Evaluating a questionnaire assessing healthcare provider perceptions of rural dementia care

Abstract

Dementia touches the lives of many people in Canada and, when it occurs, it affects all aspects of the day-to-day lives of individuals and families. Individuals with dementia living in the community may face barriers to accessing care and resources, which is further compounded for those living in rural and remote areas. How healthcare providers in rural settings meet the needs of those living with dementia in the community is not well documented. Understanding the challenges of rural healthcare providers is essential for improving services along the continuum of care for dementia. A questionnaire was developed by the Rural Dementia Action Research (RaDAR) team to assess current strengths and gaps in dementia care along the continuum from assessment through management in rural primary healthcare settings. The questionnaire was based upon the RaDAR program framework and a scoping literature review conducted by Aminzadeh et al. (2012). The purpose of this study was to pretest the questionnaire to determine whether it was feasible and acceptable to participants, and if there was adequate evidence for validity of the instrument. The pretest study was conducted with twelve participants from four healthcare provider categories (i.e., family physicians, nurse practitioners, homecare registered nurses, and occupational therapists). Semi-structured telephone interviews were conducted to assess feasibility, acceptability, and evidence for validity of the questionnaire. The design was an iterative, sequential evaluation process, which allowed modification to the questionnaire throughout the data collection period. Data sources included the transcribed interviews, participant feedback, graduate student researcher notations, and RaDAR team notations. The pretest showed that the questionnaire was feasible based on the length of the interview and the format for administration. The questionnaire was shown to be acceptable to participants based on the wording, flow, and level of understandability of the content. Multiple sources of evidence for validity were identified, including item content and response process. Consensus was reached by the RaDAR team and graduate student that the questionnaire was ready for use in a larger study.