A Preliminary Assessment of the Psychometric Properties of a New Communication Aid to Support Assessments of Financial Decision-Making Capacity in People with Aphasia

Abstract

Background Financial decision-making is complex and requires an in-depth assessment. In the presence of communication disorders, like aphasia, such assessments become challenging and require the use of a dedicated communication aid. No communication aid currently exists to support financial decision-making capacity (DMC) assessments for persons with aphasia (PWA).(1) We sought to establish the validity, reliability, and feasibility of a newly constructed communication aid desigqned for this purpose. Methods A mixed methods study was performed, divided into three phases. Phase one was aimed at capturing current understanding of DMC and communication by community-dwelling seniors, using focus groups. The second phase involved the development of a new communication aid to assist with the assessment of financial DMC for PWA. The third phase aimed to establish the psychometric properties of this new visual communication aid. Results The new communication aid is a 37-page, paper-based document, with 34 picture-based questions. Due to unforeseen difficulties in participant recruitment for evaluating the communication aid, a preliminary evaluation was performed on the results from eight participants. These indicated the com-munication aid had moderate inter-rater reliability (Gwet’s AC1 kappa of 0.51 [CI 0.4362 to 0.5816, p < .000]), good internal consistency (0.76), and was usable. Conclusions This newly developed communication aid is one of a kind, and provides essential support for PWA requiring a financial DMC assessment, which was not previously available. Preliminary evaluation of its psychometric properties is promising; however, further validation is required to confirm its validity and reliability in the proposed sample size.