A methodological study on the combination of qualitative and quantitative methods in cognitive interviewing for cross-cultural adaptation.
Miao Jia, Yao Gu, Yanhua Chen and 6 others
PMID 34719124WHAT IT FOUND
Twenty-seven stroke survivors found many items in a Mandarin post-stroke checklist hard to understand because of long wording, technical terms, double-barrelled questions, and unfamiliar examples.
The checklist was revised to address them.
Key findings
01Focus groups using the QAS-99 codebook identified 38 problems, and cognitive interviews identified 30 problems.
02The paper reports that 87% of problems found in cognitive interviews were identical to problems raised in focus groups.
03Participants reported difficulty with lengthy items, technical terms, phonetic words, inappropriate assumptions, double-barrelled items, and sensitive family questions.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in normal outpatient, hospital, and community settings, not a dedicated cognitive testing laboratory. Participants had no prior experience with cognitive interviews. It tested one Mandarin translation of one interviewer-administered checklist, so it may not apply to other questionnaires or self-administered forms. The Mandarin checklist was not validated in this study. People with cognitive impairment, dysphasia, or limited Mandarin fluency were excluded, so it says little about those groups. The paper reports item problems and revisions, not clinical outcomes. Saturation rules for items and alternative subitems remain unclear.
Declared interests
No conflict of interest was declared. Funding came from Guangzhou Municipal Science and Technology Bureau and Nanfang Hospital.
The easy way to misread this
Do not read this as validation that the Mandarin Post-Stroke Checklist improves patient care or that the revised wording is clinically proven. The study tested how 27 stroke survivors understood and revised items, not whether the checklist changed outcomes.