A three-phase mixed methods study was undertaken to inform the development and design of this questionnaire: Phase 1, an analysis of existing tools and semi-structured interviews with patients and professionals to establish the concepts to be measured and content of the measure; Phase 2, development of questionnaire items suitable for patients and professionals; Phase 3, pre-testing the single measure to assess acceptability and understanding to both stakeholder groups. Interviews and pre-testing took place over a 12 month period with patients and professionals from five specialities recruited from two UK hospital Trusts.
Subsequent to the above study, the WHQ was field-tested for completion by patients (self-assessment) and healthcare professionals (observer-assessment) in a large study following abdominal surgery. An 18 item WHQ was adopted as the final version. The WHQ has demonstrated strong internal consistency and good reliability between test-retest and self- versus observer assessment.
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