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Development of a reliable self-report outcome measure for pragmatic trials of communication therapy following stroke: the Communication Outcome after Stroke (COAST) scale

University of Leeds, School of Healthcare, Leeds, a.f.long{at}leeds.ac.uk

A. Hesketh

University of Manchester

G. Paszek

University of Manchester

M. Booth

Salford Royal Hospitals Trust

A. Bowen

University of Manchester, Manchester, UK on behalf of the ACTNoW Research Study

Objective: To develop and validate a clinically feasible measure of communication effectiveness for people with any type of communication problem following stroke.

Design: Cross-sectional, interview-based, psychometric study, building on the development phase for construction of the Communication Outcome after Stroke (COAST) scale.

Setting: A community sample from the northwest of England, UK.

Subjects: One hundred and two people with communication problems (aphasia and/or dysarthria) following a stroke, within the previous 4—12 months.

Interventions: Administration of the COAST scale, on two occasions, within a two-week period, and collection of demographic and other data relating to disability, degree of aphasia (where appropriate) and hospital diagnosis of aphasia/dysarthria.

Main measures: Acceptability (missing values), reliability (internal consistency and test—retest reliability) and item analysis (item redundancy).

Results: Ninety-seven (visit 1) and 98 (visit 2) respondents provided usable data for the psychometric analysis. The 29-item COAST scale showed good acceptability (few missing values, sample spread 28—100%), internal consistency and test—retest reliability for the scale ( = 0.95; ICC = 0.90) and its subscales ( = 0.65—0.93; ICC = 0.72—0.88), but possible item redundancy. A revised scale of 20 items was produced, demonstrating good internal consistency and test—retest reliability ( = 0.83—92; ICC = 0.72—0.88).

Conclusions: The COAST is a patient-centred, practical and reliable measure that can be used to assess self-perceived communication effectiveness for people with aphasia and/or dysarthria. Further testing on construct validity and responsiveness to change is needed before the measure can be firmly recommended for use within clinical practice and research.

Clinical Rehabilitation, Vol. 22, No. 12, 1083-1094 (2008)
DOI: 10.1177/0269215508090091


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				A. Long, A. Hesketh, and A. Bowen Communication outcome after stroke: a new measure of the carer's perspective Clinical Rehabilitation, September 1, 2009; 23(9): 846 - 856. [Abstract] [PDF]