How Do Patients Understand Questions about Lower Urinary Tract Symptoms? A Qualitative Study of Problems in Completing Urological Questionnaires

Florine W. M. Schlatmann (), Michael R. van Balken, Andrea F. de Winter, Igle-Jan de Jong and Carel J. M. Jansen
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Florine W. M. Schlatmann: Department of Urology, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
Michael R. van Balken: Department of Urology, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands
Andrea F. de Winter: Department of Health Literacy and Prevention, Health Science, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
Igle-Jan de Jong: Department of Urology, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
Carel J. M. Jansen: Department of Communication and Information Studies, University of Groningen, 9712 EK Groningen, The Netherlands

IJERPH, 2022, vol. 19, issue 15, 1-24

Abstract: Lower urinary tract symptoms are common complaints in ageing people. For a urological evaluation of such complaints in men, the International Prostate Symptom Score (IPSS) is used worldwide. Previous quantitative studies have revealed serious problems in completing this questionnaire. In order to gain insight into the nature and causes of these problems, we conducted a qualitative study. Not only the purely verbal IPSS was studied but also two alternatives, including pictograms: the Visual Prostate Symptom Score (VPSS) and the Score Visuel Prostatique en Image (SVPI). Men aged 40 years and over with an inadequate level of health literacy (IHL; n = 18) or an adequate level of health literacy (AHL; n = 47) participated. Each participant filled out one of the three questionnaires while thinking aloud. The analysis of their utterances revealed problems in both health literacy groups with form-filling tasks and subtasks for all three questionnaires. Most noticeable were the problems with the IPSS; the terminology and layout of this form led to difficulties. In the VPSS and SVPI, the pictograms sometimes raised problems. As in previous research on form-filling behavior, an overestimation by form designers of form fillers’ knowledge and skills seems to be an important explanation for the problems observed.

Keywords: lower urinary tract symptoms questionnaires; health literacy; working-aloud method (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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