Allyssa Jiselle M. Cabalonga, Oella Mari M. Cabangon, Joshua Adrielle T. Cabra, Ian Lindley C. Cabral, Ma. Frances F. Cagampan, Nick Louise A. Cajano, Jhovenay U. Calixto, Ma. Teresa Tricia Guison-Bautista, Ma. Minerva P. Calimag, Wennielyn F. Fajilan, John Dale V. Trogo
Apr 2023 DOI 10.35460/2546-1621.2022-0045 Access
Introduction: Telemedicine services have steadily been relied upon since the onset of the COVID-19 pandemic. Understanding its usability and contextual performance is of paramount importance if it were to pervade the local health delivery system. Hence, a tool to assess usability is warranted.
Objective: The study aims to adapt a reliable and validated instrument in English to Filipino, the Telehealth Usability Questionnaire (TUQ), on evaluating the usability of telemedicine services in the Philippines.
Methodology: The research is a translation and validation study. The methodology includes forward translation in collaboration with our UST Sentro sa Salin at Araling Salin and expert panel review with five experts using the telehealth system. It was followed by pretesting (pilot testing and cognitive debriefing) of the pre-final tool to 30 family medicine telehealth patients and field testing of the final instrument to 85 telehealth patients from USTH. Appropriate statistical methods for assessment included internal consistency, content validity and linguistic with conceptual equivalence.
Results: All translated items were retained, but through the focus group discussion, several statements were modified to fit the cultural context. Each item and the overall tool showed excellent validity and internal consistency. The mean difference scores for each item and domain were less than ±0.25. Tests of equivalence showed that majority of items and each domain were not statistically different (p>0.05), suggesting that both questionnaires are similar and homogenous. Furthermore, the Bland-Altman plots for each dimension/domain are within the upper and lower boundaries indicating agreement between the two versions.
Conclusion: TUQ-Filipino is a valid and appropriate instrument to assess telehealth usability in the local setting.
Key words: Telehealth, TUQ-F, Cross-Cultural Adaptation, Validation, Filipino
- World Health Organization (WHO). A health telematics policy in support of WHO’s Health-For-All strategy for global health development: report of the WHO group consultation on health telematics. Geneva, Switzerland: World Health Organization; 1998.
- U.S. Health Researches & Services Administration. Telehealth programs [Internet]. 2017 [cited 2021 Jul 21]. Available from: https://www.hrsa.gov/rural-health/telehealth
- Gajarawala SN, Pelkowski JN. Telehealth benefits and barriers. J Nurse Pract [Internet]. 2021;17(2):218–21. Available from: http://dx.doi.org/10.1016/j.nurpra.2020.09.013
- Hyder MA, Razzak J. Telemedicine in the United States: An introduction for students and residents. J Med Internet Res [Internet]. 2020;22(11):e20839. Available from: http://dx.doi.org/10.2196/20839
- Madarang C. Filipinos can now consult a doctor from home through DOH’s new telemedicine website [Internet]. Interaksyon - PhilStar. 2020 [cited 2020 Sep 27]. Available from: https://interaksyon.philstar.com/trends-spotlights/2020/05/27/169395/filipinos-can-no w-consult-a-doctor-from-home-through-dohs-new-telemedicine-website/
- Yip MP, Chang AM, Chan J, MacKenzie AE. Development of the telemedicine satisfaction questionnaire to evaluate patient satisfaction with telemedicine: a preliminary study. J Telemed Telecare [Internet]. 2003;9(1):46–50. Available from: http://dx.doi.org/10.1258/135763303321159693
- Demiris G, Speedie SM, Hicks LL. Assessment of patients’ acceptance of and satisfaction with teledermatology. J Med Syst [Internet]. 2004;28(6):575–9. Available from: http://dx.doi.org/10.1023/b:joms.0000044959.71456.df
- Bakken S, Grullon-Figueroa L, Izquierdo R, Lee N-J, Morin P, Palmas W, et al. Development, validation, and use of English and Spanish versions of the telemedicine satisfaction and usefulness questionnaire. J Am Med Inform Assoc [Internet]. 2006;13(6):660–7. Available from: http://dx.doi.org/10.1197/jamia.M2146
- Parmanto B, Lewis AN Jr, Graham KM, Bertolet MH. Development of the Telehealth Usability Questionnaire (TUQ). Int J Telerehabil [Internet]. 2016 Spring;8(1):3–10. Available from: http://dx.doi.org/10.5195/ijt.2016.6196
- Armstrong TS, Cohen MZ, Eriksen L, Cleeland C. Content validity of self-report measurement instruments: an illustration from the development of the Brain Tumor Module of the M.D. Anderson Symptom Inventory. Oncol Nurs Forum [Internet]. 2005;32(3):669–76. Available from: http://dx.doi.org/10.1188/05.ONF.669-676
- Lynn MR. Determination and Quantification of Content Validity. 1986; 35(6), 382–5. Available from https://doi.org/10.1097/00006199-198611000-00017
- Malmqvist J, Hellberg K, Möllås G, Rose R, Shevlin M. Conducting the pilot study: A neglected part of the research process? Methodological findings supporting the importance of piloting in qualitative research studies. Int J Qual Methods [Internet]. 2019;18:160940691987834. Available from: http://dx.doi.org/10.1177/1609406919878341
- Polit DF, Yang FM. Measurement and the Measurement of Change. LWW; 2015.
