Background & Aims
Pain is one of the main motivators in life. Chronic pain without an evident cause often leads to extensive medical examinations, inadequate or delayed treatment and increased impairment in biopsychosocial aspects of patients’ lives. It is common for patients to fill out questionnaires prior to the appointment. This serves to triage the complexity of individual cases and to make optimum use of limited time resources. In the age of digitalization, conventional paper questionnaires could soon be considered obsolete. The aim was to assess the completion rate of paper questionnaires and thus the effectiveness of information gathering in an unit specializing in orofacial complaints.
Methods
Every registered patient in the orofacial pain unit receives a three-paged paper questionnaire to complete before the appointment. 407 paper questionnaires from patients who visited the orofacial pain unit of the School of Dental Medicine, Department of Reconstructive Dentistry and Gerodontology at the University of Bern between October 2017 and December 2021 were identified. Questionnaires in which less than one page was completed were excluded as the data was deemed insufficient for further analysis. A total of 390 questionnaires were analyzed. Once all personal data had been removed, the questions and answer fields were defined. It was then recorded for each item whether an answer had been provided or left blank. Incomplete questionnaires were analyzed further. Statistical analysis was carried out using Excel.
Results
More than half (58%) of all questionnaires included were completed in full. Almost all questionnaires (95%) achieved a completion rate of at least 75%. The first sections regarding main complaints and additional burdens were completed in all questionnaires. Of the incomplete questionnaires, the items on maximum tolerable pain intensity and maximum pain intensity in the last 30 days (as part of the Graded Chronic Pain Scale) were most frequently left blank (70% and 62% respectively). Less than a quarter (23%) did not answer the screening question about a possible injustice experience. 21% left the question about the duration of the complaints unanswered. 17% did not tick any adjectives regarding the character of the pain. The screening questions on sleep disorders (part of the Insomnia Severity Index) and on burden perception were not filled in by 13% of patients. Only 4% did not answer the question as to whether parafunctions (such as sleep or awake bruxism) were known.
Conclusions
Overall it can be concluded that the completion rate for a conventional paper questionnaire is good and can provide useful information to the caregiver prior to the appointment. Edwards et al. found that the completion rate decreases with the length of the questionnaire. Our three paged questionnaire reflects similar findings. A study comparing paper and web-based assessments found a better completion rate for the digital version (Yu, 2021). Certain biases or errors can occur depending on the design of digital questionnaires, e. g. forced answering in order to proceed or preset answer options, whereas in a paper version patients can draw or add comments to express the situation more accurately. Surprisingly, the questions on subjective pain assessment using a numeric rating scale were the most frequently omitted. This could be attributed to the difficulty of measuring pain on a one-dimensional scale.
References
Yu, H., Yu, Q., Nie, Y., Xu, W., Pu, Y., Dai, W., Wei, X., & Shi, Q. (2021). Data Quality of Longitudinally Collected Patient-Reported Outcomes After Thoracic Surgery: Comparison of Paper- and Web-Based Assessments. Journal of Medical Internet Research, 23(11), e28915. https://doi.org/10.2196/28915
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