The use of cognitive interviewing methodology in the design and testing of a screening tool for supportive and palliative care needs

The authors describe the use of cognitive interviewing methodology in the development of a new supportive and palliative care screening measure to identify the specialist supportive and palliative care needs of patients with an advanced illness. A draft screening measure was developed by literature reviewing and consultation with patients, carers and health and social care professionals. Using this draft, cognitive interviews were conducted with six professionals and one consumer using the 'thinking aloud technique' to assess the perception, usefulness and interpretation of each question on the measure. The focus of these interviews was to identify unclear words or phrases and to explore how the questions worked in eliciting a response. A content analysis of the interviews was used to identify problems with the text, phrasing and format of the questions and accompanying responses. The authors found the technique to be useful in identifying jargon or confusing questions. A number of perspectives were taken into account by speaking to health and social care professionals in primary care and secondary care who would be offering the measure to future patients. The most sensitive questions were highlighted, and this enabled the researchers to consider how these should be asked and responded to in subsequent versions of the measure. The measure was re-drafted in light of these comments.