Table 2 Narrative results of thematic analysis from Semi-structured Interviews
Main theme | Sub-theme | Narrative results | |
|---|---|---|---|
Patients | Healthcare professionals | ||
Content | Scope | 1. Current PROMs instruments are selectively focused and whilst providing in-depth information on i.e. symptomatology of the disease frequently neglects other important aspects like economics of treatment and psychological impact of disease. | |
1. A balance needs to be struck as to how detailed the questions should be. A significant number of PROMs questions appear repetitive and responders cannot differentiate the subtlety within. | 1. PROMs instrument should also capture demographic i.e. occupation and visual requirements and comorbidity data as these factors will skew responses. 2. Not sufficient to address patient’s concerns, fears and doubts. | ||
Language | 1. Simple and specific terms should be used in the instruments to prevent confusion, increase accuracy andreduce responder fatigue. | ||
1. Is there an easier word to use besides errands | 1. If technical terms are unavoidable, examples or pictures can be used to improve understanding. 2. In formulating and phrasing of PROMs questions, the usage of active voice and inclusion of a temporal comparative element will enhancement comprehension and detect disease progression. | ||
Localization and contextualization | 1. PROMs instrument should be localized to the setting it is used and allow responders to relate the questions to their daily living. | ||
1. The most relevant and useful PROMs questions are those relating to disease impact on vision and how it compromises personal safety or impair daily living. 2. Playing games such as bingo or bridge…better to use local context like playing mahjong. 3. Subway should be replaced with MRT. | |||
Administration | Relevance | 1. The instrument needs to yield tangible benefits to the patients’ management i.e. in the form of follow up actions like referrals to be considered useful. 2. Not really relevant as I am doing good so no concerns. 3. As glaucoma is a symptomless disease in the early stages, PROMs instrument may not be particularly useful for patients with mild disease. | 1. For a mild glaucoma patient, this may not be relevant |
Logistics | 1. Time spend on the PROMs instrument should be keep to a minimum. Current questionnaires tend to be rather lengthy and unsuitable to be completed in a busy outpatient setting. 2. I need someone to read this out to me because I have very poor vision! 3. Traditional paper and pen administration may be impossible for those with advanced disease and poor vision. | ||
User-friendliness | 1. Font size, type and questionnaire layout is important to improve the user experience and enhance participation rates. This is especially so as responders are likely visual impaired due to disease or pharmacological dilation. | ||
1. Cannot really see because of the dilation eyedrop…the fonts should be larger. | |||