Problems eliciting cues in SEIQoL-DW: quality of life areas in small-cell lung cancer patients

The Schedule of Individual Quality of Life - Direct Weighting (SEIQoL-DW) is an individualized approach in the measurement of quality of life in which patients can choose, value and weight five areas that they consider important for their quality of life. Although a number of studies have reported on the feasibility of the administration of the instrument, little is known about how patients choose and define these five areas, the so-called 'cues'. This article describes problems in the elicitation of cues experienced in a qualitative, exploratory study among small-cell lung cancer patients (n = 31) in the Netherlands. Cues originate from patient-interviewer interaction which is best described as an area of tension between the patient's answers and the instrument instructions. As a result, the interviewer may inadvertently introduce bias while attempting to elicit cues, ultimately affecting patients' SEIQoL-DW measures. In order to prevent possible unnoticed interviewer bias special attention should be paid to the interviewer behaviour. Methods to record the meaning of cues should be considered. More research is needed in order to investigate differences in nominating cues with and without the use of the prompt list.