Construção e investigação da validade de conteúdo e estrutura interna do Inventário de Habilidades Comunicativas do Terapeuta – Versão Paciente (IHCT-P)

Abstract

The objectives of this study are: (1) to develop the items for the Therapist's Communicative Skills Inventory - Patient Version (IHCT-P); (2) to investigate its Content Validity evidence; and (3) to investigate its psychometric properties, based on the analysis of its internal structure. The construction of the items was based on a narrative review of the literature on the subject. The preliminary version of the IHCT-P contained 40 items, of which 17 covered category 1 (Verbal Skills); 13, category 2 (Non-Verbal Skills); 10, Category 3 (Paraverbal Skills). First, the items were analyzed by five professionals with clinical and empirical expertise. Each one was evaluated based on the criteria of Practical Pertinence, Theoretical Relevance and Clarity of Language, rated on a 5-point Likert scale. The Content Validity Coefficient (CVC) was investigated using the criterion CVC>0.8. The CVC's of the Practical Pertinence (CVCPP=0.945), Theoretical Relevance (CVCRT=0.930) and Clarity of Language (CVCCL=0.927) criteria were considered adequate. After deleting three items, modifying 14 and adding two, the IHCT-P had 39 items. Subsequently, this instrument underwent an evaluation of the target audience, in order to analyze whether the items are understandable for subjects with low education. Thus, the IHCT-P was presented to 30 participants, 15 women (50%), aged between 19 and 42 years (M=28,3;SD=6,2), most with higher education (63.3%). The items were answered according to two criteria: (a) Language; and (b) Comprehension, based on a 5-point Likert scale. The CVC was investigated using the criterion CVC>0.8. The CVC's proved to be appropriate for both the Clarity of Language (CVCCL=0.980) and Comprehension (CVCC=0.981) criteria. The content validity in these two phases of the study resulted in the exclusion of two items, 16 were modified and two were added, totalizing 39 items. In the first exploratory factor analysis (EFA), the MAP and PA methods recommended the extraction of two factors and the Hull method, one factor. Facing the theoretical model, it was decided to use the one-dimensional model. However, seven items did not show a substantial factor loading. Therefore, a second EFA, containing 32 items, was conducted. The instrument's internal consistency was considered adequate. Although the literature points out three factors for Communication Skills (verbal, non-verbal and paraverbal), in the therapeutic context, based on the sample used, the instrument proved to be one-dimensional. Significant correlations (age) and comparisons between groups (gender, education, diagnosis and duration of therapy) were not found. This instrument can help in the therapist's self-assessment, in supervision practices and in interventions. It is hoped that this dissertation can contribute to a broader understanding of the Therapist's Communication Skills, highlighting the role they play in the therapeutic context. It is emphasized, however, that empirical investigations are necessary, as well as further validation studies of this instrument.