Table 2 Adjustments made to the electronic danish version of PEmb-QoL and VEINES-QoL/Sym questionnaire from 19 cognitive interviews with patients who have had a VTE

Translation process

Title wording “VEINES-QoL/sym questionnaire” and “Pemb-QoL questionnaire”

Patients did not understand the content and purpose of the questionnaires based on the title

“VEINES-QoL/sym questionnaire on quality of life after venous thrombosis” and “Pemb-QoL questionnaire on quality of life after pulmonary embolism”

In item 2.e, the wording “At any time of the day” understood as “continuously”

Patients experiencing symptoms at several times of the day, but not at all times of the day, wanted to check off more than one answer, which is not possible.

“At several times of the day”

In item 3 “…, how would you rate the condition of your lungs/leg problem in general now?”

Patients questioned the term “in general”, so we removed it.

“…, how would you rate the condition of your lungs/leg problem now?”

In item 4.c in VEINES-QoL/sym, the wording

“taking public transportation” not associated with standing for a long time

Taking public transport is mostly not associated with a standing activity in Denmark, but patients do have problems standing in long queues.

“Standing in long queues”

Phrasing of questions in items 5a– 5d

The wording of questions was changed from passive to active form.

E.g. 5a. “I have cut down the amount of time…”

In item 6 the word “normal” in the sentence “…your normal social activities…”

“Normal activities” could be misunderstood in Danish, i.e., there may be a difference between what society means are normal activities and what your normal activities are.

“…your social activities…”

In Item 7a-7f and item 8a-8f the response items were specified.

“Pain” was added to all items in question 7 and “breathless” was added to all items in question 8.

E.g. question 7

a.) No pain

In item 7 and 8, the position of the time phrase “…during the past 4 weeks?”

In Danish, words related to time are often placed differently in sentences compared to English.

“During the past 4 weeks, how…”

In item 9. i., the wording “traveling” was only associated with longer journeys, e.g. going abroad.

The word “taking a trip” was added since patients do not travel that much, but rather go on smaller trips where they may be limited due to their VTE event.

“…feel limited in traveling or taking a trip?”

Migration process

Problem

Explanation

Change

Patients skip the introduction text and go directly to the questions.

Because touch-screen tablet and mobile phone offers less screen space, introductory texts were too extensive, and patients scroll directly to the questions.

Introductory texts were reduced and simplified.

Response buttons were too small

Patients found it difficult to click on response buttons both on touch-screen and computers because the buttons were too small.

Response buttons were enlarged where possible in REDCap settings.

Depending on the device used by patients, word division was sometimes wrong in sentences.

Because computers and some tablets offer more screen space, the text is presented in larger font and displayed on the same screen automatically. Smaller devices have more compact text, and the word division were sometimes wrong.

Front sizes were changed from automatically size to a permanently size, and manual word division were added.