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.

中文翻译：

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痴呆症的沟通支持需求评估 (CoSNAT-D)：一项国际内容验证研究

语言和沟通能力的下降在痴呆症患者中很常见，并影响到日常生活的许多领域，包括积极参与社会活动和决策。尽管越来越多的证据支持解决痴呆症患者语言和交流能力下降的方法，但在这一人群中，交流康复的概念在很大程度上被忽视了。本文报告了一种新工具的内容验证，即痴呆症通信支持需求评估工具 (CoSNAT-D)。该工具的开发是为了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 是唯一采用三向知情方法的可用工具，考虑痴呆症患者、他们的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 2018 年 12 月期间使用修改后的 Delphi 方法建立的。一个国际专家小组通过迭代反馈过程对经过面部验证的项目库中的 32 个项目的重要性和相关性进行了评级。对于项目的重要性和相关性，共识是预先确定为 70% 的协议。使用描述性统计数据和每轮提供的评论的定性内容分析来分析数据。从事痴呆症、语言和交流方面工作的 28 位专家参与了德尔福调查。定性分析导致增加了五个项目，其中三个在第 3 轮中达成了所需的共识。在三轮中对 35/37 个项目建立了共识。CoSNAT-D 的试点版本展示了足够的内容有效性和表面有效性。CoSNAT-D 的使用可以帮助一系列医疗保健专业人员就适当的后续管理步骤进行决策，从而改善痴呆症患者以及语言和沟通障碍患者的护理路径。有必要建立进一步的心理测量特性。