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Chapter 2
assisting a patient to complete a questionnaire in case of language barriers or low literacy. Standardizing the role of the interviewer is another problem. If the role of the interviewer is not standardized, and there are no indications that it currently is, reproducibility and inter- and intra-reliability of the PSC is questionable. Instead of using a ‘real life’ interviewer, existing ICT technology could help to make the PSC easier to use. If the PSC were to be digitalized the role of the interviewer could be taken over by computer assistance. This would solve the problem of standardizing the given assistance. Furthermore, through speech technology patients could be enabled to hear as well as read the questions and by adding touchscreen technology patients could be enabled to give answers without the necessity of using a keyboard or computer mouse or having to write down the answers. Previous studies have shown that adding such technology successfully increases the usability of health related questionnaires for low literate patients [37-43]. Looking at the results of the current study the PSC should also be translated into the native languages of, at least, the largest immigrant groups of the Netherlands.
Making the PSC easy to use, especially for low health literate patients, could potentially help enhance the quality of care of this vulnerable population. The purpose of the PSC is to help patients to formulate their three most important physical therapy treatment goals. People with limited health literacy have little knowledge about their own health conditions, which has broad ramifications on how they interact with their health care providers. Patients with low health literacy skills have trouble determining which information their providers need and which information is irrelevant. They often lack the health care vocabulary to report symptoms accurately and may convey information illogically or in a jumbled order [44]. Using the PSC could therefore play a potentially important role in increasing the quality of the patient-provider-interaction between physical therapists and low health literate patients. Perceived ease of use has a positive influence on perceived usefulness [14]. Making the PSC easier to use might therefore at the same time increase patients’ perceived usefulness of the questionnaire.
The findings on perceived ease of use of the PCS in our study are in accordance with the findings of four other studies on ease of use of specific questionnaires [22-25]: all four studies except for the study of
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