Page 206 - THE DUTCH TALKING TOUCH SCREEN QUESTIONNAIRE

Chapter 5
Comparable to the design process of the TTSQ in the current project, the content of the TT of Paiva et al. [22] was developed with input from patients and experts in oncology. Afterwards, the prototype was tested on comprehension and reliability. However, all of this was done using a paper-and-pencil version of the questionnaire. This means all patients that helped to develop and test the questionnaire were adequately literate or else they would not have been able to give the right input. Therefore psychometric properties of cancer-related questionnaires, like the one that was subject of the study of Paiva et al., established in adequately literate populations do not automatically apply to low literate populations. This may limit the generalizability of the results in the study of Paiva et al. [22].
Ease of use
The usability results of previously-published papers on TTs are hard to compare with the results published in the current thesis. The main reason for this is that respondents in all other studies were allowed to ask for the assistance of a researcher during completion of the questionnaire [15-26], while the participants in the two usability studies in this current thesis were not. The participants in the usability study on the Dutch TTSQ only were encouraged by the interviewer sometimes to “try again” if the touchscreen did not respond to their touch because they tapped too softly or pushed too hard on the screen. The participants in the study on the Turkish version of the TTSQ did not get any encouragement or support from the researchers at all. Some of the earlier published articles reported the percentages of participants who received help [16,17,20,22,25] and some gave some information about the amount of help that was received [17,20,22,25]. Three articles provide small bits of information on the characteristics of the participants that needed (the most) help with completion of the TTs. The information given indicates that low-skilled and inexperienced participants needed the most help [17,20,25]. This seems to align with the results on satisfaction reported in three TT evaluation studies [16,19,21] which show that, although overall satisfaction on the ease of use was high, satisfaction among lower-skilled or digitally- inexperienced participants was lower. The other studies did not specify the results on satisfaction by patient characteristics. Although it is difficult to compare the results of the earlier published TT studies with the results on usability in Chapter 4.2 and 4.3 of the current thesis, they all seem to indicate that it is harder for less-skilled and
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