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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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The Use of Cognitive Interviewing to Assess the Content Validity of the Bulgarian Disabilities of the Arm, Shoulder and Hand

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  • presenting/speaker Johanna Jacobson-Petrov - University Hospital for Emergency Medicine Pirogov, Sofia, Bulgaria
  • Christina Jerosch-Herold - University of East Anglia, Norwich, United Kingdom
  • Lyudmil Simeonov - University Hospital for Emergency Medicine Pirogov, Sofia, Bulgaria

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSHT19-1214

doi: 10.3205/19ifssh1515, urn:nbn:de:0183-19ifssh15153

Published: February 6, 2020

© 2020 Jacobson-Petrov et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

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Objective: The Bulgarian DASH has not undergone any evaluation of its psychometric properties. Psychometric testing on a questionnaire where content validity has not been established would be premature. The purpose of this study was to assess the content validity of the Bulgarian DASH using a qualitative approach.

Materials and Methods: Cognitive interviewing is a technique used to evaluate content validity. Establishing how patients understand items on a questionnaire is an important step in the process of translation and cultural adaptation of PROM's. Verbal probing with a reparative approach was used. This technique is an iterative process allowing problems in a questionnaire to be concurrently identified and fixed.

A total of 21 patients were interviewed with questions focusing on probing their experience of filling out the Bulgarian DASH. The interviews were recorded, transcribed and analyzed using text summary. This process was repeated until no further problems were identified.

Results: Cognitive interviewing demonstrated that questions on the Bulgarian DASH, initially thought to have been problematic, were appropriately translated and adapted. The problem that consistently arose was a misunderstanding of the instructions. The majority of patients answered the questionnaire based on their ability to complete the task with the injured hand only. Changes were made to the instructions, including giving verbal clarification and examples to the patient before the questionnaire was started.

Conclusions: This qualitative study of content validity highlighted problem areas in the instruction section of the translated and culturally adapted Bulgarian DASH. The problems were addressed and final probing and text analysis demonstrated no further issues. Now that content validity has been established, psychometric testing of the Bulgarian DASH can begin.