- Tsang S, Royse C, Terkawi A. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth [Internet]. 2017;11(5):80. Available from: http://dx.doi.org/10.4103/sja.sja_203_17
- Zamanzadeh V, Rassouli M, Abbaszadeh A, et al. Details of content validity and objectifying it in instrument development [Internet]. Nursing Practice Today. [cited 2021]. Available from: https://npt.tums.ac.ir/index.php/npt/article/view/24
- Fleiss JL. Statistical Methods for Rates and Proportions. Wiley-Interscience; 1981.
- Goforth C. Using and Interpreting Cronbach’s Alpha | University of Virginia Library Research Data Services + Sciences [Internet]. University of Virginia Library Research Data Services + Sciences. 2015 [cited 2021]. Available from: https://data.library.virginia.edu/using-and-interpreting-cronbachs-alpha/
- Schober P, Vetter TR. Nonparametric statistical methods in medical research. Anesth Analg [Internet]. 2020;131(6):1862–3. Available from: http://dx.doi.org/10.1213/ANE.0000000000005101
- Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med. 2005;37(5):360–3.
- Uebersax J. Tests of Marginal Homogeneity. John Uebersax Home Page [Internet]. 2006 August 13 [cited 2022]. Available from: https://www.john-uebersax.com/stat/margin.htm#npar
- Lane DA, Jajoo J, Taylor RS, Lip GY, Jolly K, Birmingham Rehabilitation Uptake Maximisation (BRUM) Steering Committee. Cross-cultural adaptation into Punjabi of the English version of the hospital anxiety and depression scale. BMC Psychiatry [Internet]. 2007;7(1):5. Available from: http://dx.doi.org/10.1186/1471-244X-7-5
- Torres GCS, Macindo JRB. Cross-cultural validation into Filipino of the Consumer Assessment of Health-Care Providers and Systems Surgical Care Survey (S-CAHPS). J Patient Exp [Internet]. 2020;7(6):1136–43. Available from: http://dx.doi.org/10.1177/2374373520910027
- Karras DJ. Statistical methodology: II. Reliability and variability assessment in study design, Part A. Acad Emerg Med [Internet]. 1997;4(1):64–71. Available from: http://dx.doi.org/10.1111/j.1553-2712.1997.tb03646.x
- Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J Med Educ [Internet]. 2011;2:53–5. Available from: http://dx.doi.org/10.5116/ijme.4dfb.8dfd
- Bowling A. Measuring Health. Buckingham: Open University Press; 2005.
- Lawshe CH. A Quantitative Approach to Content Validity. Lafayette, IN: Personnel Psychology; 1976.
- Davis LL. Instrument review: Getting the most from a panel of experts. Appl Nurs Res [Internet]. 1992;5(4):194–7. Available from: http://dx.doi.org/10.1016/s0897-1897(05)80008-4
- Fleiss JL, Levin B, Paik MC. Statistical Methods for Rates and Proportions. John Wiley & Sons; 2013.
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