Article

Establishing valid and reliable measures for use with patients with disorders of
consciousness (DOC) following profound brain injury is challenging due to a
number of factors including the complex presentation of such patients and
assessor variability. The auditory modality has been demonstrated to have greater
sensitivity for detecting awareness in DOC patients. However, there are no
measures developed to assess auditory responsiveness specifically. The objective
of this study was to examine the psychometric properties of the principal
subscale of a music therapy assessment tool (MATADOC) developed for use with
adult DOC patients. The subscale assesses behavioural domains essential for
diagnosis of awareness. Twenty-one adult patients were recruited from a
specialist rehabilitation unit. In a prospective study with repeated measures,
internal consistency, inter-rater and test-retest reliability and dimensionality
were examined. The five-item scale showed satisfactory internal reliability
(alpha = .76) and a strong first principal component. Corrected item-total
correlations were all > .45. Inter-rater intra-class correlations (ICCs) ranged
from 0.65-1.00 and intra-rater ICCs from 0.77-0.90. Rasch analysis confirmed
these impressions of a reliable, unidimensional and homogenous scale. Diagnostic
outcomes had 100% agreement with a validated external reference standard. The
results indicate that the MATADOC principal subscale provides a new behavioural
measure that can contribute to interdisciplinary assessment of awareness with DOC
patients.

Langue : ANGLAIS