The importance of content and face validity in instrument development: lessons learnt from service users when developing the Recovering Quality of Life measure (ReQoL)

Abstract

PurposeService user involvement in instrument development is increasingly recognised as important, but is often not done and seldom reported. This has adverse implications for the content validity of a measure. The aim of this paper is to identify the types of items that service users felt were important to be included or excluded from a new Recovering Quality of Life measure for people with mental health difficulties.MethodsPotential items were presented to service users in face-to-face structured individual interviews and focus groups. The items were primarily taken or adapted from current measures and covered themes identified from earlier qualitative work as being important to quality of life. Content and thematic analysis was undertaken to identify the types of items which were either important or unacceptable to service users.ResultsWe identified five key themes of the types of items that service users found acceptable or unacceptable; the items should be relevant and meaningful, unambiguous, easy to answer particularly when distressed, do not cause further upset, and be non-judgemental. Importantly, this was from the perspective of the service user.ConclusionsThis research has underlined the importance of service users’ views on the acceptability and validity of items for use in developing a new measure. Whether or not service users favoured an item was associated with their ability or intention to respond accurately and honestly to the item which will impact on the validity and sensitivity of the measure.

Enhancing ‘meaningfulness’ of functional assessments: UK adaptation of the Amsterdam IADL questionnaire

“…A further strength is the inclusion of a range of stakeholders, including people with cognitive impairment and relatives of people with MCI and dementia. To date relatively few assessments of content validity, utilize the knowledge and expertise of patients and caregivers, which often solely relies on the judgments of clinicians (Connell et al, 2018). In addition, we compared the instrument to another IADL measure (ECog) administered to the same participant group, enabling a direct comparison between the two IADL instruments.…”

Barriers and challenges against the utilization of novel teaching methods for nursing students from the perspective of nursing instructors

“…Accordingly, all items received scores above 0.79. Moreover, the total content validity of the questionnaire was computed using S-CVI/Ave where the minimum score of 0.79 was considered to be acceptable [18]. Based on the results, the S-CVI/Ave of the questionnaire was found to be 0.96.…”

An emerging framework for fully incorporating public involvement (PI) into patient-reported outcome measures (PROMs)

“…PI can shed light on how it would feel to be the patient or individual to experience completing a questionnaire by commenting on potentially negative questions (which might make people focus on negative aspects of their life), positive questions (which might be upsetting if they appear insensitive), and items which might seem irrelevant (which might be frustrating). The explanation and ordering of the questions should be carefully considered [29].…”