2.9 Process of instrument development
Established principles of survey design were
applied.18 The steps taken to develop and validate the
survey instrument are outlined in Table 1.
[Place Table 1 here]
2.9.1 Step 1: Item
generation
Before developing the questions, the constructs that we intended to
measure required identification and definition. These included KAP, as
well as demographic questions. A database search was undertaken to
identify aspects of OBP and KAP that should be included in the
questionnaire. Electronic searches of CINAHL (Cumulative Index to
Nursing and Allied Health Literature) via EBSCOhost, Pubmed and Google
Scholar were conducted between July 2017 and March 2018 using the search
string hand therap* AND (occupation* OR occupation based practice* OR
occupation based intervention OR occupation as a means and occupation as
an end). These keywords were chosen based on the different operational
definitions for the concept of OBP used in previous studies. Papers had
to be in English and published from 2000 onwards. A total of 26 papers
were retrieved during the database search and used in the development of
the survey items.
As no existing questionnaires measuring KAP related to OBP in hand
therapy had been identified in the first database search, studies
investigating KAP as single constructs in hand therapy literature, or in
related areas, were sought, and relevant items were identified. Key
points were extracted from the definitions of each construct, and
relevant items were identified and extracted8,9,20,21,22,23,24 (see Table 2). As the literature on
occupation-based hand therapy predominantly focussed on barriers and
facilitators,21,24,25 these aspects were included in
the questionnaire to obtain information on practice influences that
could be compared across other studies. Table 2 outlines the
questionnaire constructs with the key points extracted from their
definitions, and the studies from which the information was obtained.
[Place Table 2 here]
A table of specifications was developed by listing each construct (KAP
and influences) with all related key points on the vertical axis and
applicable themes related to OBP on the horizontal axis. Each cell was
then summarised by a draft question/statement that linked with an aspect
of the construct (on the vertical axis) with the theme (on the
horizontal axis). Statement wording was additionally informed through
personal and professional experience, until saturation was
reached.18 Survey items were then generated from the
items listed in the table of specifications.