Development and Content Validation of the CEECCA Questionnaire to Assess Ability to Communicate among Individuals with Aphasia Based on the NANDA-I and NOC

Abstract

This study presents the development and content validation of an instrument assessing the ability to communicate among individuals with aphasia. The study consists of three stages: (i) Selection and definition of the component dimensions and areas, construction of items assessing these dimensions, administration instructions, and qualitative criteria for assigning diagnoses; (ii) Face validity and content validity; (iii) Pilot test. The tentative questionnaire was designed using two defining characteristics of the NANDA-I (“Impaired verbal communication” and “Readiness for enhanced communication”) and the NOC outcome indicators “Communication”, “Communication: Expressive”, “Communication: Receptive”, and “Information Processing”. The areas and items reached initial content validity index (CVI) and representativeness index (RI) values of 0.87 and above. Those that did not reach the expected values were modified after expert review. The resulting questionnaire was pilot-tested for feasibility and administration times. An instrument containing five dimensions, fourteen areas, and 43 items was obtained and administered in 15 (12–31) minutes. A panel of experts evaluated the final questionnaire (CEECCA), awarding its areas and items CVI and RI values of 0.90 and above. In the absence of further psychometric studies, the questionnaire appears to be useful for assessing ability to communicate in individuals with aphasia.

Psychometric Testing of the CEECCA Questionnaire to Assess Ability to Communicate among Individuals with Aphasia

“…The psychometric tests carried out on the assessment instrument derived from this study have yielded satisfactory results, providing a valid, reliable tool for nurses to assess the main dimensions of language in individuals with aphasia in a simple way and adapted to their daily work. The CEECCA is an instrument whose design [21] and validation processes incorporate aspects of NANDA-I nursing diagnoses and NOC outcome criteria. This allows consistency to be maintained throughout the nursing process as applied in clinical practice [41].…”

“…The protocol used was based on the proposals put forward by Carvajal et al [22] and Ramada-Rodilla et al [23] for validating health measurement instruments already used in other studies on the design and validation of assessment instruments based on the NANDA-I and NOC classifications [24,25]. Once the design, construction, and content validity phases of the CEECCA were completed [21], the instrument was tested on a sample of individuals with aphasia to calculate the remaining psychometric properties. Data collection process and statistical tests used to determine the validity and reliability of the questionnaire are described below.…”

“…Its design includes the defining characteristics (DCs) of the two communication-related NANDA-I nursing diagnoses: "Impaired verbal communication" (00051) and "Readiness for enhanced communication" (00157), as well as the NOC outcome indicators "Communication" (0902), "Communication: expressive" (0903), "Communication: receptive" (0904), and "Information processing" (0907). In an initial study [21], the design and construction process of the CEECCA and the results of the content validity tests were published. In these tests, the CEECCA obtained high content validity and representativeness scores.…”