Development and Preliminary Validation of the Coma Arousal Communication Scale

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Clinical Psychology

Background:

• Assessing communication in patients emerging from coma is challenging.
• Existing tools may not fully capture the nuances of patient-caregiver interaction during this critical phase.

Purpose of the Study:

• To develop and validate the Coma Arousal Communication Scale (CACS).
• To evaluate the scale's reliability, internal consistency, and sensitivity to change.

Main Methods:

• Expert-led development of a questionnaire assessing communication modes, themes, and caregiver strategies.
• Psychometric validation involving caregivers of 40 coma patients and 29 controls.

Main Results:

• The CACS showed excellent intra- and interrater reliability (ICC 0.76–0.98).
• Moderate to almost perfect agreement was found for most items, with slight agreement on compensatory strategies.
• Good internal consistency and sensitivity to change were observed in patients with recent brain injury.

Conclusions:

• The Coma Arousal Communication Scale is a reliable tool for evaluating communication in individuals emerging from coma.
• Further research is needed to better characterize caregiver compensatory strategies.