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Presentation at a workshop on Research Methodology in Health Sciences held at the Northern Area Armed Forces Hospital on 29 December 2020 at 6.30 pm. By Professor Omar Hasan Kasule MB ChB (MUK), MPH (Harvard), DrPH (Harvard) Professor of Epidemiology and Bioethics, King Fahad Medical City
CONTENT:
} Utmost care should
be taken in preparing the study questionnaire.
} Correct decisions
must be made about what items to include in the questionnaire. This is guided
by the hypothesis under study and knowledge of potential confounding factors.
} A start is made by
reviewing questionnaires of previous similar studies.
} The content of a
question may be one of the following: knowledge, attitude, belief, experience,
behavior, and attributes.
WORDING OF QUESTIONS:
} The following
should be observed in selecting questionnaire items: clarity,
comprehensibility, neutrality, and scaling.
} The question must
be worded properly to make sure they are easy to understand.
} The wording of the
questionnaire items should leave no room for ambiguity.
} The words must be
easy. Technical jargon must be avoided.
} The wording should
be neutral, neither positive nor negative. Biased questions are leading,
threatening, value-laden, or assumptions.
} Each question
should contain only one concept or item of information; questions should not be
double-barreled.
} The responses must
be scaled appropriately. Double negatives should be avoided.
FORMAT AND LAYOUT:
} The format and
layout of the questionnaire are important and have an impact on response rates.
} The order of the
questions must be logical moving from the superficial to the more detailed.
} Embarrassing
questions should be kept towards the end because they may spoil the whole
interview.
} Closed questions
are preferred to open questions.
} Questions should
not be too long.
} The total number
of questions must be appropriate.
} The questionnaire
should be designed for easy reading. The use of boxes and different colors helps.
The font print size must be readable.
} The logical
sequence of questions must be proper. Skip patterns should be worked out
carefully and exhaustively.
PILOT TESTING:
} The reliability
and validity of the questionnaire should be tested during the pilot study.
} Pilot testing also
has the additional advantage of testing the study procedures and administrative
bottlenecks.
} The following are
common problems in questionnaires that can be uncovered during pilot testing:
ambiguous questions, questions that are not self-explanatory, two questions in
one, use of unfamiliar words, asking for events that are difficult to remember,
insufficient number of response categories, overlapping categories, questions
that are too long, questions that have too many ideas, questions that require
too much detail, leading questions, improper use of rating scales.
ETHICAL AND CONFIDENTIALITY ISSUES:
} Before
administering a questionnaire, the investigator should be aware of some ethical
issues. Informed consent must be obtained.
} The information
provided could be subpoenaed by a court of law and the investigator cannot refuse
to release it.
} In the course of
the interview the investigator may get information that requires taking
life-saving measures. Taking these measures will however compromise confidentiality. Such a situation may arise in the case of an interviewee who
informs the interviewer that he is planning to commit suicide later that day.
Such information may have to be conveyed immediately to the authorities
concerned.
APPENDIX: EXAMPLE OF A WELL-DESIGNED QUESTIONNAIRE: