Evaluating the Face Validity of the ICECAP-O Capabilities Measure: A “Think Aloud” Study with Hip and Knee Arthroplasty Patients
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The ICECAP-O index of capabilities measure for older people is intended to be used in the evaluation of health and social care interventions. Focusing on quality of life, rather than health or other influences on quality of life. This study evaluated the face validity of the self-administered ICECAP-O capabilities measure for older people by investigating how participants interpret and respond to questions using the cognitive interviewing technique. Twenty patients with osteoarthritis of the knee or hip participated in a cognitive interview whilst completing the ICECAP-O capabilities measure. Cognitive interviews were conducted using the concurrent ‘think aloud’ design. All interviews were audio recorded and transcribed verbatim and analysed (i) using a standardised classification scheme to identify response problems and (ii) qualitatively thematically analysed to explore the nature of the problems that the participants experienced when completing the measure. Problems were identified in 7 % of participants’ responses. The majority of problems identified were comprehension problems. Thematic analysis highlighted the extent to which participants’ distinguished between functioning and capability. Cognitive interviewing was a valuable technique for pre-testing the face validity, acceptability and content validity of the ICECAP-O capabilities measure. Participants had minimal difficulties completing the ICECAP-O capabilities measure. Those difficulties identified have prompted suggestions for improving the measure.
KeywordsCognitive interviewing Think aloud Osteoarthritis Capabilities Health outcome instrument
The authors would like to thank those who participated in the “think aloud” interviews and the staff at the orthopaedic clinics that helped with recruitment and Teressa McIlvenna for assisting with data collection. This work was supported by the MRC Health Services Research Collaboration.
- Coast, J., Peters, T. J., Natarajan, L., Sproston, K., & Flynn, T. (2008b). An assessment of the construct validity of the descriptive system for the ICECAP capability measure for older people. [Research Support, Non-U.S. Gov’t Validation Studies]. Quality of Life Research, 17(7), 967–976. doi: 10.1007/s11136-008-9372-z.CrossRefGoogle Scholar
- Couzner, L., Ratcliffe, J., Lester, L., Flynn, T., & Crotty, M. (2012). Measuring and valuing quality of life for public health research: application of the ICECAP-O capability index in the Australian general population. International Journal of Public Health. doi: 10.1007/s00038-012-0407-4.Google Scholar
- Davis, J., Liu-Ambrose, T., Richardson, C., Bryan, S. (2012). A comparison of the ICECAP-O with EQ-5D in a falls prevention clinical setting: are they complements or substitutes? Quality of Life Research, 1–9. doi: 10.1007/s11136-012-0225-4.
- Davis, J. C., Bryan, S., McLeod, R., Rogers, J., Khan, K., & Liu-Ambrose, T. (2012b). Exploration of the association between quality of life, assessed by the EQ-5D and ICECAP-O, and falls risk, cognitive function and daily function, in older adults with mobility impairments. [Journal article]. BMC Geriatrics, 12(1), 65.CrossRefGoogle Scholar
- Ericsson, K., & Simon, H. (1993). Protocol analysis: Verbal reports as data. Cambridge: MIT Press.Google Scholar
- Francis, J., & Byford, S. (2011). SCIE’s approach to economic evaluation in social care. London: Social Care Institute for Excellence.Google Scholar
- Grewal, I., Lewis, J., Flynn, T., Brown, J., Bond, J., & Coast, J. (2006). Developing attributes for a generic quality of life measure for older people: preferences or capabilities? [Research Support, Non-U.S. Gov’t]. Social Science and Medicine, 62(8), 1891–1901. doi: 10.1016/j.socscimed.2005.08.023.CrossRefGoogle Scholar
- Henderson, C., Knapp, M., Fernandez, J. L., Beecham, J., Hirani, S. P., Cartwright, M., . . . Whole System Demonstrator evaluation, t. (2013). Cost effectiveness of telehealth for patients with long term conditions (Whole Systems Demonstrator telehealth questionnaire study): nested economic evaluation in a pragmatic, cluster randomised controlled trial. [Research Support, Non-U.S. Gov’t]. BMJ, 346, f1035. doi: 10.1136/bmj.f1035.
- Kaklamanou, D., Armitage, C. J., & Jones, C. R. (2012). A further look into compensatory health beliefs: a think aloud study. [Journal article]. British Journal of Health Psychology, 24(10), 2044–8287.Google Scholar
- Makai, P., Brouwer, W. B., Koopmanschap, M. A., & Nieboer, A. A. (2012). Capabilities and quality of life in Dutch psycho-geriatric nursing homes: an exploratory study using a proxy version of the ICECAP-O. Quality of Life Research, 21(5), 801–812. doi: 10.1007/s11136-011-9997-1.CrossRefGoogle Scholar
- Mitchell, P. M., Roberts, T. E., Barton, P. M., Pollard, B. S., & Coast, J. (2013). Predicting the ICECAP-O capability index from the WOMAC osteoarthritis index: is mapping onto capability from condition-specific health status questionnaires feasible? Medical Decision Making, 33(4), 547–557. doi: 10.1177/0272989x12475092.CrossRefGoogle Scholar
- National Joint Register. (2012). www.njrcentre.org.uk: National Joint Register.
- Ratcliffe, J., Lester, L. H., Couzner, L., & Crotty, M. (2013). An assessment of the relationship between informal caring and quality of life in older community-dwelling adults–more positives than negatives? Health & Social Care in the Community, 21(1), 35–46. doi: 10.1111/j.1365-2524.2012.01085.x.CrossRefGoogle Scholar
- Sen, A. (1992). Inequality reexamined. New York: Russell Sage.Google Scholar
- Sen, A. (Ed.). (1993). Capability and well-being. Oxford: Clarendon.Google Scholar
- Tourangeau, R. (1984). Cognitive sciences and survey methods. In T. Jabine, M. Straf, J. Tanur, & R. Tourangeau (Eds.), Cognitive aspects of survey methodology: Building a bridge between disciplines. Washington: National Academy Press. Reprinted from: Not in File.Google Scholar
- Wilkie, R., Peat, G., Thomas, E., Hooper, H., & Croft, P. R. (2005). The Keele assessment of participation: a new instrument to measure participation restriction in population studies. Combined qualitative and quantitative examination of its psychometric properties. Quality of Life Research, 14(8), 1889–1899.CrossRefGoogle Scholar
- Willis, G. B. (2006). Cognitive interviewing. A tool for improving questionnaire design. Quality of Life Research.Google Scholar