Background
Family involvement in in-patient care enhances patient safety and quality of care by reducing complications and hospital length of stay. A valid measurement of family involvement in care is needed when implementing and evaluating family involvement-promoting activities.
Methods
The design of this study was inspired by the guidelines for best practices for developing and validating measurement scales. The steps used were: identifying domains and generating items, assessing content validity, and pre-testing items with the target population. An expert group rated item relevance and the content validity index was calculated. Nineteen online Think-aloud interviews were conducted with family members of former in-patient surgical patients.
Results
The domains of family involvement and item selection from two preexisting questionnaires were grounded in scholarly literature. Items were adapted for family members in the in-patient care setting. Item content validity varied between 0.71–1.00, scale content validity/averaging was 0.90. After adjustments, the items were pretested through on-line cognitive interviews with family members. Three main problem areas were found: defining family involvement, misinterpretation of different terms, and underuse of one response option. These problems were adjusted for. The Family Involvement in Care Questionnaire consists of 16 items with a four-point Likert scale and two open-ended items.
Conclusion
On-line think aloud interviews are a feasible method when evaluating new questionnaires. Problems experienced by the target population were identified prior to a large quantitative psychometric evaluation of the questionnaire.