Abstract Background Existential and spiritual concerns influence coping, adherence, and quality of life in IBD but are rarely assessed in routine care. The present study explored the clinical usability of two Italian tools - the Spiritual Needs Questionnaire-Extended Version (SpNQ-EV-ITA) and the Interpretation of Illness Questionnaire (IIQ-ITA) - through cognitive interviewing. Methods Qualitative think-aloud interviews were conducted with individuals living with IBD and healthcare professionals. Participants verbalised their understanding while completing each instrument; prompts clarified wording, relevance to disease stages, and acceptability. Issues were flagged when ≥3 participants raised problems (≈≥15%). Clinicians discussed feasibility and pathways for integrating the tools into nursing assessments. Results Seventeen cognitive interviews were completed (Figure 1). For SpNQ-EV-ITA, 17/35 items (49%) required refinement, mainly around: (i) semantics of “spiritual needs”; (ii) items perceived as overly intimate (e.g., forgiveness); (iii) phase-specific relevance (remission vs flare) (Figure 2). For IIQ-ITA, 2/8 items (25%) warranted conceptual clarification (e.g., the notion of illness as a “relieving break” and “call for help”) (Figure 2). No item showed systematic misunderstanding after rephrasing suggestions. Clinicians reported high perceived value for early identification of unmet existential needs and highlighted three practical uses: screening in nurse-led clinics, tailoring communication and education, and fast-tracking referral to psychosocial/spiritual care when indicated. Conclusion Both instruments demonstrated good comprehensibility and face/content validity with targeted wording adjustments. In clinical practice, SpNQ-EV-ITA and IIQ-ITA can support person-centred IBD care by uncovering existential needs that often remain invisible in standard assessments. Next steps include psychometric testing and the development of a brief clinical pathway (screening → discussion → referral) to embed these tools into everyday workflows. References: - Büssing, A., Balzat, H. J., & Heusser, P. (2010). Spiritual needs of patients with chronic pain diseases and cancer—validation of the Spiritual Needs Questionnaire (SpNQ). European Journal of Medical Research, 15(6), 266–273. - Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186–3191. - Willis, G. B. (2015). Analysis of the Cognitive Interview in Questionnaire Design. Oxford University Press. - Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357. Conflict of interest: Bonato, Marta: No conflict of interest Tasson, Laura: No conflict of interest Varagnolo, Claudia: No conflict of interest Canova, Cristina: No conflict of interest Martinato, Matteo: No conflict of interest
Bonato et al. (Thu,) studied this question.