These are the themes that this paper will focus on prior to setting out the guidelines that we subsequently constructed.

Background In healthcare, many service evaluation questionnaires use free-text boxes without formal mechanisms for analysis. Patients and carers spend time documenting concerns that are often ignored or managed locally in an ad hoc manner. Currently, palliative care experiences of patients and carers in Wales are measured using a service evaluation questionnaire, comprising both closed and open-ended questions. Previous research, exploring free-text responses from this questionnaire, suggests that questionnaire refinement should accommodate service users' expressed priorities and concerns, and highlights the need to incorporate free-text data analysis strategies during study design. Methods Results from a previous analysis of 596 free-text responses provided the basis for an expert consensus day, where the current service evaluation questionnaire was refined. The refined version was tested during cognitive interviews with patients (n=10) and carers (n=7) receiving palliative care from 1 of 2 UK hospices. Data were analysed thematically. Results Interviews highlighted minor areas for change within the questionnaire and provided broader insight into patients' experiences of palliative care services. Patients and carers place an emphasis on simplifying language, decreasing the numeric response range and reducing written instructions; relying instead on visual cues, including formatting and layout. Findings highlighted the importance patients attached to providing meaningful free-text contributions. Conclusions Questionnaire refinement should use the patient perspective to effectively facilitate respondent understanding, pertinence and usability. The importance of employing data analysis strategies during questionnaire design may reduce research waste, thus enabling a better interrogation of service provision.

BackgroundThe iWantGreatCare (iWGC) questionnaire was developed by the Palliative Care Implementation Board and aims to evaluate palliative care service provision in Wales, through the appraisal of care, as encapsulated in 10 questions and a free text box.In order to fully reflect patients' and families' experiences of care, we previously undertook a qualitative analysis of the free text comments of 596 patients and carers, which highlighted areas not fully assessed in the scored results. Following this analysis, we are undertaking a further project to refine the questionnaire to accommodate patients' and carers' priorities and concerns.MethodsThe questionnaire was refined via an expert consensus day with healthcare professionals, researchers and a lay representative, utilising the qualitative free text analysis, and is now being tested using face–to-face, semi-structured, cognitive interviews with patients (n=10) and carers (n=10), who use palliative care services at two hospices in South Wales. The questionnaire comprehensively encompasses the elements of palliative care previously identified as important to patients and carers. Interviews aim to test whether the questions are understandable and pertinent to those completing the questionnaire. Interview transcripts from recorded data are to be analysed using a six phase thematic analysis.ResultsIt is expected that the interviews will inform the final questionnaire revision prior to being presented to the Palliative Care Implementation Board for their consideration. The results of these cognitive interviews and the refined questionnaire will be outlined and discussed in this presentation.

IntroductionIn 2009 the Palliative Care Implementation Board developed a survey to evaluate palliative care service provision in Wales. Through the use of the iWantGreatCare platform patients and carers, from inpatient and community settings, are able to share their experiences of care through 10 likert scales and a free-text section. Subsequently, qualitative analysis of the comments of patients and carers has highlighted areas of care not fully assessed in the scored results. Accordingly, this project now aims to use the qualitative findings to refine and test the questionnaire to ascertain whether the new iteration accommodates service users' priorities and concerns, whilst being pertinent and understandable.Aim(s) and method(s)Ethical approvals were gained in August 2013. The refined questionnaire was developed through an expert consensus day and is now being tested using semi-structured, cognitive interviews with patients (n=10) and carers (n=10) using palliative care services at two hospices in South Wales. The research sites aim to give a multifaceted insight in to the efficacy of the new questionnaire by gathering information from inpatient and community participants. Transcripts from interviews are being analysed thematically.ResultsIt is expected that the interviews will highlight minor areas for change within the questionnaire, while also providing a broader insight into the experiences of patients using community and inpatient palliative care services.Conclusion(s)Study results will be presented to the Palliative Care Implementation Board for their consideration and potential adaptation of the existing questionnaire.