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Fong TCT, Lo TLT, Ho RTH. Psychometric properties of the 12-item Stroke-Specific Quality of Life Scale among stroke survivors in Hong Kong. Sci Rep 2023; 13:1510. [PMID: 36707541 PMCID: PMC9883526 DOI: 10.1038/s41598-023-28636-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 01/23/2023] [Indexed: 01/28/2023] Open
Abstract
The present study examined the psychometric properties of the 12-item Stroke-Specific Quality of Life Scale (SSQOL-12) in 184 stroke survivors in Hong Kong. The participants completed a self-report questionnaire including the SSQOL-12, SF-12 health survey, and validating variables at baseline and 148 stroke survivors completed SSQOL-12 two months later. Confirmatory factor analysis investigated the construct validity, reliability, and measurement invariance of SSQOL-12 across two months. Concurrent, convergent, and divergent validity was examined with respect to SF-12, hope, self-esteem, functional disability, anxiety, and depression. The original 2-factor model did not reveal a superior fit over the 1-factor model and a modified 1-factor model provided an acceptable fit to the data in both waves. The SSQOL-12 factor displayed substantial factor loadings (λ = 0.40-0.87), good internal consistency (Ω = 0.88), temporal stability (r = 0.70), and scalar measurement invariance across time. Stroke-specific quality of life was significantly associated with higher levels of SF-12, hope, and self-esteem and lower levels of functional disability, anxiety, and depression. Most correlations remained significant after controlling for demographic covariates and SF-12. The present findings offered empirical support for the validity and reliability of the unidimensional structure for SSQOL-12 as a measure of stroke-specific quality of life among stroke survivors.
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Affiliation(s)
- Ted C T Fong
- Centre on Behavioral Health, University of Hong Kong, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong, China.
| | - Temmy L T Lo
- Centre on Behavioral Health, University of Hong Kong, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong, China
| | - Rainbow T H Ho
- Centre on Behavioral Health, University of Hong Kong, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong, China. .,Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China.
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Andersen CR, English SW, Delaney A. Made to measure—Selecting outcomes in aneurysmal subarachnoid hemorrhage research. Front Neurol 2022; 13:1000454. [PMID: 36212648 PMCID: PMC9532574 DOI: 10.3389/fneur.2022.1000454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022] Open
Abstract
There has been limited new high-level evidence generated to guide aneurysmal subarachnoid hemorrhage (aSAH) management in the past decade. The choice of outcome measures used in aSAH clinical trials may be one of the factors hindering progress. In this narrative review we consider the current process for determining “what” to measure in aSAH and identify some of the shortcomings of these approaches. A consideration of the unique clinical course of aSAH is then discussed and how this impacts on selecting the best timepoints to assess change in the chosen constructs. We also review the how to critically appraise different measurement instruments and some of the issues with how these are applied in the context of aSAH. We conclude with current initiatives to improve outcome selection in aSAH and future directions in the research agenda.
