Open Access

Cognitive Pretesting and pretest of the STRAIN questionnaire to elaborate work-related stress of health care staff in Switzerland / Verständlichkeitsprüfung und Pretest des STRAIN-Fragebogens zur Erhebung der Arbeitsbelastung bei Gesundheitsfachpersonen in der Schweiz


The workforce shortage in health care is a major challenge worldwide. In Switzerland, this shortage is not only demographically caused but also due to workload. Adequate measures require a good data basis. The aim of this study is to test instrument specially developed for the health professions to measure work-related stress in practice. Cognitive pretesting was used for the evaluation. Overall, 18 semi-structured single-interviews with nurses and nursing assistants were conducted. In two rounds, the question-answer-process was analysed for 11 questions. The STRAIN questionnaire was then pretested by 17 health professionals. In the first round, 42 problems were identified based on the phases of the “Cognitive Aspects of Survey Methodology”. Of these, 57 % were comprehension problems. This was shown by the polysemantic usage or unknowingness of terms. Further 38 % were problems with the answer categories, such as a missing category or an inappropriate formulation. Further questions were modified through a final pretest. The uniform comprehensibility has been achieved. Due to the questionnaire length, an online tool with a save function should be used. The results of this study are similar to those of comparable studies, which also show the most common problems with understanding. This is due to changes of concepts’ meanings over time and culture. A cognitive pretest is therefore recommended, especially for a heterogeneous target group such as health professions.

English, German
Publication timeframe:
Volume Open
Journal Subjects:
Medicine, Clinical Medicine, other