{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T03:35:16Z","timestamp":1785209716825,"version":"3.55.0"},"reference-count":24,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,11,3]]},"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the psychometric properties of the Holden Communication Scale (HCS) and the association between scores on HCS and cognitive function among persons with dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Internal consistency was assessed by the Cronbach's \u03b1 coefficient and inter-item correlations. Test-retest was carried out to test the instrument's stability. An exploratory factor analysis with the principal components extraction method and oblimin rotation was performed to evaluate construct validity. Pearson's correlation coefficients were calculated to explore associations between the scores on the HCS and cognitive function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 128 persons with moderate-to-severe cognitive impairment (mean Mini-Mental State Examination (MMSE) score 8.9 (SD 7.0)) participated. The mean age was 85.2 (SD 7.2) and 101 of the participants were women. The Cronbach's \u03b1 of the HCS was 0.94 and test-retest reliability was r=0.71. The corrected item-total correlation ranged from 0.63 to 0.79 and factor analysis showed a 1-factor structure of the HCS, which explained 63% of the variance. However, a forced 3-factor structure explained 76% of the variance. The correlation between cognitive function as measured by the MMSE and ability to communicate as measured with HCS was found to be moderate for those with an MMSE score of 0\u201310 (\u22120.61) and low for persons with an MMSE score of 11\u201320 (\u22120.06).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The HCS is a reliable and valid scale for assessing communication ability in persons with moderate and severe cognitive impairment, and might have a 1-factor or 3-factor structure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-013447","type":"journal-article","created":{"date-parts":[[2016,12,13]],"date-time":"2016-12-13T20:40:22Z","timestamp":1481661622000},"page":"e013447","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Psychometric evaluation of the Holden Communication Scale (HCS) for persons with dementia"],"prefix":"10.1136","volume":"6","author":[{"given":"Benedicte S\u00f8rensen","family":"Str\u00f8m","sequence":"first","affiliation":[{"name":"VID Specialized University, Center for Diakonia and Professional Practice, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Knut","family":"Engedal","sequence":"additional","affiliation":[{"name":"Norwegian Advisory Unit for Aging and Health, Vestfold Hospital HF, T\u00f8nsberg, Norway"},{"name":"Department of Geriatrics, Oslo University Hospital, T\u00f8nsberg, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u016brat\u0117","family":"\u0160altyt\u0117 Benth","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Campus Ahus, University of Oslo, L\u00f8renskog, Norway"},{"name":"H\u00d8KH, Research Centre, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen-Karine","family":"Grov","sequence":"additional","affiliation":[{"name":"Oslo and Akershus University College of Applied Sciences, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,12,13]]},"reference":[{"key":"2025121512543598000_6.12.e013447.1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.jab.2016.02.002","article-title":"Speech and language impairments in dementia","volume":"14","author":"Klimova","year":"2016","journal-title":"J Appl Biomed"},{"key":"2025121512543598000_6.12.e013447.2","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1017\/S0267190508080045","article-title":"Language and dementia: neuropsychological aspects","volume":"28","author":"Kempler","year":"2008","journal-title":"Annu Rev Appl Linguist"},{"key":"2025121512543598000_6.12.e013447.3","unstructured":"Engedal K , Haugen PK , Br\u00e6khus A . Demens: fakta og utfordringer: en l\u00e6rebok. T\u00f8nsberg: Aldring og helse, 2009."},{"key":"2025121512543598000_6.12.e013447.4","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70063-2"},{"key":"2025121512543598000_6.12.e013447.5","unstructured":"Kitwood T . Dementia reconsidered: the person comes first. Buckingham: Open University Press, 1997."