Page 192 - THE DUTCH TALKING TOUCH SCREEN QUESTIONNAIRE

Chapter 5
TTSQ and how their answers came about.
The current chapter starts with a summary of the main findings presented within this thesis which are then put into a broader perspective and will be followed by recommendations for further research and development of talking touchscreens for use in clinical practice to support patients with low HL to participate more actively in provider-patient interactions.
MAIN FINDINGS
Chapter 2 presents the results of a qualitative study which describes the problems 50 physical therapy patients with Dutch and Turkish backgrounds and diverse levels of health literacy encountered during completion of the Patient-Specific Complaint questionnaire (PSC) [1,2]; the most frequently used questionnaire by Dutch physical therapists [5]. The results show that all respondents, except one, experienced problems completing the questionnaire. Most problems were related to comprehension of the instructions and questions and this led 24 respondents, most of whom had low HL, to give invalid answers.
Chapter 3 describes the development of the Dutch version of the Talking Touch Screen Questionnaire. Guidelines for designing interactive questionnaires for low literacy persons were derived from the lessons learned during the co-design process which involved 10 persons with low literacy helping to design the TTSQ. This co-design process resulted in a prototype of the TTSQ which was a digital application on the original iPad 1 with a 9.7-inch screen. A tablet computer was found to be the most suitable device to meet the needs of low literacy people since it had the advantages of a computer, but did not look like one and operating it did not require reading or writing skills. Questions on pain location and pain intensity were added to the original questions of the PSC [1,2], because users were primarily interested in reporting their complaints, not their activity limitations. Visual (videos and photos) and auditory (speech technology) support were added to enable participants to see and hear the questions, which were shown on separate screens. Response items could be selected by tapping on the touchscreen and plain language was used in all spoken and written text within the TTSQ. The results of this study show that, apart from the more ‘technical’ support, it is important to take the social and
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