Development and content validation of a questionnaire identifying patients' functional priorities and abilities after hip or knee arthroplasty

Disabil Rehabil. 2024 Aug 18:1-15. doi: 10.1080/09638288.2024.2390648. Online ahead of print.

Abstract

Purpose: To develop a self-report questionnaire evaluating functional priorities after hip or knee arthroplasty and evaluate patients' understanding of its items and conceptual relevance.

Methods: A self-report questionnaire was first developed based on the International Classification of Functioning, Disability, and Health (ICF) core set for osteoarthritis (OA). In the second stage, two research physiotherapists thoroughly reviewed and refined the questionnaire, and another physiotherapist conducted cognitive think-aloud interviews with 18 patients to assess the face and content validity of the questionnaire.

Results: All categories and corresponding activities of ICF core set for OA were used to develop the questionnaire. Several questionnaire issues were identified and addressed. Most challenges were related to comprehension, followed by item ordering and visual elements. Patients identified ambiguous wording which we subsequently simplified. Ten activities of the core set were excluded due to lack of face validity, two activities were added, and four activities were modified.

Conclusion: The findings suggest that the ICF core set for OA needs to be adjusted for patients undergoing hip or knee arthroplasty and highlight the feasibility of applying a modified core set to assess functional priorities after hip or knee arthroplasty.

Keywords: Knee and hip arthroplasty; content validity; functional priorities; questionnaire development.

Plain language summary

The questionnaire developed in this study can be used to assess patients’ functional priorities after hip or knee arthroplasty for osteoarthritis.Several activities that comprise the International Classification of Functioning, Disability and Health (ICF) core set for osteoarthritis could be used to assess functional priorities after hip or knee arthroplasty.Some categories need to be removed or modified within this core set based on feedback from patients during the think-aloud sessions in our study.Using our questionnaire to determine postoperative patient priorities can help identify appropriate patient-centered outcome measures to use after hip or knee arthroplasty.