Dutch-USEQ

The use of virtual reality (VR) as a non-pharmacological intervention in reducing pain and anxiety has greatly increased over the past decade. Through means of distraction and relaxation, VR shows to be effective in reducing pain perception and anxiety levels during medical procedures and the perioperative period. Evaluation of the user experience is of paramount importance, since knowledge about user satisfaction and usability has a positive influence on implementation of use in clinical practice.  

Currently, there are several questionnaires that are validated and widely used for assessing usability in digital healthcare innovations. The most commonly used measure is the System Usability Scale (SUS) developed by Brooke (1996). The SUS is internationally used for evaluating different technological systems (e.g. eHealth and mobile applications, websites, computers). However, the biggest downside of the SUS is that it is very generic since it is validated for evaluation of a wide range of systems. Therefore, questions specifically targeted to obtain responses about satisfaction of rehabilitation systems using virtual environments are not included. Although the SUS was previously used for evaluating rehabilitation through virtual reality systems since there were no questionnaires available that were specifically targeted to measure rehabilitation through these systems.

As a result of the lack of availability of questionnaires assessing usability and user satisfaction of virtual rehabilitation systems, Gil-Gomez et al. (2017) have developed a new user satisfaction questionnaire that is specifically designed for this purpose. This User Satisfaction Evaluation Questionnaire (USEQ) consists of 6 questions that can be answered on a five-point Likert scale, evaluating satisfaction of virtual reality rehabilitation systems. Internal consistency appeared to be adequate (Cronbach’s α= 0.716) and a principal components analysis (PCA) indicated a one-factor solution, which accounted for 43 % of the total variance. A meaningful importance of each individual item was indicated since each individual item had a correlation with the factor that was greater than 0.4. Patients reported satisfaction with the number of questions and found the questionnaire easy to understand.  

The USEQ was later translated to European Portuguese by Domingos et al. (2021). After translation, psychometric evaluation was carried out by determining the structural validity, construct validity and internal consistency.  Findings from this study were consistent with the psychometric evaluation of the original English questionnaire. The Portuguese translation found that 47% of variance was explained by the one-factor solution; acceptable fit of the items; adequate internal consistency and a correlation with the SUS, underscoring its convergent validity.

Despite the growing use of virtual reality for rehabilitation purposes in the pediatric population has greatly increased over the past decade, a validated measure for reviewing usability and satisfaction in this particular age group is not yet available. This stresses the importance of a validated questionnaire for the purpose of evaluating usability and user satisfaction in the Dutch, pediatric population, subsequently optimizing implementation strategies for use in clinical practice. 

The aim of this study is to develop a Dutch adaptation and translation of the User Satisfaction Evaluation Questionnaire (USEQ), for measuring user satisfaction and usability in a Dutch pediatric population (6-18 years old), and to determine its psychometric properties.   

Prospective psychometric validation study 

Questionnaire for evaluating the user satisfaction and usability in virtual rehabilitation systems  

This study is classified as negligible risk and the burden is minimal. Nowadays, VR is already used in pediatric hospital wards to distract children form unpleasant medical procedures such as blood withdrawal or wound dressing changes and is a part of the standard armamentarium used in pediatric healthcare for these cases. Children already treated with VR in the hospital ward will be asked to fill out the translated USEQ, consisting of 6 questions, after which they will be interviewed with follow-up questions regarding their opinion on the translation of the questionnaire. The only potential burden is that patients are asked to invest minimal time in completing the questionnaire and are asked to answer questions about its structure.