Enhancing validity through cognitive interviewing. A methodological example using the Epilepsy Monitoring Unit Comfort Questionnaire

• Published in: Journal of advanced nursing 2019-01, Vol.75 (1), p.224-233
• Main Author: Egger‐Rainer, Andrea
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; cognitive interviewing; Comfort; comfort questionnaire; Comprehension; Cross-Sectional Studies; Epilepsy; Epilepsy - psychology; epilepsy monitoring unit; face validity; Female; Humans; instrument development; Interviews; Kindness; Literacy; Male; Middle Aged; Motivational Interviewing - standards; Nursing; qualitative method; Quantitative psychology; questionnaire design; questionnaire pre‐testing; Questionnaires; question‐and‐answer model; Reproducibility of Results; Research Design; Research Methodology: Empirical Research–Methodology; Research Papers; Retrieval; Surveys and Questionnaires - standards; Validity
• ISSN: 0309-2402; 1365-2648
• DOI: 10.1111/jan.13867

Aims To identify problematic items, assess completeness and user‐friendliness, and undertake modifications to enhance face validity of the newly developed Epilepsy Monitoring Unit Comfort Questionnaire. Design Qualitative‐descriptive cross‐sectional study. Methods Five iterative rounds of cognitive interviewing were conducted with members of the target population between July ‐ November 2017. Think‐aloud technique, verbal probing, and observation were used, to assess how respondents understood and answered questions. Data analysis was based on the framework method; an eight‐column framework matrix was created for this purpose. Results In 25 interviews, problems regarding completeness of the item pool, comprehension of items, retrieval of information, judgment while finding answers and reporting the appropriate responses could be detected. According to the results, 27 items remained unchanged, 11 items were reworded, and six items were added. Instructions section of the questionnaire was reworked, too. Conclusion Although time‐consuming, cognitive interviewing turned out to be a valuable approach for revealing problems in an instrument, which would, otherwise, remain undetected and threaten validity. 目的 识别问题项目、评价完整性和用户方便性,并进行修改,以提高新编制的癫痫监测器舒适度问卷的表面有效性。 设计 定性描述性横断面研究。 方法 2017年7月˜11月对目标人群进行5轮重复认知访谈。运用有声思维、语言探究、观察等方法,评估受访者对问题的理解和回答。数据分析基于框架法,为此建立了八列框架矩阵。 结果 在25次访谈中,可以发现关于题库的完整性、题目理解、信息检索、寻找答案时的判断以及报告适当答案等问题。根据调查结果,有27个题目保持不变,11个题目被改写,6个题目被添加。问卷的说明部分也经过了修改。 结论 认知访谈虽然耗费时间,但却是揭示问题的一种有价值的方法,否则将无法发现问题并影响有效性。