Chapter 11: Designing Surveys and Questionnaires

Introduction

One of the most popular methods for collecting information is the survey approach. A survey consists of a set of questions that elicits quantitative or qualitative responses. Surveys can be conducted for a variety of purposes using different formats and delivery methods, including questionnaires in hard copy or online, and face-to-face or telephone interviews.

Surveys can be used as a data gathering technique in descriptive, exploratory, or explanatory studies. Data may be intended for generalization to a larger population or as a description of a smaller defined group. The purpose of this chapter is to present an overview of the structure of survey instruments, with a focus on essential elements of survey design, construction, question writing, and delivery methods.

Purposes of Surveys

Surveys can be used for descriptive purposes or to generate data to test specific hypotheses.

Descriptive Surveys

Descriptive surveys are intended to characterize knowledge, behaviors, patterns, attitudes, or demographics of individuals within a given population. Such surveys are often used to inform marketing decisions, public policy, or quality improvement. For instance, many healthcare institutions use surveys to determine patient satisfaction¹ and to describe patient demographics.²

Data can be accessed for many federal and state surveys.³ For example, large national surveys such as the U.S. Census, the National Health Interview Survey,⁴ and the National Nursing Home Survey⁵ provide important population data that can be used for many varied purposes, including documenting the incidence of disease, estimating research needs, describing the quality of life of different groups, and generating policy recommendations.

Testing Hypotheses

Surveys may also involve testing hypotheses about the nature of relationships within a population. Data can be used to establish outcomes following intervention, explore relationships among clinical variables, or examine risk factors for disease or disability. Surveys can be used for data collection in experimental studies to compare outcomes across groups when studying variables such as attitudes and perceptions.

For example, questionnaires have been used to compare quality of life following bilateral or unilateral cochlear implants,⁶ to establish the relationship between medical adherence and health literacy,⁷ and to study the influence of life-style preferences and comorbidities on type 2 diabetes.⁸

Standardized questionnaires are also used extensively as self-report instruments for assessing outcomes related to broad clinical constructs such as function, pain, health status, and quality of life. These instruments are designed to generate scores that can be used to evaluate patient improvement and to support clinical decision making, requiring extensive validation procedures. We will discuss these types of scales in Chapter 12, but the concepts presented here related to designing surveys will apply to those instruments as well.