Strøm Benedicte Sørensen, Engedal Knut, Šaltytė Benth Jūratė, Grov Ellen-Karine
VID Specialized University, Center for Diakonia and Professional Practice, Oslo, Norway.
Norwegian Advisory Unit for Aging and Health, Vestfold Hospital HF, Tønsberg, Norway.
BMJ Open. 2016 Dec 13;6(12):e013447. doi: 10.1136/bmjopen-2016-013447.
To investigate the psychometric properties of the Holden Communication Scale (HCS) and the association between scores on HCS and cognitive function among persons with dementia.
Internal consistency was assessed by the Cronbach's α coefficient and inter-item correlations. Test-retest was carried out to test the instrument's stability. An exploratory factor analysis with the principal components extraction method and oblimin rotation was performed to evaluate construct validity. Pearson's correlation coefficients were calculated to explore associations between the scores on the HCS and cognitive function.
A total of 128 persons with moderate-to-severe cognitive impairment (mean Mini-Mental State Examination (MMSE) score 8.9 (SD 7.0)) participated. The mean age was 85.2 (SD 7.2) and 101 of the participants were women. The Cronbach's α of the HCS was 0.94 and test-retest reliability was r=0.71. The corrected item-total correlation ranged from 0.63 to 0.79 and factor analysis showed a 1-factor structure of the HCS, which explained 63% of the variance. However, a forced 3-factor structure explained 76% of the variance. The correlation between cognitive function as measured by the MMSE and ability to communicate as measured with HCS was found to be moderate for those with an MMSE score of 0-10 (-0.61) and low for persons with an MMSE score of 11-20 (-0.06).
The HCS is a reliable and valid scale for assessing communication ability in persons with moderate and severe cognitive impairment, and might have a 1-factor or 3-factor structure.
探讨霍尔登沟通量表（HCS）的心理测量特性以及痴呆患者HCS得分与认知功能之间的关联。
通过克朗巴赫α系数和项目间相关性评估内部一致性。进行重测以检验该工具的稳定性。采用主成分提取法和斜交旋转进行探索性因素分析，以评估结构效度。计算皮尔逊相关系数，以探讨HCS得分与认知功能之间的关联。
共有128名中重度认知障碍患者（简易精神状态检查表（MMSE）平均得分8.9（标准差7.0））参与研究。平均年龄为85.2（标准差7.2），其中101名参与者为女性。HCS的克朗巴赫α系数为0.94，重测信度为r = 0.71。校正后的项目总分相关性范围为0.63至0.79，因素分析显示HCS具有单因素结构，解释了63%的方差。然而，强制的三因素结构解释了76%的方差。发现MMSE测量的认知功能与HCS测量的沟通能力之间的相关性，对于MMSE评分为0 - 10的患者为中度（-0.61），对于MMSE评分为11 - 20的患者为低度（-0.06）。
HCS是评估中重度认知障碍患者沟通能力的可靠且有效的量表，可能具有单因素或三因素结构。