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Affiliation(s)
- Christopher R. Andersen
- Northern Clinical School, Sydney University, Sydney, NSW, Australia
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia
- Intensive Care Department, Royal North Shore Hospital, Sydney, NSW, Australia
- *Correspondence: Christopher R. Andersen
| | - Shane W. English
- Department of Medicine (Critical Care), uOttawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute (OHRI), Ottawa, ON, Canada
| | - Anthony Delaney
- Northern Clinical School, Sydney University, Sydney, NSW, Australia
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia
- Intensive Care Department, Royal North Shore Hospital, Sydney, NSW, Australia
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da Cunha MJ, Pinto C, Schifino GP, Sant'Anna Py I, Cimolin V, Pagnussat AS. Bicephalic Transcranial Direct-Current Stimulation Does Not Add Benefits to a Footdrop Stimulator for Improving Functional Mobility in People With Chronic Hemiparesis After Stroke: A Double-Blind, Randomized Controlled Trial. Phys Ther 2022; 102:6605113. [PMID: 35689805 DOI: 10.1093/ptj/pzac079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 12/23/2021] [Accepted: 06/04/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The aim of this study was to assess the effects of applying transcranial direct-current stimulation (tDCS), a footdrop stimulator (FDS), and gait training simultaneously on functional mobility in people with chronic hemiparesis after stroke. METHODS In this double-blind controlled trial, 32 individuals with mild, moderate, and severe chronic hemiparesis after stroke were randomized to tDCS plus FDS or sham tDCS plus FDS groups. Both groups underwent 10 concurrent tDCS and FDS gait training sessions 5 times per week for 2 weeks. Functional mobility was evaluated by the Timed "Up & Go" test (TUG). Secondary outcomes included spasticity of plantarflexors, knee extensors, and hip adductors; quality of life; and walking endurance (distance covered during each treadmill gait training session). Clinical assessments were performed before treatment, after treatment, and at a 1-month follow-up. A generalized estimating equation was used to compare the effects of time, group, and time × group interaction. RESULTS No difference between groups was observed during performance of the TUG or other outcomes. TUG performance was improved in both the tDCS plus FDS group (before treatment = 24.29 [95% CI = 17.72-33.28]; after treatment = 21.75 [95% CI = 15.75-30.08]) and the sham tDCS plus FDS group (before treatment = 19.63 [95% CI = 16.06-23.0]; after treatment = 18.45 [95% CI = 15.26-22.3]). This improvement remained at the follow-up evaluation. Both groups also showed reduced spasticity of plantarflexors and knee extensors, increased quality of life, and increased total distance walked. CONCLUSION This study provided no evidence that bicephalic tDCS improves functional mobility, spasticity, quality of life, or walking endurance in people with chronic hemiparesis after stroke. IMPACT Bicephalic tDCS does not add relevant benefits to FDS and gait training in people who have chronic hemiparesis after stroke. Given that tDCS has few additional effects and given its costs for clinical practice, tDCS for rehabilitation in people with chronic hemiparesis after stroke is discouraged. FDS and gait training improve functional mobility, walking resistance, and quality of life in people with chronic hemiparesis after stroke.
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Affiliation(s)
- Maira Jaqueline da Cunha
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Movement Analysis and Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Camila Pinto
- Health Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Movement Analysis and Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Giulia Palermo Schifino
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Movement Analysis and Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Isabela Sant'Anna Py
- Movement Analysis and Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Veronica Cimolin
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Aline Souza Pagnussat
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Health Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Movement Analysis and Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
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Patient-Reported Outcome for Endovascular Treatment versus Microsurgical Clipping in Aneurysmal Subarachnoid Hemorrhage. World Neurosurg 2021; 155:e695-e703. [PMID: 34500096 DOI: 10.1016/j.wneu.2021.08.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Aneurysmal subarachnoid hemorrhage has a high mortality with significant impact on quality of life despite effective management strategies including endovascular treatment and/or microsurgical clipping. Although the modalities have undergone clinical comparison, they have not been evaluated on patient-reported outcomes (PROs). This study compared endovascular versus microsurgical treatment using a PRO measure. METHODS We conducted a cross-sectional telephonic survey of adult patients conducted at Hamad General Hospital, Doha, Qatar between 2017 and 2019. Candidate study participants were identified from procedure logs and hospital electronic health records for endovascular treatment (N = 32) versus microsurgical clipping (N = 32) of cerebral aneurysm. The primary outcome measure was the short version of the Stroke-Specific Quality of Life (SS-QoL) measure. The secondary outcome measure was the screened clinician-reported modified Rankin Scale (mRS) for all screened patients (n = 137). Mean scores were compared for the 2 treatment groups. RESULTS The SS-QoL mean score was 4.23 (standard deviation ± 0.77) in endovascular treatment and 4.19 ± 0.19 in surgical clipping (P = 0.90). In exploratory analysis, mean physical domain score was 3.17 ± 0.60 versus 2.98 ± 0.66 in endovascular treatment and surgical clipping groups, respectively. Mean psychosocial domain scores were 4.43 ± 0.85 versus 4.18 ± 0.0.92, respectively. In multivariable analysis, none of the clinical variables were significantly related to SS-QoL except vasospasm irrespective of intervention received. In secondary outcome analysis, modified Rankin Scale score was higher for endovascular treatment (P = 0.04). CONCLUSIONS Published evidence has supported clinical benefits of endovascular treatment for cerebral aneurysm treatment, but this study did not find any difference in PROs. Future studies of treatments should include PRO to identify potential differences from the patient's perspective.
