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questionnaire at all. Almost half of the respondents were not positive about the usefulness of the PSC in relation to their health care process. Six respondents spoke about using PSC outcomes at an aggregate level. They were all worried about their privacy and feared that this could turn against them if they would need more or more expensive treatment than the ‘average patient’. The developers of the PSC reported issues about the ease of use of the PSC in one of their first publications on the questionnaire in 1999 \[29\]. They wrote that during the first intake patients were often surprised and needed time to think about the selection of activities. They advised to use two intake visits to give patients time to reflect on activities that were limited due to their health problem between these two intakes. They added that they realized that planning two intake visits would probably not always be practical. They suggested that it might be possible to have only one intake visit if prior to the intake patients would be asked by telephone or email to pay attention to activities of daily living that are limited due to their health problem \[29\]. This complex assignment might be hard to understand for low health literate patients, especially when it is given over the phone or by email. Furthermore the developers of the PSC stated that for the selection procedure within the PSC an interviewer is needed to insure that patients select activities that their health problem made difficult for them, that are important to them, and they find difficult to avoid. But they also hypothesized that it could be possible to replace the interviewer by a better formulated instruction \[29\]. Based on the results of this study it can be concluded that with the current written instruction the majority of our respondents would have needed help from an interviewer to be able to complete the PSC as the developers intended. From prior experience as clinicians and from feedback from the participating physical therapists in this study, the researchers of the current study know that physical therapists often take on the suggested role of interviewer when they use the PSC in their practice. They help patients completing the questionnaire by reading the questions out loud and explaining the meaning of the questions and answers if necessary. This is very time consuming and therefore takes up valuable treatment time. Helping the patient might also diminish the validity of the results of the questionnaire while it is hard to determine to what extent the response process is influenced by the person who is helping the patient. This also applies to family or friends Perceived ease of use and usefulness 41 2