Patients were asked to fill in the questionnaire and rate clarity and comprehensiveness of the title, questionnaire instruction, and questions on two eleven-point visual analogue scales (VAS), ranging from zero to ten (where ten indicated the highest level).
Despite the comprehensiveness of this questionnaire, its use may be limited in a community mental health setting as the number of items makes the scale difficult to implement in routine clinical evaluation and items were derived from a mostly non-clinical sample.
In-depth individual interviews were then used to validate the comprehensiveness and understandability of the questionnaire.
Then, individual interviews were conducted to ensure comprehensiveness, feasibility, and understandability of the questionnaire, which was developed based on the findings of the focus group discussions.
Two major concerns about the questionnaire-based studies are (1) the low response rate and (2) the potential lack of comprehensiveness due to the design of the questionnaire.
The purpose was to ensure comprehensiveness, clarity, cultural relevance and appropriateness of the questionnaire for the patients.
To ensure clarity and comprehensiveness, the questionnaire was face-validated within a group of health services researchers and it was pilot-tested with a sample of residents from the school of medicine at the American University of Beirut.
To ensure content validity, clinicians and a psychologist reviewed the final English version of the questionnaire to assess its relevance, appropriateness, clarity, and comprehensiveness.
Cognitive interviews were conducted to assess the respondents' understanding of the questionnaire and its items, in relation to the intended meaning and to evaluate comprehensiveness of the content to evaluate the target concept [ 14].
