Validated Online Questionnaires: What do Patients Prefer?

Tulha A1, Piccini A1, Martinho N2, Calado M1, Vigatto V1, Riccetto C3, Palma P3, Botelho S4

Research Type


Abstract Category

Quality of Life / Patient and Caregiver Experiences

Abstract 106
E-Poster 1
Scientific Open Discussion ePoster Session 7
Wednesday 4th September 2019
13:20 - 13:25 (ePoster Station 4)
Exhibition Hall
Quality of Life (QoL) Physiotherapy Questionnaire Outcomes Research Methods
1.Federal University of Alfenas, 2.State University of Campinas/Regional University Center of Espírito Santo do Pinhal, 3.State University of Campinas, 4.Federal University of Alfenas/State University of Campinas

Amanda Tulha



Hypothesis / aims of study
Validated questionnaires are recommended and widely used as an instrument of scientific research and clinical practice. However, its traditional form of use is performed by clinical interviews, which involves dedication to fill several printed forms, displacement of the patient to the place of application, time spent to fill and analyze them, and, consequently, cost. Meanwhile, the online version has the following advantages: quick response reach, free system, viability of analysis by the interviewer, user interface that can be accessed anywhere or at any time. The use of technological resources and the insertion of new methods of interviews have grown in health in general and it justifies the attempt to verify the perception of the patients submitted to this new tool. The objective was to compare the effectiveness of the traditional interview process versus the digital platform from the perspective of patients in relation to convenience, facility and quickness.
Study design, materials and methods
The study, approved by the Ethics Committee of the institution, was conducted in medical centers, the participants were pregnant and all signed the consent form. Thus, the steps of the study are represented in Figure 1 and are: (1) interview in person with the paper version of the WHO Quality of Life Assessment Questionnaire (WHOQOL-BREF) self-administered questionnaire, validated in Portuguese [1]; (2) After a 1-week interval, a second interview was performed with the same questionnaire, but using the online version through a digital platform and (3) to compare the effectiveness, the participants' preferences were assessed for the variables convenience, facility and quickness of both the traditional model (paper) and online questionnaires, using a numerical scale graded from zero to ten points and considering the higher the score, the greater the preference for the method. Up to three attempts were made to contact the patients in order to remind them about the date of completion of the online questionnaire through a mobile message. For statistical analysis, the Shapiro-Wilk test was used to verify the normality of data and Mann-Withney test for comparison of means, considering a confidence interval of 95%.
From a total of 43 pregnant women, mean age 26 ± 5.6 years old, their average gestational age was 22 ± 11 weeks, 70% had an average income of 1-2 wages, 67% declared themselves as white, and all had at least completed elementary education and had internet access. The results of the statistical analysis are shown in table 1.
Interpretation of results
The study showed statistically significant results for the variables convenience (p = 0.01) and quickness (p = 0.001) when comparing the methods of applying questionnaires on paper and online, demonstrating the preference of the participants' response between these items. The study by Kongsved et al [2] affirms that offering online versions can be more feasible in follow-up and resource-saving studies, as well as in the perspective of the participants of the present study, and also to be used in clinical practice. Other authors [3] recommend the use of both forms, paper and online, from the perspective of research development or clinical practice, however there are few studies that report the perspective of participants such as this one. However, Harisson et al in their study shows that new studies must be carried out to prove the interview methods used, as well as to develop new strategies. This justifies the continuation of the study, and it is necessary to ensure that there is no loss of information or that patients have no difficulty in completing these questionnaires.
Concluding message
The online version of the questionnaire in terms of convenience and quickness demonstrated better results from the participants' perspective than the paper version. In the facility variable, there were no statistically significant results, considering the need to continue this study.
Figure 1 Figure 1. Methodological Process
Figure 2 Table 1. Assessment of the preference between online and paper version of the WHOQOL-bref questionnaire. Description: 1Mann-Whitney test. *p-value<0.05. M: mean; SD: standard deviation; 95% confidence interval.
  1. Fleck MPA, Louzada S, Xavier M et al. Application of the Portuguese version of the abbreviated instrument of quality life WHOQOL-bref. Rev. Saúde Pública vol.34 n.2 São Paulo Apr.2000
  2. Kongsved SM, Basnov M, Holm-Christensen K, Hjollund NH. Response rate and completeness of questionnaires: a randomized study of Internet versus paper-and-pencil versions. J Med Internet Res. 2007 Jul-Sep; 9(3): e25.
  3. Uren AD, Cotterill N, Parke SE, Abrams P. Psychometric equivalence of electronic and telephone completion of the ICIQ modules.Neurourol Urodyn. 2017 Jun;36(5):1342-1349. doi: 10.1002/nau.23103. Epub 2016 Aug 11.
Funding Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG) Clinical Trial No Subjects Human Ethics Committee Ethics Committee of the Federal University of Alfenas and carried out following the doctors and legal precepts (CAAE Report Number: 81392017.1.0000.5142) Helsinki Yes Informed Consent Yes