Chapter 29. Questionnaires
Kader Parahoo
▪ Introduction: what is a questionnaire?
▪ The purpose of questionnaires
▪ Developing and planning questionnaires
▪ Constructing questionnaires
▪ Ethical implications
▪ Advantages and limitations of questionnaires
▪ An example of a questionnaire
▪ Conclusion
The purpose of questionnaires
Questionnaires are often used to collect data on attributes (e.g. demographic details or personality traits), attitudes, beliefs, experience (including perceptions and feelings), behaviour (past, present and future) and activities (e.g. bed occupancy or use of resources). Questionnaires can be used to examine patterns, trends and statistical correlations (relationships) between variables (e.g. between alcohol consumption and occupation). The type of data required by questionnaires is mostly quantifiable. They offer the possibility for respondents to remain anonymous and they are suitable for sensitive topics which people may be reluctant to talk about.
Questionnaires are valuable in providing data to inform policy, practice and education. On page 300 are some examples of the use of questionnaires in nursing research:
Practice: Asthma treatment needs: a comparison of patients’ and health care professionals’ perceptions (Hyland & Stahl 2004).
Education: Are mentors ready to make a difference? A survey of mentors’ attitudes towards nurse education (Pulsford et al 2002).
Developing and planning questionnaires
Developing questionnaires is systematic, time-consuming and laborious, requiring much preparation before the first question is phrased. Research questions should be clear and realistic. An example of research questions for a study which used a questionnaire can be found in Ahlberg et al (2004, pp. 207–208). The aim of the study was to provide knowledge about predictors of cancer-related fatigue. The research questions were:
▪ How do patients diagnosed with uterine cancer describe their experience of fatigue, psychological distress (anxiety and depression), coping resources and quality of life?
▪ What are the correlations among general fatigue, psychological distress, coping resources and quality of life in patients with uterine cancer?
▪ Does the degree of psychological distress (anxiety and depression) or coping resources predict the degree of general fatigue in patients with uterine cancer?
Research questions, or objectives, have to be feasible and realistic bearing in mind the resources available, including time. The length of the questionnaire and the degree of burden on respondents should also be considered.
The research questions may indicate whether there is a need to ‘reinvent the wheel’ or whether existing questionnaires, or scales, can be used (with permission from the originator/s). At the planning stage, researchers should take into account who the ‘audience’ for the questionnaire is (e.g. children, older people, professionals or lay persons) and how they will be accessed. Preliminary enquiry about the feasibility of obtaining an adequate sample for the study should be made. The sample size should be kept in mind at this stage.
In summary, serious consideration should be given to the research topic and questions, the nature and size of sample, the role and tasks of team members and the resources available for the study before the questions can be formulated.
Constructing questionnaires
Layout and structure
The questionnaire should be structured in such a way that it is user-friendly, easy to understand and to answer. The research questions or objectives provide a guide to how the questionnaire is structured and how many questions are asked. For example, if a questionnaire examines nurses’ knowledge of and attitudes to research, and their research activities, then each of these key concepts or variables (knowledge, attitude and behaviour) should be allocated a number of questions to address these issues adequately. These key variables could form different sections in the questionnaire. It could start with demographic questions followed in turn by sections on knowledge, attitudes and activities. Such a structure will provide a logical sequence of questions.
Question wording
One underlying principle of question wording is to keep questions short. This should, however, be balanced with the need to be specific about what is being asked. An example of a short question is:
YesNo
Do you smoke?□□
This question, however, lacks specificity. It is not clear whether smoking in this case refers to cigars, cigarettes, a pipe or cannabis. It also does not specify the period of smoking. A clear and specific question could be:
YesNo
Do you currently smoke cigarettes?□□
Leading questions
Avoid these: they are worded in such a way that they encourage respondents to give the answer the researcher wants. An example of a leading question is:
Eating fatty food can be harmful to health. Do you agree that all food products should be labelled?
YesNo
□□
It would be hard for people to answer ‘no’ to such a question.
Double-barrelled question
Sometimes two questions are merged into one and it is difficult to give one answer to them. For example:
Were you satisfied with the service and the price?
YesNo
□□
The respondent may have been satisfied with the service but not with the price.
Hypothetical question
Researchers should avoid asking hypothetical questions as they are not real enough for people to seriously give their views on them. For example:
Do you think there should be more ambulances?
YesNo
□□
Few people will reply ‘no’ to this question.
Questions about other people
Questionnaires should be about respondents’ own views, attitudes, knowledge or behaviour, not about other people’s. A question such as:
is asking respondents to guess an answer, because it is not possible for them to know whether people are in favour or not.
Do you think people are in favour of capital punishment?
YesNo
□□
Questions which can be obtained more easily from other sources
If a researcher wants to know the visiting times for relatives on a particular ward, there is no point in asking this question to all nurses on the same ward. They may, however, be asked about their views on whether the visiting times are helpful or not to visitors.
Slang
Slang words, professional terminologies, abbreviations (even well-known ones) should be avoided.
Questions which strain the memoryof respondents
Care should be taken to avoid overlapping categories.
Finally, it is important to test the questionnaire (discussed later in the chapter) before it is administered.
Question format
Questions can be asked in a variety of formats or styles, but the choice of format depends on the type of data which the researcher requires. Questions can be closed or open-ended. For example, if the question is ‘What sources do you access when seeking information about blood pressure?’, the researcher can provide a list of answers which the respondent can choose from (closed). Alternatively they can be asked to list as many sources as they can (open-ended). The common formats used for questions are described below.
Multi-choice questions
Apart from questions requiring a ‘yes’ or ‘no’ answer, researchers can offer participants a list of items which they can choose from to indicate their response. For example, respondents could be asked to indicate their mode of travel from home to work, from the following:
Car□
Bus□
Train□
Bicycle□
With multi-choice questions, the researcher must ensure that all the possible options are provided. Even then, an additional box for ‘other’ should be included in case the respondent in the above example travels by a mode of transport that the researcher had not thought of (e.g. by motorbike). Clear instructions as to whether respondents should ‘tick’ one or more boxes should be given. In the above example it may be that some people may travel by bus or car before catching a train.
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