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Prioritization and Timing of Outcomes and Endpoints After Aneurysmal Subarachnoid Hemorrhage in Clinical Trials and Observational Studies: Proposal of a Multidisciplinary Research Group. Neurocrit Care 2020; 30:102-113. [PMID: 31123994 DOI: 10.1007/s12028-019-00737-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION In studies on aneurysmal subarachnoid hemorrhage (SAH), substantial variability exists in the use and timing of outcomes and endpoints, which complicates interpretation and comparison of results between studies. The aim of the National Institute of Health/National Institute of Neurological Disorders and Stroke/National Library of Medicine Unruptured Intracranial Aneurysm (UIA) and SAH common data elements (CDE) Project was to provide a common structure for future UIA and SAH research. METHODS This article summarizes the recommendations of the UIA and SAH CDE Outcomes and Endpoints subgroup, which consisted of an international and multidisciplinary ad hoc panel of experts in clinical outcomes after SAH. Consensus recommendations were developed by review of previously published CDEs for other neurological diseases and the SAH literature. Recommendations for CDEs were classified by priority into "Core," "Supplemental-Highly Recommended," "Supplemental," and "Exploratory." RESULTS The subgroup identified over 50 outcomes measures and template case report forms (CRFs) to be included as part of the UIA and SAH CDE recommendations. None was classified as "Core". The modified Rankin Scale score and Montreal Cognitive Assessment were considered the preferred outcomes and classified as Supplemental-Highly Recommended. Death, Glasgow Outcome Scale score, and Glasgow Outcome Scale-extended were classified as Supplemental. All other outcome measures were categorized as "Exploratory". We propose outcome assessment at 3 months and at 12 months for studies interested in long-term outcomes. We give recommendations for standardized dichotomization. CONCLUSION The recommended outcome measures and CRFs have been distilled from a broad pool of potentially useful CDEs, scales, instruments, and endpoints. The adherence to these recommendations will facilitate the comparison of results across studies and meta-analyses of individual patient data.
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Common Data Elements for Unruptured Intracranial Aneurysm and Subarachnoid Hemorrhage Clinical Research: Recommendations from the Working Group on Long-Term Therapies. Neurocrit Care 2020; 30:79-86. [PMID: 31077078 DOI: 10.1007/s12028-019-00727-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The goal for the long-term therapies (LTT) working group (WG) of the Unruptured Intracranial Aneurysm (UIA) and Subarachnoid Hemorrhage (SAH) common data elements (CDEs) was to develop a comprehensive set of CDEs, data definitions, case report forms, and guidelines for use in UIA and SAH LTT clinical research, as part of a new joint effort between the National Institute of Neurological Disorders and Stroke (NINDS) and the National Library of Medicine of the US National Institutes of Health. These UIA and SAH CDEs will join other neurological disease-specific CDEs already developed and available for use by research investigators. METHODS The eight LTT WG members comprised international UIA, and SAH experts reviewed existing NINDS CDEs and instruments, created new elements when needed, and provided recommendations for future LTT clinical research. The recommendations were compiled, internally reviewed by the all UIA and SAH WGs and steering committee members. The NINDS CDE team also reviewed the final version before posting the SAH Version 1.0 CDE recommendations on the NINDS CDE website. RESULTS The NINDS UIA and SAH LTT CDEs and supporting documents are publicly available on the NINDS CDE ( https://www.commondataelements.ninds.nih.gov/#page=Default ) and NIH Repository ( https://cde.nlm.nih.gov/home ) websites. The subcommittee members discussed and reviewed various parameters, outcomes, and endpoints in UIA and SAH LTT studies. The following meetings with WG members, the LTT WG's recommendations are incorporated into the disease/injury-related events, assessments and examinations, and treatment/intervention data domains. CONCLUSIONS Noting gaps in the literature regarding medication and rehabilitation parameters in UIA and SAH clinical studies, the current CDE recommendations aim to arouse interest to explore the impact of medication and rehabilitation treatments and therapies and encourage the convergence of LTT clinical study parameters to develop a harmonized standard.
