Academic journal article Journal of Medical Speech - Language Pathology

Development of a Measure of Communication Activity for the Acute Hospital Setting: Part II. Item Analysis, Selection, and Reliability

Academic journal article Journal of Medical Speech - Language Pathology

Development of a Measure of Communication Activity for the Acute Hospital Setting: Part II. Item Analysis, Selection, and Reliability

Article excerpt

This article is the second in a two-part series that describes the development of the Inpatient Functional Communication Interview (IFCI; O'Halloran, Worrall, Toffolo, Code, & Hickson, 2004). The first study (O'Halloran, Worrall, & Hickson, 2007) investigated two measures of communication activity for the acute hospital setting and concluded that the assessment items on these measures did not adequately reflect the range and type of communication activities that were actually observed during hospital staff and patient communication and concluded that neither assessment was suitable for use in the acute hospital setting. This second article describes how a new measure of communication activity for the acute hospital setting, the IFCI, was developed using the communication situations that were observed in the first phase of this research. The Multiple Attribute Utility Technique (MAUT; Edwards & Newman, 1982) was used to select a smaller number of communication situations needed for a short clinical assessment from the larger pool identified from the observation study. Finally, a preliminary investigation of the IFCI indicated 90.7% interrater reliability and 93.8% intrarater reliability. Therefore, it was concluded that the IFCI was a reliable measure of staff-patient communication in everyday activities in the hospital setting.

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This article describes the second phase of research into the development of a measure of communication activity for the acute hospital setting. The first phase of this research, reported in "Development of a measure of communication activity for the acute hospital setting: Part 1: rationale and preliminary findings" (O'Halloran, Worrall, & Hickson, 2007) investigated whether two measures of communication activity, the Functional Communication Profile (FCP; Sarno, 1969) and the Inpatient Functional Communication Interview-Research Version (IFCI-RV: Toffolo, Code, & McCooey, 1995) were applicable to the acute hospital setting. This research concluded that the assessment items on neither of these two measures sufficiently captured the 31 communication activities that were directly observed in hospital staff-patient interactions. Phase two of this research sought to develop a new measure of communication activity for the acute hospital setting based on these 31 communication activities.

A measure that assessed a patient's ability to communicate in all 31 communication activities would be impractical in the acute hospital setting. Therefore we wanted to select only the most relevant communication activities to include as items in this measure. However, in doing this, it became evident that there was very little guidance in the literature on the process of identifying and selecting communication situations for a communication activity measure. For example, the development of earlier communication activity measures, such as the ASHA Functional Assessment of Communication Skills (Frattali, Thompson, Holland, Wohl, & Ferketic, 1995) and the Communication Activities of Daily Living-2 (Holland, Frattali, & Fromm, 1998) relied on speech-language pathologists to generate the communication situations that were included in these measures. While these communication situations have high face validity, they may not actually reflect the communication situations that are important to people with communication difficulties and their communication partners. An alternative method of identifying communication situations for a communication activity measure that more closely reflects the perspectives of people with communication difficulties and their conversational partners was utilized in the development of the Communicative Effectiveness Index (CETI; Lomas, Pickard, Bester, Elbard, Finlayson, & Zoghaib, 1989). The communication situations that became the items on the CETI were identified through a structured interview process with people with aphasia and their conversational partners. …

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