Table 5 Coding framework for cognitive interviews and frequency of issues
Aspects of information processing | Definition | Examples | Questions |
|---|---|---|---|
Comprehension | |||
Difficult item | Delay in comprehending question meaning and difficulty answering | Q17: Dialysis affects patients’ lives in various ways and in early dialysis it is unlikely they could manage many tasks (2/10) | Q7, 8, 11, 12, 17 |
Wording | Issue with wording or phrasing of the question | Q9: ‘Normal life’ discussed and ‘daily life’ suggested (3/10) | Q3, 7, 9, 12, 15, 20, 32 |
Need for clarification | Participant needed more information to answer question | Q29: Patients asked if it included time on dialysis or just when they were off it (4/10) | Q1, 2, 29 |
Misinterpretation | Question not interpreted the way it was intended | Q21: Both patients and partners thought question asked about their own positivity (3/10) | Q21, 22, 29 |
Multiple interpretations | There are two or more possible interpretations | Q27: Talked about communication in regard to wider context rather than within couple and did not like phrasing (5/10) | Q10, 13, 16, 27, 31 |
Semantic difficulties | The meaning of a word or phrase is not understood | Q1: Definition of QOL questioned and noted that everyone may define it differently (1/10) | Q1 |
Hesitation | Excessive pausing or re-reading while comprehending the question | Q26: Re-read question two times but confidently marked answer (1/10) | Q26 |
Incomprehension | The meaning of the question is not understood | NA | |
Retrieval* | |||
Lack of information | Participants did not have knowledge that could inform question | Q3: Partners stated they had no or low expectations (3/10) | Q1, 3, 5, 16 |
Judgement | |||
Relevance | The extent to which the question is relevant to their experience | Q23: Partners commented that during early dialysis they did not express their feelings because they were focusing on being positive or still learning about dialysis (2/10) | Q1, 13, 14, 15, 21, 22, 23, 28 |
Repetition | A question has the same meaning as a previous one | Q7: Question similar to other Q9, Q16, Q17 (3/10) | Q7, 8, 11, 24, 25, 26 |
Time frame | Refers to the reference point for answering the question | Q1: Patient considered question in reference to QOL before chronic kidney disease rather than last 2 weeks (1/10) | Q1, 2, 9, 34 |
Responding | |||
Hesitation | Excessive pausing or hesitation | Q10: Partner thought about patient’s engagement in overall treatment (1/10) | Q3, 8, 10, 12, 25 |
Response scale confusion | Difficulty when marking response on the scale | Q22: Selected 1 when verbal reasoning indicated a score of 5 (1/10) | Q7, 22, 31, 33 |
Missed question | Question not answered, either intentionally or accidentally | Q13: Spoke about the question but could not select a response (1/10) | Q3, 12, 13 |
Response scale wording | Issues with wording of the response scale | Q32: Difficult to differentiate between 4 = A great deal and 5 = Completely (1/10) | Q1, 7, 32 |
Response scale scoring | Issues with the scoring of the response scale | Q12: Noticed the scoring was different from previous questions (reverse scored) and recommended changing it to prevent mistakes (1/10) | Q2, 12, 25 |
Other | |||
Formatting | Changes to format recommended | Q9: Recommended moving it after Q6 (1/10) | Q4, 5, 9 |
Positive feedback | |||
Important question** | Question highlighted as important | Q6: Patient said it was key to adapting to dialysis (1/10) | Q6, 33, 34 |
Good question | Participant states that a question is good | Q12: Patient stated they liked it because it asked about an often-overlooked topic (1/10) | Q12, 20, 21, 22 |
Straight-forward question** | Participant states a question is straight-forward | Q11: Patients stated it was a clear question (2/10) | Q11 |