Can self-report questionnaires create illness cognitions in middle-aged men?

Area of Science:

• Medical Sociology
• Health Psychology
• Patient-Reported Outcomes Research

Background:

• Understanding patient perceptions of illness is crucial for effective healthcare.
• Self-reported outcomes can be influenced by various factors, including survey design.
• Lower urinary tract symptoms (LUTS) are common in middle-aged men and impact quality of life.

Purpose of the Study:

• To investigate how the surrounding questions in a survey affect self-reported illness perceptions.
• To determine if the context of a questionnaire influences the reported impact of lower urinary tract symptoms (LUTS).

Main Methods:

• A single-item measure of perceived LUTS impact was included twice in a survey for 1,790 men.
• The measure was placed after a general symptoms questionnaire and after an LUTS-specific questionnaire.
• The order of these questionnaire contexts was counterbalanced in a subsample.

Main Results:

• Self-reported impact scores for LUTS were significantly lower when the question followed an LUTS-specific questionnaire compared to a general symptoms questionnaire.
• This context effect was more pronounced in men with higher LUTS severity.
• No order effects were observed between the two questionnaire contexts.

Conclusions:

• The context in which a self-report measure is presented systematically alters responses.
• These findings highlight the importance of considering questionnaire design when interpreting patient-reported outcome measures.
• The observed effect has implications for evaluating healthcare interventions and informing treatment decisions, particularly in populations with varying symptom severity.