},{"key":"2025121512543598000_6.12.e013447.6","doi-asserted-by":"crossref","first-page":"225","DOI":"10.5324\/nje.v22i2.1570","article-title":"The prevalence and the course of neuropsychiatric symptoms in patients with dementia","volume":"22","author":"Bergh","year":"2012","journal-title":"Norsk Epidemiologi"},{"key":"2025121512543598000_6.12.e013447.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2012.09.027"},{"key":"2025121512543598000_6.12.e013447.8","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1111\/jocn.13169","article-title":"Sensory stimulation for persons with dementia: a review of the literature","volume":"25","author":"Str\u00f8m","year":"2016","journal-title":"J Clin Nurs"},{"key":"2025121512543598000_6.12.e013447.9","first-page":"pii:906818","article-title":"Methods to enhance verbal communication between individuals with Alzheimer's disease and their formal and informal caregivers: a systematic review","volume":"2010","author":"Egan","year":"2010","journal-title":"Int J Alzheimers Dis"},{"key":"2025121512543598000_6.12.e013447.10","unstructured":"Sonas aPc. Sonas Workshop Booklet, 2011."},{"key":"2025121512543598000_6.12.e013447.11","unstructured":"Holden UP , Woods RT . Positive approaches to dementia care. Edinburgh: Churchill Livingstone, 1995."},{"key":"2025121512543598000_6.12.e013447.12","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1159\/000444789","article-title":"A psychometric evaluation of the Threadgold Communication Tool for persons with dementia","volume":"6","author":"Str\u00f8m","year":"2016","journal-title":"Dement Geriatr Cogn Dis Extra"},{"key":"2025121512543598000_6.12.e013447.13","doi-asserted-by":"publisher","DOI":"10.1097\/01.JGP.0000192478.82189.a8"},{"key":"2025121512543598000_6.12.e013447.14","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"2025121512543598000_6.12.e013447.15","doi-asserted-by":"crossref","unstructured":"Hardy MA , Bryman A . Handbook of data analysis. London: Sage Publications, 2004.","DOI":"10.4135\/9781848608184"},{"key":"2025121512543598000_6.12.e013447.16","unstructured":"Persaud ML . Pleasure in the daily lives of people living with advanced dementia in a long-term care facility: a multiple case study approach. Canada: University of Toronto, 2009."},{"key":"2025121512543598000_6.12.e013447.17","unstructured":"Myskja A . Integrated music in nursing homes: an approach to dementia care: PhD dissertation under the auspices of the Grieg Academy, GAMUT, University of Bergen, November 2011: (doktoravhandling). Universitetet i Bergen. Griegakademiet, Bergen, 2011."},{"key":"2025121512543598000_6.12.e013447.18","doi-asserted-by":"publisher","DOI":"10.1111\/jan.12059"},{"key":"2025121512543598000_6.12.e013447.19","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1891\/1078-4535.21.1.47","article-title":"Joy, happiness, and humor in dementia care: a qualitative study","volume":"21","author":"Person","year":"2015","journal-title":"Creat Nurs"},{"key":"2025121512543598000_6.12.e013447.20","doi-asserted-by":"crossref","unstructured":"Pett MA , Lackey NR , Sullivan JJ . Making sense of factor analysis: the use of factor analysis for instrument development in health care research. SAGE Publications, 2003.","DOI":"10.4135\/9781412984898"},{"key":"2025121512543598000_6.12.e013447.21","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010357"},{"key":"2025121512543598000_6.12.e013447.22","doi-asserted-by":"crossref","first-page":"111","DOI":"10.3233\/JAD-150413","article-title":"Altered sense of humor in dementia","volume":"49","author":"Clark","year":"2015","journal-title":"J Alzheimers Dis"},{"key":"2025121512543598000_6.12.e013447.23","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6882-10-1"},{"key":"2025121512543598000_6.12.e013447.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2011.12.003"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2016-013447","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T20:54:45Z","timestamp":1765832085000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2016-013447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,12]]},"references-count":24,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2016,12,13]]},"published-print":{"date-parts":[[2016,12]]}},"alternative-id":["10.1136\/bmjopen-2016-013447"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2016-013447","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,12]]}}}