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Nobels-Janssen E, van der Wees PJ, Verhagen WIM, Westert GP, Bartels RHMA, Boogaarts JD. Patient-reported outcome measures in subarachnoid hemorrhage: A systematic review. Neurology 2019; 92:1096-1112. [PMID: 31076533 PMCID: PMC6556093 DOI: 10.1212/wnl.0000000000007618] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/11/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Patient-reported outcomes (PROs) are aspects of a patient's health status and are considered important for stimulating patient-centered care. Current outcome measures in clinical care for patients with aneurysmal subarachnoid hemorrhage (aSAH) are insufficient to capture PROs. In this systematic review, we aimed to summarize the evidence regarding the quality of patient-reported outcome measures (PROMs) in aSAH patients. METHODS We performed a systematic review of the literature published from inception until October 29, 2018, in PubMed, the Cochrane Central Register of Controlled Trials, and EMBASE. Eligible studies had to evaluate measurement properties and capture PROs in aSAH patients. The quality of the studies and measurement properties were assessed using the consensus-based standards for the selection of health status measurement instruments (COSMIN) checklist. The review protocol was registered with PROSPERO (CRD42018058566). RESULTS We identified 9 articles that reported the assessment of 7 different disease-specific and generic PROMs used for aSAH patients, including 5 that focused on the Stroke-Specific Quality of Life Scale (SS-QoL). The methodologic quality of the validation processes used was generally doubtful. None of the PROMs complied with current standards for content validity. CONCLUSIONS Due to the low quality of evidence for the measurement properties, the evidence base for selecting a suitable PROM for use with aSAH patients is insufficient. Given the specific long-term consequences of aSAH, we consider a disease-specific PROM the most appropriate, with SS-QoL the most suitable PROM currently available.
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Affiliation(s)
- Edith Nobels-Janssen
- From the Department of Neurology (E.N.-J., W.I.M.V.), Canisius Wilhelmina Hospital; and Department of Neurosurgery (E.N.-J., R.H.M.A.B., J.D.B.) and Radboud Institute of Health Sciences, IQ Health care (P.J.v.d.W., G.P.W.), Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Philip J van der Wees
- From the Department of Neurology (E.N.-J., W.I.M.V.), Canisius Wilhelmina Hospital; and Department of Neurosurgery (E.N.-J., R.H.M.A.B., J.D.B.) and Radboud Institute of Health Sciences, IQ Health care (P.J.v.d.W., G.P.W.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Wim I M Verhagen
- From the Department of Neurology (E.N.-J., W.I.M.V.), Canisius Wilhelmina Hospital; and Department of Neurosurgery (E.N.-J., R.H.M.A.B., J.D.B.) and Radboud Institute of Health Sciences, IQ Health care (P.J.v.d.W., G.P.W.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Gert P Westert
- From the Department of Neurology (E.N.-J., W.I.M.V.), Canisius Wilhelmina Hospital; and Department of Neurosurgery (E.N.-J., R.H.M.A.B., J.D.B.) and Radboud Institute of Health Sciences, IQ Health care (P.J.v.d.W., G.P.W.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ronald H M A Bartels
- From the Department of Neurology (E.N.-J., W.I.M.V.), Canisius Wilhelmina Hospital; and Department of Neurosurgery (E.N.-J., R.H.M.A.B., J.D.B.) and Radboud Institute of Health Sciences, IQ Health care (P.J.v.d.W., G.P.W.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jeroen D Boogaarts
- From the Department of Neurology (E.N.-J., W.I.M.V.), Canisius Wilhelmina Hospital; and Department of Neurosurgery (E.N.-J., R.H.M.A.B., J.D.B.) and Radboud Institute of Health Sciences, IQ Health care (P.J.v.d.W., G.P.W.), Radboud University Medical Center, Nijmegen, the Netherlands
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Odetunde MO, Akinpelu AO, Odole AC. Cross-cultural adaptatiion and validation of the stroke specific quality of life 2.0 scale into Hausa language. J Patient Rep Outcomes 2018; 2:63. [PMID: 30574661 PMCID: PMC6301903 DOI: 10.1186/s41687-018-0082-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 11/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Stroke Specific Quality of Life 2.0 (SS-QoL 2.0) is a widely used scale that has been cross-culturally adapted to many languages including Yoruba, one of the three major Nigerian languages. Non-availability of SS-QoL 2.0 in Hausa, the indigenous language of Northern Nigeria has restricted its use in Hausa stroke-survivors (SSV). This study was aimed at cross-culturally adapting SS-QoL 2.0 to Hausa