Background
Methods
Study design and ethics
Sampling and recruitment
Demographic data
Cognitive interviewing procedure
Sample size and saturation
Data analysis
Findings
Participants
Variable | Mean ± SD | Range | Frequency (n) | Percentage (%) |
---|---|---|---|---|
Participants with or without CTS (n = 10) | ||||
Age (y) | 35.2 ± 9.9 | 19–48 | ||
Duration of symptoms (y) | 3.9 ± 3.3 | 0.5–12 | ||
Severity of CTS | Mild, n = 2 | |||
Moderate, n = 2 | ||||
Severe, n = 1 | ||||
Participants without CTS, n = 5 | ||||
Type of occupation | ||||
Manual | 5 | 50 | ||
Not manual | 4 | 40 | ||
No occupation | 1 | 10 | ||
Gender | ||||
Women | 8 | 80 | ||
Men | 2 | 20 | ||
Experts group (n = 8) | ||||
Work experience (y) | 11.6 ± 6.4 | 4–20 | ||
Profession | ||||
Occupational therapy | 2 | 25 | ||
Physiotherapy | 6 | 75 | ||
Level of education | ||||
B.Sc. | 3 | 37 | ||
M.Sc. | 2 | 25 | ||
Ph.D. | 3 | 37 |
Problematic themes identified by cognitive interviewing
Questions themes | Q1 | Q2 | Q3 | Q4 | Q5 | Q6 | Q7 | Q8 | Q9 | Total number of errors for each category across all of the questions |
---|---|---|---|---|---|---|---|---|---|---|
C | E:2 | E:5 | E:5 | P:3 | E:4 | E:6 | E:25 | |||
P:3 | P:3 | P:5 | P:1 | P:4 | P:16 | |||||
T:41 | ||||||||||
R | E:6 | E:5 | E:3 | E:6 | E:2 | E:1 | E:23 | |||
P:1 | P:1 | P:1 | P:5 | P:8 | ||||||
T:31 | ||||||||||
IR | E:3 | E:3 | ||||||||
RP | P:1 | P:1 | P:2 | |||||||
PM | E:1 | E:2 | E:3 | |||||||
Total number of errors for each question: | E:7 | E:7 | E:8 | E:8 | E:10 | E:2 | E:3 | E:6 | E:54 | |
P:1 | P:4 | P:4 | P:5 | P:3 | P:17 | P:5 | P:26 | |||
T:80 |
“I always ask that question, and I like it. However, you’ve got to define what is a splint; people ask me this all the time. Is it a brace, is it a glove? I think splint is usually considered to be custom-made and made at a hospital; versus a brace which you can pick up from a shelf. I think it is a valuable question by just modifying it to: have your symptoms improved with using support on your wrist?"—EP3
"Using the term night in this question could be problematic… I was thinking about saying "has pain disrupted your resting time?" because some people sleep during the day, some sleep during the night, it depends. Alternatively, say when you are sleeping"—ES3
Another issue was raised on the activities (reading a newspaper, steering a car, and knitting) mentioned by the sixth question. Eleven participants stated that those activities are not very common anymore and not everybody tends to do them, including themselves."If somebody is working throughout the night and sleeping during the day, we cannot ask them about days and nights. I usually tend to ask patients about their symptoms during sleep”—EP2
"I do get tingling when I am biking, but I do not knit or read a newspaper. Moreover, I do not have numbness. I think other activities might be included in the list to make it more relevant to everyone"—EO2
“The concept of pain is not clear, and it might confuse different people based on their perception of pain”—EP3"The word ‘severe' is not well-defined. Some people who might be experiencing tingling and numbness during pregnancy, but it might not be severe, or they do not see it as severe, and they would answer ‘no' to this question"—EO1"Definition of the word ‘severe' must be better stated; it might mean different things to different people"—EO2
“And, I do not have tingling when I drive because I do not tend to drive long distances anymore or rest my arms in driving if it is more than 30 min”—PNC4 response to question #6.
“No. I should not say no, though, because it helped at night, but it did not help me at work. Because I know I should have worn them at work, but it was too difficult, so I am not using them at work…"—PNC1 response to question #9.
Participants’ opinion on content coverage
Discussion
Question # | Original questions | Modified questions |
---|---|---|
1 | Has pain in the wrist woken you at night | Do you wake up because of pain in your wrist? |
2 | Has tingling and numbness in your hand woken you during the night? | Do you wake up because of tingling or numbness in your fingers? |
3 | Has tingling and numbness in your hand been more pronounced first thing in the morning | Do you have tingling or numbness in your fingers when you first wake up? |
4 | Do you have any trick movements to make the tingling, numbness go from your hands? | Do you have any quick movements or positions that relieve your tingling or numbness? |
5 | Do you have tingling and numbness in your little finger any time | Do you have numbness or tingling in your little (small/pinky) finger? |
6 | Has tingling and numbness presented when you were reading a newspaper, steering a car or knitting | Do certain activities (for example, holding objects or repetitive finger movement) increase the numbness or tingling in your fingers? |
7 | Do you have any neck pain? | Do you often have neck pain? |
8 | If applicable has the tingling and numbness in your hand been severe during pregnancy | Did you have numbness or tingling in your fingers when you were pregnant? (If relevant) |
9 | Has it helped the tingling and numbness on wearing a splint on your wrist | Have your symptoms improved with using a wrist support brace or splint? (if relevant) |
Q1: Has pain in the wrist woken you at night?
Q2: Has tingling and numbness in your hand woken you during the night?
Q3: Has tingling and numbness in your hand been more pronounced first thing in the morning.
Q4: Do you have any trick movements to make the tingling, numbness go from your hands?
Q5: Do you have tingling and numbness in your little finger any time?
Q6: Has tingling and numbness presented when you were reading a newspaper, steering a car or knitting?
Q7: Do you have any neck pain?
Q8: If applicable has the tingling and numbness in your hand been severe during pregnancy?
Q9: Has it helped the tingling and numbness on wearing a splint on your wrist?
Recommendations on potential addition of questions to the Kamath and Stothard questionnaire
1 | Do you wake up because of pain in your wrist? | Yes | No |
2 | Do you wake up because of tingling or numbness in your fingers? | Yes | No |
3 | Do you have tingling or numbness in your fingers when you first wake up? | Yes | No |
4 | Is your numbness or tingling mainly in your thumb, index, and/or middle finger? | Yes | No |
5 | Do you have any quick movements or positions that relieve your tingling or numbness? | Yes | No |
6 | Do you have numbness or tingling in your little (small/pinky) finger? | Yes | No |
7 | Do certain activities (for example, holding objects or repetitive finger movement) increase the numbness or tingling in your fingers? | Yes | No |
8 | Do you drop small objects like coins or a cup? | Yes | No |
9 | Do you often have neck pain? | Yes | No |
10 | Did you have numbness or tingling in your fingers when you were pregnant? (If relevant) | Yes | No |
Not relevant to me | |||
11 | Do you have numbness or tingling in your toes? | Yes | No |
12 | Have your symptoms improved with using wrist support brace or splint? (If relevant) | Yes | No |
Not relevant to me |