Reliability and validity of the Korean version of the Communicative Activity Log (CAL)

Abstract

Background: The ultimate goal of aphasia rehabilitation is to enhance communicative activities in people with aphasia (PWA) in order to increase their daily activities and social participation. The amount of communication and its quality largely vary according to language and cultural differences.Aims: This study was designed to develop a Korean version of the Communicative Activity Log (CAL), and to verify its reliability and validity for PWA after stroke.Methods & Procedures: A Korean version of the CAL (K-CAL) was developed through a cross-cultural adaptation process consisting of the following six steps: translation, reconciliation, back-translation, cognitive debriefing, feedback, and final reconciliation. Internal consistency, test–retest reliability, concurrent validity, and construct validity were used to verify its reliability and validity for PWA after stroke. A total of 50 PWA completed the K-CAL with the help of caregivers. All participants completed the K-CAL again 1 week later to measure test–retest reliability. Communication score on the Korean version of Stroke and Aphasia Quality of Life Scale-39 (K-SAQOL-39) was used to demonstrate concurrent validity. Severity of aphasia assessed by Korean version of the Frenchay Aphasia Screening Test (K-FAST) was used to determine construct validity of the K-CAL.Outcomes & Results: Among the 50 PWA, 20 had cerebral infarction and 30 had brain haemorrhage. Mean duration after onset of aphasia was 47.96 ± 62.01 months. Mean communication scores on the K-SAQOL-39 and K-FAST were 2.63 ± 0.97 and 12.69 ± 9.78 points, respectively. K-CAL demonstrated high internal consistency (Cronbach’s α = .987) and test–retest reliability (r = .915, p < .001). Correlation between K-CAL and communication score on the K-SAQOL-39 revealed a high concurrent validity (r = .915, p < .001). Correlation between K-CAL and K-FAST also showed a high construct validity (r = .882, p < .001).Conclusions: A K-CAL was successfully developed through a cross-cultural adaptation process. Our results suggested that K-CAL had high reliability and validity for assessing communicative behaviour of Korean PWA after stroke.