title: Using the Three-Step Test Interview to understand how patients perceive the St. George's Respiratory Questionnaire for COPD patients (SGRQ-C).
abstract: The aim of this study was to assess the experiences of patients with chronic obstructive pulmonary disease (COPD) while they were completing the St. George's Respiratory Questionnaire for COPD patients (SGRQ-C), using qualitative research methods.
  
  
  
  Twenty Dutch COPD patients were recruited through pulmonary physicians [13 women; mean age = 63.3 years (SD = 11.4)]. A trained interviewer applied the Three-Step Test Interview which allowed the interviewer to follow the thought process of the patient filling out the SGRQ-C. The official Dutch translation of the SGRQ-C was used.
  
  
  
  Patients missed a recall period for the Symptoms subscale; were uncertain how to interpret specific words and phrases like "good days", "games", and "housework"; were confused by long-item stems that included a list of activities; and were frustrated by the dichotomous format used for the majority of SGRQ-C items (true/false).
  
  
  
  Overall, patients were satisfied with the SGRQ-C. Nevertheless, making minor adjustments could further increase its quality. This includes reintroducing a recall period in the first set of items such as used in the previous version and splitting up items consisting of multiple activities. Furthermore, we recommend using the same response format (4 or 5 response categories) for all items.
authors.affiliation: Department of Research Methodology, Measurement, and Data-Analysis, Behavioural, Management and Social Sciences, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands. muirne.paap@cemo.uio.no.
authors.forename: Muirne C S
authors.initials: MC
authors.lastname: Paap
authors.affiliation: University of Twente, Enschede, The Netherlands.
authors.forename: Lukas
authors.initials: L
authors.lastname: Lange
authors.affiliation: Department of Research Methodology, Measurement, and Data-Analysis, Behavioural, Management and Social Sciences, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands.|Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: Job
authors.initials: J
authors.lastname: van der Palen
authors.affiliation: Department of Psychology, Health and Technology, Behavioural, Management and Social Sciences, University of Twente, Enschede, The Netherlands.
authors.forename: Christina
authors.initials: C
authors.lastname: Bode
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D032882:Comprehension; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010808:Physical Examination; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D014177:Translations
keywords: COPD; Cognitive interview; HRQoL; Interview study; Qualitative research