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Questionnaire Use and Development in Health Research
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This is a peer-reviewed entry published in Encyclopedia Journal, full entry can be found at 10.3390/encyclopedia5020065
A questionnaire is a structured instrument used in health research to systematically collect data on perceptions, behaviors, and health outcomes. It serves as a fundamental tool for capturing patient-reported outcomes, evaluating treatment effectiveness, and monitoring public health trends. Questionnaires can be administered in various formats, including paper-based, digital, or interactive systems, and must be carefully designed to ensure reliability, validity, and minimal bias. While validated questionnaires facilitate cross-study comparability, new instruments may be needed to address emerging health concerns or specific cultural contexts. Adhering to best practices in survey methodology allows researchers to maximize the utility of questionnaires, ensuring accurate, reproducible, and ethically sound health research.
questionnaire design measurement psychometrics survey design
Questionnaires are essential tools in health research, functioning as structured instruments for the systematic and consistent collection of information from patients, healthcare providers, and broader populations. Despite their widespread use, the terminology, design principles, and methodological standards for questionnaire development remain inconsistently applied across disciplines. This entry was written in response to a recognized need for a comprehensive yet accessible reference that synthesizes best practices across the lifecycle of questionnaire use in health research. Our goal is not to prescribe a singular approach or propose a universal checklist, nor to suggest that a single questionnaire could or should incorporate every principle discussed herein. Instead, the principles outlined are intended to provide a conceptual and methodological framework that researchers can adapt according to the context, purpose, and constraints of their specific studies.
A questionnaire typically comprises a set of questions designed to capture data on behaviors, attitudes, perceptions, symptoms, or other measurable phenomena. Depending on its design, it may include open-ended, closed-ended, or mixed-format questions, resulting in qualitative, quantitative, or mixed data types. Questionnaires can be administered through various formats, including paper-based surveys, digital platforms, or interactive systems [1]. Although they are relatively low-cost and scalable, the development or selection of a questionnaire requires meticulous planning and design to ensure the collection of valid, reliable, and unbiased data [2].
In health research, precise terminology regarding questionnaires is important but often inconsistently applied, leading to conceptual confusion, particularly among new investigators. Terms such as survey, instrument, questionnaire, scale, and inventory are frequently used interchangeably, despite referring to distinct concepts with specific methodological implications. To improve clarity, these terms can be organized into a hierarchical framework based on their scope and application (Table 1).
Table 1. Description and typical applications of common terms in questionnaire-based research.
Table
Term Description Typical Use
Survey A broad methodological approach involving the design, administration, and analysis of data collection procedures. To gather information from a population using various tools and techniques.
Instrument Any tool or device used to measure variables in research. General term for tools such as questionnaires, scales, or tests.
Questionnaire A structured set of questions used to collect self-reported data from respondents. Used to assess behaviors, attitudes, symptoms, or experiences.
Scale A component or standalone tool designed to measure a single latent construct. Used to generate a score representing a specific psychological or health-related variable (e.g., anxiety, pain).
Inventory A comprehensive questionnaire designed to measure multiple constructs or dimensions. Used to assess complex traits or multidimensional profiles (e.g., personality, coping styles).
First, the term survey refers to the broadest methodological approach. It encompasses the planning, design, administration, and analysis of data collection procedures. Surveys may employ a variety of data collection tools, including questionnaires, interviews, and observational methods. For example, a patient satisfaction survey might involve distributing a questionnaire alongside qualitative interviews to achieve a more comprehensive understanding of patient experiences.
Second, instrument is an umbrella term encompassing any tool or device used to measure variables in research. This category includes questionnaires, scales, inventories, diagnostic tests, and observational checklists. Third, a questionnaire is a structured set of questions designed to elicit information from respondents. Questionnaires may include a range of item types, such as open-ended, closed-ended, or Likert-type questions, and can be used to assess one or multiple constructs. For example, the International Physical Activity Questionnaire (IPAQ) is a widely used tool to quantify physical activity levels in epidemiological studies [3].
Fourth, a scale refers to a specific component within a questionnaire, or a standalone tool, designed to measure a single latent construct, such as anxiety (e.g., Generalized Anxiety Disorder 7-item Scale, GAD-7 [4]), pain (e.g., visual analogue scale, VAS [5]), or fatigue (e.g., Fatigue Assessment Scale, FAS [6]). Scales typically consist of multiple items that, when aggregated, yield a composite score representing the underlying variable.
Finally, an inventory is a more comprehensive type of questionnaire, often used to measure multiple dimensions or traits, such as those found in personality assessments. For example, the Minnesota Multiphasic Personality Inventory (MMPI) is a widely used standardized psychometric test designed to assess adult personality traits and psychopathology [7]. Unlike scales, inventories are not limited to a single construct and often contain multiple subscales or domains [8].
Selecting the appropriate tool also depends on the research context. Questionnaires and scales are most commonly used in quantitative studies, where measurement precision and statistical analysis are essential. Inventories may be employed in quantitative or mixed-methods research [9], particularly when assessing complex psychological or behavioral profiles. Although qualitative studies are less reliant on structured instruments, they may still incorporate questionnaires with open-ended items or use them in conjunction with interviews or focus groups to support methodological triangulation.

References

  1. Boynton, P.M.; Greenhalgh, T. Selecting, designing, and developing your questionnaire. BMJ 2004, 328, 1312–1315.
  2. Thwaites Bee, D.; Murdoch-Eaton, D. Questionnaire design: The good, the bad and the pitfalls. Arch. Dis. Child. Educ. Pract. Ed. 2016, 101, 210–212.
  3. Craig, C.L.; Marshall, A.L.; Sjöström, M.; Bauman, A.E.; Booth, M.L.; Ainsworth, B.E.; Pratt, M.; Ekelund, U.; Yngve, A.; Sallis, J.F.; et al. International physical activity questionnaire: 12-country reliability and validity. Med. Sci. Sports Exerc. 2003, 35, 1381–1395.
  4. Spitzer, R.L.; Kroenke, K.; Williams, J.B.; Löwe, B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch. Intern. Med. 2006, 166, 1092–1097.
  5. Heller, G.Z.; Manuguerra, M.; Chow, R. How to analyze the Visual Analogue Scale: Myths, truths and clinical relevance. Scand. J. Pain 2016, 13, 67–75.
  6. Michielsen, H.J.; De Vries, J.; Van Heck, G.L. Psychometric qualities of a brief self-rated fatigue measure: The Fatigue Assessment Scale. J. Psychosom. Res. 2003, 54, 345–352.
  7. Sellbom, M. The MMPI-2-Restructured Form (MMPI-2-RF): Assessment of personality and psychopathology in the twenty-first century. Annu. Rev. Clin. Psychol. 2019, 15, 149–177.
  8. Younas, A.; Porr, C. A step-by-step approach to developing scales for survey research. Nurse Res. 2018, 26, 14–19.
  9. Rana, K.; Chimoriya, R. A guide to a mixed-methods approach to healthcare research. Encyclopedia 2025, 5, 51.
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Subjects: Psychology
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Malcolm Koo
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Shih-Wei Yang
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Online Date: 20 May 2025
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