ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2025
Young children (6-7 years) can meaningfully participate in cognitive interviews assessing comprehensibility in health-related quality of life domains: a qualitative study.
Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Using cognitive interviews with children to test the content validity of a paediatric patient reported experience measure.BMJ paediatrics open · 2026Article
- "Reading level is just one component": best practices for cognitive debriefing patient-reported outcome instruments with pediatric populations.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Review
- Psychometric properties of MyCommunication-Children: an item bank for measuring communicative participation in children with speech, language, voice disorders or hearing loss.Journal of patient-reported outcomes · 2026Article
- Cognitive Testing of the People's Voice Survey Instrument to Assess Adults' and Adolescents' Experience in European Healthcare Systems.Healthcare (Basel, Switzerland) · 2026Article
- Validating a codesigned paediatric patient reported experience measure: a study protocol.BMJ paediatrics open · 2025Article
- 'How low can you go?' Developers' perspectives on involving young children in the development of patient reported outcome measures.Journal of patient-reported outcomes · 2025Article
- Self-Experienced Difficulties in Communicative Participation in Children With Speech, Language and Communication Needs-A Concept Elicitation Study.International journal of language & communication disordersArticle
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Abstract
purposeEstablishing the comprehensibility of patient reported outcome measures (PROMs) in quality of life research is essential. Cognitive interviews are recommended as a 'gold standard' for evaluating comprehensibility among adult populations but are not routinely used with young children (≤ 7 years). The current study therefore aimed to evaluate the feasibility of cognitive interviewing using traditional and adapted methods with children aged 6-7 years to evaluate PROM item comprehensibility.
methodsFourteen children (6-7 years) with a range of diagnosed health conditions participated in individual cognitive interviews. Each child answered six mock PROM items (physical, psychological, and social health-related quality of life domains) and concurrent verbal probes were used to evaluate item comprehensibility. Interviews were audio recorded and transcribed verbatim. Transcripts were analysed using a novel Comprehensibility Continuum which coded the extent of alignment between children's explanations of items and intended meanings.
resultsCognitive interviews were successful; extent of comprehensibility could be determined for 83/84 (99%) item discussions. Most items were comprehensible, with children describing the intended item meaning for 74/84 (88%) items evidenced by contextual examples and/or de-contextual definitions in children's responses to verbal probes. Three items ('walk', 'sad', and 'made fun of') were identified as requiring further testing and/or refinement, where a lower percentage of discussions contained evidence of intended item meaning.
conclusionDespite previous uncertainty, this study demonstrates how methodological challenges can be addressed to enable young children's participation in cognitive interviews evaluating item comprehensibility, ultimately contributing to the accurate measurement of young children's health outcomes in healthcare and research.
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