gms | German Medical Science

Background and Purpose: When admitted to an Epilepsy Monitoring Unit (EMU), some patients feel uncomfortable. In order to provide appropriate measures, nurses should assess comfort levels. Based on Kolcaba’s General Comfort Questionnaire (GCQ), nurse researchers have developed setting-specific instruments. For usage in Austrian Epilepsy Monitoring Units (EMUs), in a former study the GCQ was translated and items were assessed for cultural equivalence. Afterwards, inappropriate items were omitted and specific ones added. The aim of this study was to identify problematic items and necessary modifications to enhance the content validity of the newly developed EMUCQ.

Methods: EMU patients in Salzburg were recruited with a purposive sampling strategy. Five rounds of cognitive interviews were conducted using the think-aloud method and verbal probing to comprehend how patients understand and answer the questions. Eight additional items underwent patient rating in terms of their relevance for the EMUCQ. Qualitative data analysis was based on the framework method.

Results: From July to November 2017, a total of 12 men and 13 women participated in the study. In the questionnaire, 27 items remained unchanged while 11 items were reworded. Either these items were misunderstood or the patients referred to their situation at home when answering. Additionally, another six items that were considered relevant were added.

Conclusions: Cognitive interviewing proved to be an inevitable part of instrument development. The patients provided feedback about understandability and practicability of the questionnaire and the researcher could clarify problems immediately. A field pilot will be the next step for further testing.