Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, United States.
Department of Rehabilitation Medicine, University of Washington, Box 356490, Seattle, WA 98195, United States.
J Commun Disord. 2023 Mar-Apr;102:106312. doi: 10.1016/j.jcomdis.2023.106312. Epub 2023 Feb 4.
The Communicative Participation Item Bank (CPIB) is a person-reported outcome measure designed for adults with communication disorders. The CPIB has not been validated for use with clients seeking gender-affirming communication care. The purpose of this study was to determine modifications needed to the CPIB for it to be appropriate for transgender respondents.
Individual qualitative cognitive interviews were conducted with 14 transgender adults (seven assigned male at birth, six assigned female at birth, one intersex / assigned female at birth). As participants completed the CPIB, they were asked to 'think out loud' to share their reactions to the items, reasons for their item responses, and any recommendations for changing the CPIB. Interviews were recorded, transcribed, and analyzed to identify common and salient trends in participants' feedback.
The most salient change participants required was in the CPIB item stem. The original stem ("Does your condition interfere with….") is inappropriate for transgender clients because referring to being transgender as a 'condition' is unacceptable. A new stem ("How difficult is it for you to ….") was acceptable to participants. The original CPIB uses the phrase 'family and friends' to refer to safe and comfortable communication partners. Participants in this study reported that this does not reflect the experiences of many transgender people who are not accepted by their biological families. The recommended alternate wording is "people who know you well." The items reflected situations that were relevant to participants, and wording was acceptable with few exceptions. Participants suggested they would have responded to the CPIB items differently earlier in their transition, with their scores improving over time.
The original CPIB questionnaire should not be used with transgender clients due to unacceptable wording. The modified items generated from this study require psychometric calibration for a new CPIB version for clients seeking gender-affirming communication care.
交际参与项目库（CPIB）是一种专为有沟通障碍的成年人设计的个体报告结果测量工具。CPIB 尚未经过验证可用于寻求性别肯定沟通护理的患者。本研究的目的是确定 CPIB 需要进行哪些修改，使其适用于跨性别受访者。
对 14 名跨性别成年人（7 名出生时被指定为男性，6 名出生时被指定为女性，1 名间性/出生时被指定为女性）进行了个体定性认知访谈。当参与者完成 CPIB 时，他们被要求“大声思考”，分享他们对项目的反应、回答项目的原因，以及对修改 CPIB 的任何建议。对访谈进行了记录、转录和分析，以确定参与者反馈中的常见和突出趋势。
参与者要求的最显著变化是在 CPIB 项目标题上。原始标题（“您的病情是否会干扰……”）不适合跨性别患者，因为将跨性别称为“病情”是不可接受的。一个新的标题（“您在……方面有多困难？”）是可以接受的。原始 CPIB 使用短语“家人和朋友”来指代安全和舒适的沟通伙伴。本研究中的参与者报告说，这并不能反映许多跨性别者的经历，他们不被自己的亲生家庭所接受。推荐的替代措辞是“了解您的人”。这些项目反映了与参与者相关的情况，除了少数例外，措辞是可以接受的。参与者表示，他们在过渡的早期会对 CPIB 项目做出不同的反应，随着时间的推移，他们的得分会提高。
由于措辞不可接受，原始 CPIB 问卷不应在跨性别患者中使用。从这项研究中生成的修改后的项目需要进行心理测量校准，以创建一个用于寻求性别肯定沟通护理的新 CPIB 版本。
