105 THE STORE-AND-FORWARD TELEMEDICINE SERVICE USER-SATISFACTION QUESTIONNAIRE the poor applicability of these questionnaires specifically focusing on the patient’s perspective, we decided to exclude questionnaires solely focusing on patient satisfaction. Step 2. A structured first focus group was performed (ET and JvB) with a domain expert of Ksyos (J. de Wit) and a human factor engineering expert (LWPP) to identify requirements of the questionnaire and to appreciate prior included constructs from the literature. Participants reached a high-level consensus on the selection of revealed constructs and assessed content validity. Items of the included constructs that might be relevant were forward translated to Dutch at the main level by one researcher (JvB), and then reviewed and reformulated to the telemedicine context by two researchers (ET and Y. Broekhuizen). Afterwards, the items were backwards translated to English by the two researchers (ET and Y. Broekhuizen) and when there was no consensus the items were discussed with the other researchers. Step 3. Four telemedicine account managers and one customer service employee participated in a second structured focus group (ET and Y. Broekhuizen) to assess the face validity of the Dutch instrument. In this session, construct items were discussed regarding question formulation (wording) and applicability and consensus was reached by having participants rate all items on relevance (1=relevant to 3=not relevant). Questions could be added if an item was missing or changed if it required rephrasing. Step 4. The feasibility and comprehensiveness of the questionnaire were assessed (ET and Y. Broekhuizen) in two pre-testing rounds. In the first round, 18 random HCPs (medical specialists, paramedics, general practitioners (GPs)) working with and participating in the Ksyos test panel were invited. Participants reviewed each question’s phrasing and their applicability to the telemedicine context. The preliminary self-administered questionnaire was then built (ET, Y. Broekhuizen and M. Roskam-Mul) in an online questionnaire tool (LimeSurvey) to reveal further needed revisions, check for technical problems with filling in the questionnaire and measure completion time. For the second round, an invitation link was sent to another 21 HCPs who had not previously participated. HCPs completing the questionnaire received gift cards of €10 and €20, respectively. After integrating the feedback of the pretesting rounds, a pilot version of the questionnaire, the SAF-TSUQ, was constructed. Phase 2: validation SAF-TSUQ Subjects and data collection The SAF-TSUQ was distributed to 2179 Dutch HCPs of different specialties affiliated with Ksyos. HCPs were included when they had an active teleconsultation account registered before March 2019 in the Ksyos store-and-forward telemedicine platform and for whom an email address was known. On registration of their account, these affiliated HCPs sign an agreement with Ksyos that they will participate in scientific research and that Ksyos 6
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