Skip to main content

Table 2 Problems concerning the questionnaires HLS-EU-Q16 (= A) and HLS-EU-Q16-EZ (= B)

From: Measuring health literacy among low literate people: an exploratory feasibility study with the HLS-EU questionnaire

Problem Item - Questionnaire Quote
Comprehension problems due to…
 Vocabulary ▪ Questionnaire A ▪ “The questionnaire should be in everyday speech.” (respondent 3, respondent 8)
▪ Questionnaire A ▪ “I think you should make it simpler, a lot of people will not understand [the questionnaire (A)]. If even I find it difficult..” (respondent 9)
▪ Q5 -A and Q11 - A ▪ “What does the word ‘to judge’ (Dutch ‘beoordelen’) mean?” (respondent 3, respondent 9, respondent 11, respondent 12)
▪ Q9 - A ▪ “Drinking too much: I should drink more water. You mean too much water?” (respondent 5)
 Sentence structure ▪ Q11 - B ▪ “I have had to read the question [Q11 (B)] several times in order to understand. Sentences should be shorter.” (respondent 2)
▪ Questionnaire A ▪ “The questions should be shorter.” (respondent 8)
Decision process problems due to…
 Referencing to general practitioner ▪ Q11 - A ▪ “What does the media have to do with it? If my general practitioner has something to say to me, he should say that to my face” (respondent 3)
▪ Q1 - B ▪ “Q1 (B) is not applicable to my situation: my general practitioner properly informs me, so I would want an extra answer option ‘not necessary’ because I get all my information from my general practitioner” (respondent 6)
▪ Q5 – B ▪ “I understand the question and the words, but I still do not know what to answer. I rely on my general practitioner; he is the one I can trust…so I do not know what to answer” (respondent 2)
▪ Q8 - A ▪ “That is also a difficult question [Q8(A)], if you have mental health problems, you talk it through with your general practitioner; if you are depressed, you must go to the hospital, so I would talk to my general practitioner” (respondent 9)
▪ Q11 - A ▪ “What does the media have to do with it? If my general practitioner has something to say to me, he should say that to my face” (respondent 3)
 Cannot relate to questions about the media ▪ Q11 - A ▪ “What does the media have to do with it? If my general practitioner has something to say to me, he should say that to my face” (respondent 3)
▪ Q11 - A and Q12 – A ▪ “I follow the media, but I don’t always agree with them, it is difficult to answer” (respondent 9)
▪ Q15 - A ▪ “I don’t understand what they mean ‘to understand information presented by the media about being healthy’?” (respondent 10)
 Different interpretations of preventive examinations: confusion if question is restricted to cancer screening ▪ Q10 – A ▪ “I have renal failure, so I am subjected to many tests, I always have to get myself checked out, so I am examined preventively.” (respondent 6)
▪ Q10 - A ▪ “What do you mean with preventive? I have osteoporosis, that doesn’t happen in 1 day” interviewer refers to preventive screening of cancer “I am doing all of them [cancer screening] so that is easy for me” (respondent 9)
 Difficulties distinguishing between “appraising” or “applying” ▪ Q5 - A ▪ “I don’t know what the question is about. I think it is about judging the second doctor or is it about judging if you need a second opinion? I answered as if I were already there [with the second doctor]. You can make a question like ‘Do you find it easy to judge if u need another advice?” (respondent 8)
 Unclear distinction between questions ▪ Q1 - A vs Q6 - A ▪ “What is the difference between Q1 (A) and Q6 (A)?” (respondent 8)
▪ Q3 - A vs Q4 - A ▪ About unclear distinction between Q3 (A) and Q4 (A) “You can change Q4 (A) to ‘Are you capable of taking your medication independently?’.” (respondent 8)
Irrelevance of questions in specific situations
  ▪ Questionnaire B ▪ “The questionnaire is rather difficult, some questions I am not able to answer because I do not find myself to be in the situation that is being portrayed.” (respondent 6)