Questions for the pilot questionnaire

Questions for emotions and oral care behaviours were developed for the tool. These were based on the theoretical models for oral care developed in the second chapter of this thesis from the focus group and interview studies. Questions for participant characteristics and previous experiences of oral care

Previous attitudinal studies of oral care (Wardh et al., 1997, Binkley et al., 2004) and studies of oral care in hospitals (Grap et al., 2003, Binkley et al., 2004) were used to inform the selection and development of patient characteristics and oral care experience questions. Three common oral care procedures derived from the initial focus group study were specified for the previous experience questions.

Questions for emotions and behaviours towards oral care

Questions for emotional feelings care scenarios were informed by studies measuring affect and valence towards images (Feldman-Barrett, 2004, Libkuman et al., 2007). Theoretical models from the focus group and interview studies were used as a framework for the creation of questions as illustrated in Table 3.4. Emotional questions relating to empathetic emotions, (feelings in the patient’s position) towards oral care were also included, as “self” and “other” were not clearly delineated in the focus group or interview studies.

Table 3.4 Outline of the framework for the qualitative themes, questions and emotion scales used in the pilot questionnaire

Theme from Focus group and interview studies Question in questionnaire

Emotions scales used with question

Disgust Anxiety

Satisfaction

Attention cues How would you feel seeing this?

If you were the patient how would you feel about this?

 

 

Moral emotions If you did not brush his teeth how would you feel?

  

Physical emotions

How would you feel touching this?

How would you feel while brushing his teeth?

 

  

Questions to assess behavioural intention were based on previous studies of oral care (Grap et al., 2003, Binkley et al., 2004). The specific wording for intended procedures was informed by literature (Oppenheim, 1992) and descriptions of oral care procedures described in the focus group and interview studies. A question about asking for help with oral care was also included as this behaviour was described by a number of participants in the focus group and interview studies.

Response scales were developed for demographic, previous oral care experience, emotion and oral care behaviours. Response scales for demographics and previous experience were based on scales used in previous studies (Grap et al., 2003, Binkley et al., 2004).

Likert question scales were selected as a single scale for recording data for several emotions in line with previous emotion studies (Feldman-Barrett, 2004, Libkuman et al., 2007). A five point scale (Watson et al., 1988) was chosen to fit images and the scale on the computer screen.

A single scale of oral care frequencies was selected, this was informed by studies of oral care in hospitals (Grap et al., 2003, Binkley et al., 2004) and the evidence that oral care is most effective when it is carried out twice per day.

Referring for help was quantified in terms identified in the focus group and interview studies, as never, possibly or definitely. Questions and measures for this are shown in Table 3.5 and an illustration of the questionnaire presentation is shown in Figure 3.2.

Table 3.5 Illustration of the behavioural intention themes, questions and measures used in the pilot questionnaire

Theme Questions Measure

Behavioural intention (motivation and moderation)

For this patient would you

Brush in the mouth of the toothbrush? Use a toothbrush to clean this? Use a swab on a stick to clean this?

Frequency

Behavioural intention (moderation)

Ask or refer for help? Intention

Figure 3.2 Illustration of the scenario, image, question and scale used in the pilot questionnaire study

Questions were repeated with horizontally flipped images, to retest validity in accordance with questionnaire development practices (Oppenheim, 1992, DeVon et al., 2007). The questionnaire is shown in Appendix 3.8.

The online tool was developed using survey tracker software (Training Technologies Incorporated). This software was compatible with photographic images and was supported by the information technology department for online data delivery and collection within the School of Psychology. Data retrieval pathways were created and tested using a practice copy of the survey and dummy data.

Administration of the questionnaire

Tests were administered under the conditions previously described. A Samsung r780 laptop with a 15-inch computer screen and a mouse was used for questionnaire. Participants were seated and positioned with approximately 60cm from eyes to the screen.

Data preparation and cleaning and checking questionnaire data

Questionnaire data were retrieved from Survey Tracker software using the pathway set up in. Data were retrieved as Microsoft Excel 2007 (Microsoft, Redmond, United States of America) data files and uploaded to SPSS version 18 software (IBM Inc, New York, United States of America) for data checking and analysis. The checklist from Tabachnick and Fidel (2007) was used as a guide for data checking prior to analysis. Data were screened for accuracy outliers, missing data and out of range values using visual inspection and data sorting in Microsoft Excel 2007 (Microsoft, Redmond, United States of America). These were further examined using SPSS data frequencies, mean, mode, range minimum values, maximum values and variance. SPSS Scatterplots were used to examine heteroscedasticity. SPSS descriptives were used for skewness and kurtosis and histograms were used to visually explore the distribution of data.

Analysis of questionnaire data

Questionnaire data were analysed using SPSS version 18 software (IBM Inc, New York, United States of America), Microsoft Excel 2007 (Microsoft, Redmond, United States of America), Ggobi (Swayne et al., 2008), R (R Development Core Team, 2011) and Mondrian (Martin, 2011) software packages. Emotional response ratings were examined using frequencies,

median values and the value range. Data tables, bar plots, scatter plots and parallel plots were produced to examine visually questionnaire responses across participants and participant’s individual responses to questions for each scenario. Contingency tables and Χ2 tests were then used to test associations between responses to different questions for each scenario and to compare the responses to the same questions in the different scenarios. All statistical tests were planned with advice from statistician and psychologist with experience of these tests. Test procedures, results and interpretation of results were reviewed by and discussed with the statistician and psychologist.