Cognitive debriefing interviews

After the preliminary scales are constructed, they will be shown to participants with hand conditions in the form of semistructured cognitive interviews. These interviews will be conducted by telephone, audio recorded, transcribed and analysed. The purpose of these interviews is to ensure that participants have understood the instructions, items and the response options. The participant will be asked to go through each of the scales using the ‘think aloud’ technique, while the interviewer notes the specific content that causes problems.^{33 34} Feedback will be sought on the relevance of the items to the individual. If an item is unclear to a participant, they will be asked for suggestions on how we can improve item wording. Further probing will be used to enquire about any new content that may have been overlooked. Cognitive interviews will be performed in three rounds to provide the opportunity to make changes between rounds. The first round will include participants from the qualitative interviews from both the Australian and Canadian cohorts. Subsequent rounds will also include new participants from the USA to ensure content validity for patients in that country.