards for the selection of health status Measurement INstruments checklist was used to assess the psychometric quality reporting of the instruments.

RESULTS

Fifteen studies met the review inclusion criteria and 13 instruments were available for review. Most of the instruments did not address all knowledge components essential for CAUTI prevention as defined by the catheter lifecycle model. The psychometric quality of the instruments was not sufficiently evaluated.

CONCLUSIONS

Few instruments are available for CAUTI prevention knowledge measurement. The instruments were not closely aligned with the catheter lifecycle model as a framework. If CAUTI knowledge cannot be measured accurately using an effective instrument, this has the potential to impact negatively on clinical care and the focus of interventions. There is a need for a standardized instrument for the evaluation of CAUTI prevention knowledge so that targeted interventions can address knowledge deficits.

Development and Validation of an Item Bank for Drug Dependence Measurement Using Computer Adaptive Testing

Currently, measurement tools to assess patient-reported outcomes for drug dependence are limited in their latent trait to adapt to the needs of individual patients while also maintaining comparability of scores across patients. Purpose/Objectives: To develop an item bank for computer adaptive testing (CAT) to measure severity of drug dependence. Methods: There were four phases: (1) review the literature of drug dependence measurement; (2) formulate an item list to be assessed by experts; (3) pretest our item list in two substance dependence treatment centers; and (4) field-test and conduct psychometric performance analysis with the final item bank. Additionally, based on our response data, a CAT simulation was used to validate the item bank, Drug Dependence CAT (DD-CAT). Results: The final drug dependence item bank - with a unidimensional configuration - contained 56 items with good item-fit, high discrimination, no differential item functioning, and covered all symptoms of diagnostic criteria for drug dependence. These results revealed that the final item bank was of good quality. Additionally, the results of a simulation CAT procedure with real response data indicated that the DD-CAT item bank exhibited acceptable and reasonable test reliability, content validity, and criterion-related validity. Conclusions/Importance: The proposed item bank for DD-CAT contained acceptable reliability and validity, and exhibited a shorter but efficient assessment of drug dependence. These psychometric properties can result in shorter test times, less information loss, and a reduction in the testing burden of patients.