The instrument development process involved five phases: 1) generation of items and a weighted scoring system; 2) content validation via a quantitative survey and a modified Delphi process with an international, multi-disciplinary panel of experts; 3) inter-rater consistency; 4) alignment with
established research appraisal tools; and 5) pilot - testing of instrument usability.
Regarding the interpretation, patients»
appraisals might best be conceptualised as the description of a catalytic effect, which possibly fosters other
established therapeutic factors, such as imparting information29 or motivational clarification.37 Even though first results from comparative studies are promising, 67 68 future
research has to determine, if patients» positive
appraisals translate into superior effects of blended therapy in routine care.