Psychometric evaluation of the Holden Communication Scale (HCS) for persons with dementia
Journal article, Peer reviewed

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Date
2016Metadata
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- Artikler / Articles [1274]
Original version
10.1136/bmjopen-2016-013447Abstract
Objective: To investigate the psychometric properties
of the Holden Communication Scale (HCS) and the
association between scores on HCS and cognitive
function among persons with dementia.
Method: Internal consistency was assessed by the
Cronbach’s α coefficient and inter-item correlations.
Test-retest was carried out to test the instrument’s
stability. An exploratory factor analysis with the
principal components extraction method and oblimin
rotation was performed to evaluate construct validity.
Pearson’s correlation coefficients were calculated to
explore associations between the scores on the HCS
and cognitive function.
Results: A total of 128 persons with moderate-tosevere
cognitive impairment (mean Mini-Mental State
Examination (MMSE) score 8.9 (SD 7.0)) participated.
The mean age was 85.2 (SD 7.2) and 101 of the
participants were women. The Cronbach’s α of the
HCS was 0.94 and test-retest reliability was r=0.71.
The corrected item-total correlation ranged from 0.63
to 0.79 and factor analysis showed a 1-factor structure
of the HCS, which explained 63% of the variance.
However, a forced 3-factor structure explained 76% of
the variance. The correlation between cognitive
function as measured by the MMSE and ability to
communicate as measured with HCS was found to be
moderate for those with an MMSE score of 0–10
(−0.61) and low for persons with an MMSE score of
11–20 (−0.06).
Conclusions: The HCS is a reliable and valid scale for
assessing communication ability in persons with
moderate and severe cognitive impairment, and might
have a 1-factor or 3-factor structure.