Development of an easy-read version of the Brain Injury associated Visual Impairment - Impact Questionnaire (BIVI-IQ)

ObjectiveThe Brain Injury associated Visual Impairment - Impact Questionnaire (BIVI-IQ) was developed to measure the impact of post-brain injury visual impairment. Communication and cognitive impairments are common brain injury sequelae and a barrier to completing standard patient reported outcome measures. The objective of this study was to develop and refine an easy-read version in order to meet recommendations to promote self-reporting.DesignEasy-read version development involved stakeholder input at several meetings. An iterative refinement process was used, involving a cognitive interview, until no new issues were identified.ParticipantsStroke survivors with visual impairment and/or aphasia and relevant healthcare professional were involved in the development stage. The clinical study recruited 12 stroke survivors with visual impairment.Main measuresParticipants completed the easy-read and standard versions. The researcher documented observations and time taken. Analysis assessed association and agreement between the two versions.ResultsDevelopment considered the structure, image selection and key words. Four iterations were used before five consecutive participants reported no new issues. Image amendments involved replacing four, revising four and adding three across eight of the 13 items. A preference for the easy-read version was reported by 45.5% completing both questionnaires (n = 11). A significant, strong positive correlation was found between the easy-read and standard version total scores. Weighted Kappa found significant agreement between 12 items.ConclusionsThe easy-read version, using images to support the question wording, will increase accessibility for brain injury survivors with communication and/or cognitive difficulties. It is acceptable and further evaluation of this version is now required.