期刊论文详细信息
BMC Complementary and Alternative Medicine
Cognitive interviews guide design of a new CAM patient expectations questionnaire
Research Article
Clarissa Hsu1  Emery R Eaves2  Cheryl Ritenbaugh2  Judith A Turner3  Karen J Sherman4  Daniel C Cherkin4 
[1] Center for Community Health and Evaluation, Group Health Research Institute, 1730 Minor Avenue, Suite 1600, 98101, Seattle, WA, USA;Department of Family and Community Medicine, University of Arizona, 1450 N Cherry Avenue, 85719, Tucson, AZ, USA;Department of Psychiatry and Behavioral Sciences, University of Washington, Box 356560, 98195-6560, Seattle, WA, USA;Group Health Research Institute, 1730 Minor Avenue, Suite 1600, 98101, Seattle, WA, USA;
关键词: Cognitive interviews;    Questionnaires;    Expectations;    Low back pain;    Acupuncture;    Chiropractic;    Massage therapy;    Yoga;   
DOI  :  10.1186/1472-6882-14-39
 received in 2013-11-04, accepted in 2014-01-17,  发布年份 2014
来源: Springer
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【 摘 要 】

BackgroundNo consistent relationship exists between pre-treatment expectations and therapeutic benefit from various complementary and alternative medicine (CAM) therapies in clinical trials. However, many different expectancy measures have been used in those studies, with no validated questionnaires clearly focused on CAM and pain. We undertook cognitive interviews as part of a process to develop and validate such a questionnaire.MethodsWe reviewed questions about expectations of benefits of acupuncture, chiropractic, massage, or yoga for pain. Components of the questions – verbs, nouns, response options, terms and phrases describing back pain – were identified. Using seven different cognitive interview scripts, we conducted 39 interviews to evaluate how individuals with chronic low back pain understood these individual components in the context of expectancy questions for a therapy they had not yet received. Chosen items were those with the greatest agreement and least confusion among participants, and were closest to the meanings intended by the investigators.ResultsThe questionnaire drafted for psychometric evaluation had 18 items covering various domains of expectancy. “Back pain” was the most consistently interpreted descriptor for this condition. The most understandable response options were 0-10 scales, a structure used throughout the questionnaire, with 0 always indicating no change, and 10 anchored with an absolute descriptor such as “complete relief”. The use of words to describe midpoints was found to be confusing. The word “expect” held different and shifting meanings for participants. Thus paired items comparing “hope” and “realistically expect” were chosen to evaluate 5 different aspects of treatment expectations (back pain; back dysfunction and global effects; impact of back pain on specific areas of life; sleep, mood, and energy; coping). “Impact of back pain” on various areas of life was found to be a consistently meaningful concept, and more global than “interference”.ConclusionsCognitive interviews identified wordings with considerable agreement among both participants and investigators. Some items widely used in clinical studies had different meanings to participants than investigators, or were confusing to participants. The final 18-item questionnaire is undergoing psychometric evaluation with goals of streamlining as well as identifying best items for use when questionnaire length is constrained.

【 授权许可】

CC BY   
© Sherman et al.; licensee BioMed Central Ltd. 2014

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