and assessing validity and reliability of the Hausa version. The English version of SS-QoL 2.0 was cross-culturally adapted to Hausa following the American Association of Orthopaedic Surgeons' guideline. A final Hausa version (FHV) was produced through forward and back-translations, expert committee review, pretesting and cognitive debriefing interview. The FHV was investigated for test-retest reliability, internal consistency, convergent, construct and known-group validity on 86 consenting Hausa SSV. Hausa version of WHOQoL-BREF was used to assess convergent validity (n = 57) while English versions of SS-QoL was used to assess construct validity (n = 51) of FHV. The FHV was re-administered on 53 of the participants at 7-day interval to assess test-retest reliability. Each scale was administered in random order to eliminate bias. Data were analysed using Spearman correlation, Cronbach's alpha, Intra-class Correlation Coefficient (ICC), Independent t-test and One-way ANOVA at p < 0.05. RESULTS The SS-QoL 2.0 was successfully cross-culturally adapted to Hausa. Participants' mean overall score on SS-QoL 2.0 (145.30 ± 39.78) did not differ significantly from that of FHV (150.41 ± 40.45) p = 0.28. The mean domains score did not differ significantly except in self-care and work domains. There were weak to good correlations for 6 out of 8 similar domains on Hausa versions of SS-QoL and WHOQoL-BREF (r = 0.21-0.61; p = 0.001-0.006); and good to excellent correlations between Hausa and English versions of SS-QoL (r = 0.70-0.92; p = 0.001). The FHV showed high to excellent test-retest reliability (ICC = 0.86-0.99) and acceptable to excellent internal consistency (Cronbach's α = 0.71-0.90). No significant gender differences were demonstrated for any domains of FHV and for most domains across age groups. CONCLUSION The FHV is valid and reliable. The scale is recommended for assessing health-related quality of life among Hausa stroke survivors.
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Affiliation(s)
- Marufat O. Odetunde
- Department of Physiotherapy, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
| | - Aderonke O. Akinpelu
- Department of Physiotherapy, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| | - Adesola C. Odole
- Department of Physiotherapy, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
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Pedersen SG, Heiberg GA, Nielsen JF, Friborg O, Stabel HH, Anke A, Arntzen C. Validity, reliability and Norwegian adaptation of the Stroke-Specific Quality of Life (SS-QOL) scale. SAGE Open Med 2018; 6:2050312117752031. [PMID: 29344360 PMCID: PMC5764138 DOI: 10.1177/2050312117752031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 12/12/2017] [Indexed: 11/15/2022] Open
Abstract
Background: There is a paucity of stroke-specific instruments to assess health-related quality of life in the Norwegian language. The objective was to examine the validity and reliability of a Norwegian version of the 12-domain Stroke-Specific Quality of Life scale. Methods: A total of 125 stroke survivors were prospectively recruited. Questionnaires were administered at 3 months; 36 test–retests were performed at 12 months post stroke. The translation was conducted according to guidelines. The internal consistency was assessed with Cronbach’s alpha; convergent validity, with item-to-subscale correlations; and test–retest, with Spearman’s correlations. Scaling validity was explored by calculating both floor and ceiling effects. A priori hypotheses regarding the associations between the Stroke-Specific Quality of Life domain scores and scores of established measures were tested. Standard error of measurement was assessed. Results: The Norwegian version revealed no major changes in back translations. The internal consistency values of the domains were Cronbach’s alpha = 0.79–0.93. Rates of missing items were small, and the item-to-subscale correlation coefficients supported convergent validity (0.48–0.87). The observed floor effects were generally small, whereas the ceiling effects had moderate or high values (16%–63%). Test–retest reliability indicated stability in most domains, with Spearman’s rho = 0.67–0.94 (all p < 0.001), whereas the rho was 0.35 (p < 0.05) for the ‘Vision’ domain. Hypothesis testing supported the construct validity of the scale. Standard error of measurement values for each domain were generated to indicate the required magnitudes of detectable change. Conclusions: The Norwegian version of the Stroke-Specific Quality of Life scale is a reliable and valid instrument with good psychometric properties. It is suited for use in health research as well as in individual assessments of persons with stroke.
