The Journal of the Korea Contents Association (한국콘텐츠학회논문지)

The Korea Contents Association (한국콘텐츠학회)
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Cognitive-pragmatic Language Ability Assessment Protocol for Traumatic Brain Injury(CAPTBI): Reliability and Validity

외상성 뇌손상 환자의 인지-화용언어 능력 평가도구 개발을 위한 신뢰도 및 타당도 연구

  • 이미숙 (연세대학교 대학원 언어병리학협동과정) ;
  • 김향희 (연세대학교 의과대학 재활의학교실 및 재활의학연구소)
  • Received : 2012.12.26
  • Accepted : 2013.01.29
  • Published : 2013.02.28
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Abstract

Traumatic brain injury(TBI) is a brain damage caused by an external physical force. TBI patients have disturbances of functioning including attention, memory, reasoning,, executive function, and pragmatic language. The aim of this study was to develop the cognitive-pragmatic language ability assessment protocol for traumatic brain injury(CAPTBI) and to evaluate reliability and validity. This study was also conducted to investigate domains that contributed to differentiate between the normal and TBI groups. The CAPTBI data were obtained from 226 normal adults and 62 TBI patients(mean age=$43.95{\pm}11.92$, $46.37{\pm}11.87$, M:F=110:116, 48:14). The CAPTBI had high item internal consistency, test-retest reliability, construct validity, and concurrent validity. The normal group performed significantly better than the TBI group in all domains of the CAPTBI and the separate scores for 9 domains. All 9 domains were found to be significant variables to discriminate between the two groups. The most powerful variable was executive function followed by memory, organization, pragmatic language, problem-solving, attention, orientation, reasoning, and visuoperception in order. The CAPTBI could discriminate between the two groups accurately by 95.5%. This result demonstrated that 97.3% of normal adults and 88.7% of TBI patients could be discriminated by CAPTBI. In conclusion, The CAPTBI is appropriate for evaluating and identifying cognitive-pragmatic language disorders in TBI patients.

외상성 뇌손상(TBI)은 외부적 충격에 의해 뇌가 손상되는 것을 의미한다. 이로 인해 주의력, 기억력, 추론력, 집행기능, 화용언어 등이 전반적으로 저하된다. 본 연구에서는 외상성 뇌손상 환자의 인지-화용언어 능력 평가도구(CAPTBI)를 개발한 후, 그 신뢰도 및 타당도를 구축하고, 정상군과 환자군 간 변별에 유용한 인지-화용언어의 하위 영역들이 무엇인지를 분석하였다. 연구 대상은 정상군 226명, TBI 환자군 62명으로 평균 연령은 각각 43.95(${\pm}11.92$), 46.37(${\pm}11.87$)세, 남녀 비율은 각각 110:116, 48:14였다. CAPTBI는 내적일관성 신뢰도와 검사-재검사 신뢰도가 높았고, 내적 구성타당도와 공인타당도가 입증되었다. 또한, 두 집단은 CAPTBI 총점 및 9개 하위 영역 모두에서 유의미한 차이를 보여 CAPTBI가 집단 간 변별에 유용한 것으로 입증되었다. 두 집단 간 변별에 기여하는 하위 영역은 조직화 능력, 기억력, 집행기능, 지남력, 문제해결력, 화용언어, 추론력, 주의력, 시지각력 순으로 높았다. CAPTBI의 판별기능 적중률은 95.5%로 전체 집단 사례 중 정상군의 97.3%, 환자군의 88.7%를 정확히 판별하였다. 이에 따라, CAPTBI는 TBI 환자의 인지-화용언어 능력 평가도구로서 신뢰도와 타당도가 높고, 정상군과 환자군 간 변별에 유용한 도구임을 확인하였다.

Keywords

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