Lay Kiri, Hutchinson Claire, Song Jia, Milte Rachel, Khadka Jyoti, Ratcliffe Julie
Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Adelaide, GPO Box 2100, Adelaide, SA, 5001, Australia.
Qual Life Res. 2025 Mar;34(3):605-619. doi: 10.1007/s11136-024-03849-z. Epub 2024 Dec 3.
Older people (aged ≥ 65 years) are significant users of health and social care systems. However, many outcome measures for quality assessment and economic evaluation lack content validation for this population. Cognitive interviews are a key approach for generating content validity evidence. This systematic scoping review aimed to synthesise evidence on cognitive interviewing practices with older adults, including those with cognitive impairment and dementia, to determine the content validity of outcome measures used with these populations in health and social care settings.
A search was conducted across five databases, and results were uploaded to Covidence review management software. Two researchers performed screening and data extraction using a custom template. The initial search identified 8814 articles. After removing duplicates and conducting title and abstract screening, 105 articles remained. Full-text screening excluded 86 references, resulting in 19 included articles.
Studies utilised various cognitive interviewing approaches, predominantly concurrent think-aloud combined with verbal probing. Inductive analysis based on Tourangeau's four-stage response model was commonly used for analysing verbal protocol data. Only one in four included studies indicated any allowances to alleviate cognitive burden for older participants. There was limited involvement of older people with cognitive impairment and dementia, but studies including these populations reported several modifications enhancing meaningful inclusion.
老年人（年龄≥65岁）是卫生和社会护理系统的重要使用者。然而，许多用于质量评估和经济评价的结果指标缺乏针对该人群的内容效度验证。认知访谈是生成内容效度证据的关键方法。本系统综述旨在综合关于与老年人（包括有认知障碍和痴呆症的老年人）进行认知访谈实践的证据，以确定在卫生和社会护理环境中用于这些人群的结果指标的内容效度。
在五个数据库中进行检索，并将结果上传至Covidence综述管理软件。两名研究人员使用自定义模板进行筛选和数据提取。初步检索共识别出8814篇文章。在去除重复项并进行标题和摘要筛选后，剩余105篇文章。全文筛选排除了86篇参考文献，最终纳入19篇文章。
研究采用了各种认知访谈方法，主要是并发出声思考结合口头追问。基于图兰乔的四阶段反应模型的归纳分析常用于分析口头记录数据。纳入研究中只有四分之一表明采取了任何减轻老年参与者认知负担的措施。有认知障碍和痴呆症的老年人参与度有限，但纳入这些人群的研究报告了一些改进措施，以增强有意义的纳入。
