Purpose: The purpose of this study was to gain a comprehensive understanding of participation situations that are challenging for people with communication problems, to provide input for the further development of potential items for the Communicative Participation Item Bank (CPIB).
Method: A purposive sampling strategy was used to include a diverse group of people with communication problems. Diaries were used as a sensitizing exercise for inductive in-depth interviews. In these interviews, elements of communicative participation situations (concepts) were elicited that participants themselves experienced as difficult because of their communication problem. A thematic content analysis was used to identify overarching themes. In addition, new items were formulated based on the raw codes of the transcripts and linked to the International Classification of Functioning, Disability and Health Activity and Participation domains to examine the distribution of items across the breadth of the construct of communicative participation.
Results: Eighteen interviews yielded 44 different concepts. They were clustered in six themes, which capture the person, location, topic, mode, moment, and pace of communication. In total, 103 new items measuring communicative participation were formulated. Most of these items relate to International Classification of Functioning, Disability and Health Activity and Participation domains "interpersonal interactions and relationships," "major life areas," and "community, social, and civic life."
Conclusions: This study resulted in an overview of self-reported barriers in daily communicative participation experienced by people with communication problems. These communicative participation situations can be captured within 44 concepts, which are covered by six themes. Future work should investigate if the newly written items can be added to the CPIB. The concepts and the themes can be used in designing and delivering a participation-focused intervention for this population.