A Qualitative Approach for the Development of a Patient Experiences Questionnaire in Primary Healthcare Settings.

Background: Cognitive methodologies have been used in several areas of healthcare research for the development and evaluation of new instruments; nonetheless, their use in primary care settings along with the use of focus group methodology is rather limited. Objective: Focus group methodology was used to evaluate and improve two developing measurement tools for evaluating patients' experiences about primary healthcare services in Greece. Methodology: Two focus groups were conducted with 11 patients to test the perception, interpretation and usefulness of the questions of the new measurement tools. The agenda included 12 questions aimed at asking whether each question of the tools was understood and made sense by the participant in the same way as the researchers and if it was relevant to the primary care setting. The coding system of Willis (1999) was used to analyze the data. Results: The analysis revealed 30 problems for a number of problematic items. These included 12 clarity problems, eight response categories, one knowledge problem, one sensitive content problem, one instruction problem and one formatting problem. Moreover, six new types of problems emerged which could not be classified according to the above coding system (inapplicable problems). Conclusions: This methodological approach was useful in identifying questionnaire problems and the tool was redrafted by taking into account participants' perspectives. [ABSTRACT FROM AUTHOR]