Page 191 - THE DUTCH TALKING TOUCH SCREEN QUESTIONNAIRE

INTRODUCTION
The aim of the research project described in this thesis was to develop a tool which would help Dutch and Turkish physical therapy patients with inadequate health literacy (HL) to be more able to take an active part in the decision-making process within the diagnostic phase of physical therapy treatment in The Netherlands.
The first objective within this research project was to assess which problems physical therapy patients with diverse levels of HL and Dutch and Turkish backgrounds encountered during completion of the Patient-Specific Complaint questionnaire (PSC) [1,2]. The PSC was taken as a starting point for the development of the tool that was developed during this research project, which was called the Talking Touch Screen Questionnaire (TTSQ). The content of the PSC [1] fitted the goal of helping patients to provide relevant information regarding their health problem to their physical therapist. It aims to make the patient select his or her main limitations in functioning and formulate his or her own specific treatment goals. To assess which problems physical therapy patients encountered during completion of the PSC, cognitive interviews with twenty-five Dutch and twenty-five Turkish physical therapy patients with diverse levels of health literacy were conducted after they completed the Dutch PSC, using the probing technique described by Collins et al. [3]. The results of this study led to the second objective in this research project, which was the development of a working prototype of the Dutch TTSQ. A co-design method was applied during the development of the Dutch TTSQ by involving ten persons with low literacy in the design team from the start of the development process. User involvement in developing the Dutch TTSQ was organized through two focus group sessions (analysis phase), two user walkthroughs (design phase) and a usability test (implementation) with a new group of low literacy persons. The last objective was to test whether the newly-developed Dutch TTSQ generated accurate information on symptoms, limitations and treatment goals of patients with diverse levels of HL in a physical therapy context and to test and compare the usability of the Dutch TTSQ and its Turkish translation. The Three-Step-Test-Interview method [4], containing both think-aloud and probing techniques was used to get insight into the way 24 Dutch and 11 Turkish physical therapy patients with varying health literacy levels were able to operate the
General discussion
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