Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
School of Community Health, Faculty of Science, Charles Sturt University, Sydney, New South Wales, Australia.
Health Soc Care Community. 2022 Nov;30(6):e4745-e4757. doi: 10.1111/hsc.13881. Epub 2022 Jun 13.
The decline of language and communication abilities is common among people living with dementia and impacts on many areas of everyday life, including active participation in social activities and decision-making. Despite a growing body of supporting evidence for approaches that address language and communication decline in dementia, the concept of communication rehabilitation is largely neglected in this population. This paper reports on the content validation of a novel tool, the Communication Support Needs Assessment Tool for Dementia (CoSNAT-D). The tool has been developed to assist in the initial identification of communication difficulties and related support needs of people living with dementia. Importantly, the CoSNAT-D is the only available tool that takes a three-way informed approach, considering the view of the person living with dementia, their carer and an administering healthcare professional. Content validity was established between September and December 2018 using a modified Delphi approach. An international expert panel rated 32 items of a face-validated item pool regarding their importance and relevance through an iterative feedback process. Consensus was pre-determined at 70% of agreement for both importance and relevance of an item. Data were analysed using descriptive statistics and qualitative content analysis of comments provided in each round. Twenty-eight experts working in dementia, language and communication participated in the Delphi survey. Qualitative analysis resulted in the addition of five items, of which three reached the required consensus in Round 3. Consensus was established for 35/37 items in three rounds. The pilot version of the CoSNAT-D demonstrates adequate content validity and face validity. The use of the CoSNAT-D may assist a range of healthcare professionals in the decision-making process about appropriate next management steps, and thereby improve the care path for people with dementia and language and communication impairment. The establishment of further psychometric properties is warranted.
语言和沟通能力的下降在痴呆症患者中很常见，会影响他们日常生活的许多方面，包括积极参与社会活动和决策。尽管有越来越多的证据支持针对痴呆症患者语言和沟通能力下降的方法，但沟通康复的概念在这一人群中基本上被忽视了。本文报告了一种新工具的内容验证，即痴呆症沟通支持需求评估工具（CoSNAT-D）。该工具旨在帮助初步识别痴呆症患者的沟通困难和相关支持需求。重要的是，CoSNAT-D 是唯一一种采用三方知情方法的工具，考虑了痴呆症患者、其照顾者和管理医疗保健专业人员的观点。内容有效性是在 2018 年 9 月至 12 月使用改良德尔菲法确定的。一个国际专家小组通过迭代反馈过程，对经过验证的 32 项条目进行了重要性和相关性的评分。对于项目的重要性和相关性，共识预先确定为 70%的同意率。数据使用描述性统计和每个回合提供的评论的定性内容分析进行分析。共有 28 名在痴呆症、语言和沟通领域工作的专家参与了德尔菲调查。定性分析导致增加了 5 个项目，其中 3 个在第 3 轮达到了要求的共识。在三轮中达成了共识的有 35/37 个项目。CoSNAT-D 的试点版本具有足够的内容有效性和表面有效性。CoSNAT-D 的使用可以帮助各种医疗保健专业人员在适当的下一步管理步骤的决策过程中，从而改善痴呆症和语言沟通障碍患者的护理路径。有必要进一步确定其心理测量特性。
