Development and preliminary validation of the Conversation and Communication Questionnaire for People with Aphasia (CCQA)

Background Over recent years conversation partner (CP) schemes [1] supporting long-term community participation for people with aphasia (PWA) have gained in popularity in the UK. Such schemes are provided by various types of organisations: National Health Service departments; charities; and universities. Although the CP model has provided the basis for a network of schemes in the UK and Republic of Ireland, the evidence base for the impact of this approach remains relatively weak. There is a lack of a valid, reliable instrument to evaluate the experiences of PWA involved in the schemes, and to assess the schemes’ impact on important outcomes such as the experience of conversation / communication, participation and engagement. This ongoing study aims to develop a self-report measure for evaluating the experience of PWA involved in CP schemes, and for assessing the impact of the schemes on areas of significance to PWA. Methods The study uses mixed-methods according to principles of best practice in instrument design [2]. The development of questionnaire domains and items, and the piloting of these items, formats and response modes applies qualitative methods: i) structured searches of electronic databases and manual searches of academic texts / resources were undertaken to identify key concepts and themes associated with the aims of the CP scheme; ii) interviews / focus group discussions were undertaken with twelve PWA who are members of the Norfolk CP Trainers group; iii) cognitive interviews and pilot testing of items by PWA was carried out. Data from structured literature and resource reviews, and interviews / focus group discussions were analysed using qualitative content analysis [3]; iv) further item reduction and assessment of content and construct validity apply statistical methods. Results Potential candidate items were produced from analysis of data in stages i) and ii); nominal group techniques were then used to reach a consensus of the most frequently highlighted and significant issues of living with aphasia. Potential items were mapped to the domains of the A-FROM [4] to ensure content validation, and their readability examined. A draft 41-item measure addressing impairment, environmental, participation and personal factors and combinations of these was scrutinised by 17 PWA using cognitive interviews. This informed the production of a 30-item version, with an amended response scale, which was further piloted with twenty PWA. No significant problems have been identified with either self-completion or researcher-assisted completion. Further piloting of the CCQA with approximately 150 respondents will enable us to examine the psychometric properties of the scale to identify further items for elimination, and assessment of content and construct validity. Conclusions The CCQA has undergone robust development according to best design practices. It has the potential to be used as a self-completion or clinician / researcher-facilitated self-report measure in the process of therapy planning or outcome measurement. Acknowledgements Development of the CCQA was supported through a grant from the Tavistock Trust for Aphasia References 1.McVicker et al, 2009 Aphasiology, 23(1), 52-71 2.Fowler, FJ (2002) Survey research methods. 3rd Edition. Thousand Oaks: Sage Publications. 3.Graneheim, UH & Lundman, B (2004) Nurse Education Today, 24, 105-112 4.Kagan A et al (2008) Aphasiology, 22(3), 258–28