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. 2023 Nov 30;18(11):e0295141. doi: 10.1371/journal.pone.0295141

Table 1. Overview of issues identified in the cognitive interviews and how they were addressed.

Issue Affected items/ scales Revisions to address issue
Vague or ambiguous item statement 4, 13, 14, 16,19, 24 Items clarified to better reflect conceptual meaning and/or semantic precision
Double-barrelled item, e.g., item statement contains more than one behaviour/trait 19 First section removed to make item statement more concise and focused on the trait in question
Item relevance or applicability to Swedish context 14, 15, 20, Scale 4.1 Examples provided clarify content (21); item wordings revised and refined (14, 15, 21). Question in scale 4.1 rephrased to better suit the Swedish context with universal health care
Overlapping items (item content is perceived as repeating) Scale 2 No change at this stage, all items retained as they are considered to contribute with different aspects on a theoretical level
Unclear question format Sub-scales 1.1 and 4.1 Questions specified to better reflect intended use of the DLI; clarifying instructions added to highlight that questions relate to individual perceptions and that there are no right or wrong answers
Unsuitable or unclear response categories Sub-scales 1.1 and 1.2 Response categories changed to better suit the scale question (from very difficult/very easy to not prepared at all/very prepared)