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Affiliation(s)
- Synne Garder Pedersen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Health and Care Science, Faculty of Health Sciences, University of Tromsø - Arctic University of Norway, Tromsø, Norway
| | - Guri Anita Heiberg
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø - Arctic University of Norway, Tromsø, Norway
| | - Jørgen Feldbæk Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark
| | - Oddgeir Friborg
- Department of Psychology, Faculty of Health Sciences, University of Tromsø - Arctic University of Norway, Tromsø, Norway
| | - Henriette Holm Stabel
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø - Arctic University of Norway, Tromsø, Norway
| | - Cathrine Arntzen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Health and Care Science, Faculty of Health Sciences, University of Tromsø - Arctic University of Norway, Tromsø, Norway
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Chou CY, Huang CY, Huang YJ, Lin GH, Huang SL, Lee SC, Hsieh CL. Comparison of construct validity of two short forms of Stroke-Specific Quality of Life scale. PLoS One 2017; 12:e0188478. [PMID: 29211759 PMCID: PMC5718408 DOI: 10.1371/journal.pone.0188478] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 11/04/2017] [Indexed: 11/19/2022] Open
Abstract
Background No studies have compared the 2-factor structures of Wong’s and Post’s versions of the short-form Stroke-Specific Quality of Life (i.e., 12-item SSQOL) scale. This study compared the construct validity of 2 short-forms of the 12-item-SSQOL (not the 12-domain-SSQOL). Methods Data were obtained from a previous validation study of the original 49-item SSQOL in 263 patients. Construct validity was tested by confirmatory factor analysis (CFA) to examine whether the two-factor structure, including psychosocial and physical domains, was supported in both versions. The CFA tested the data-model fit by indices: chi-square χ2/df ratio, root mean square error of approximation (RMSEA), comparative fit index (CFI), nonnormative fit index (NNFI), standard root mean square residual (SRMR), and parsimony normed fit index (PNFI). Item factor loadings (cutoffs: .50) were examined. Model fit was compared using Akaike information criterion (AIC) and consistent AIC (i.e., CAIC) values. Results All model fit indices for Post’s version fell within expected ranges: χ2/df ratio = 2.02, RMSEA = 0.05, CFI = 0.97, NNFI = 0.97, SRMR = 0.06, and PNFI = 0.76. In the psychosocial domain, the item factor loadings ranged from 0.46 to 0.63. In the physical domain, all items (except the language and vision items) had acceptable factor loadings (0.68 to 0.88). However, in Wong’s version, none of the model indices met the criteria for good fit. In model fit comparisons, Post’s version had smaller AIC and CAIC values than did Wong’s version. Conclusions All fit indices supported Post’s version, but not Wong’s version. The construct validity of Post’s version with a 2-factor structure was confirmed, and this version of the 12-item SSQOL is recommended.
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Affiliation(s)
- Chia-Yeh Chou
- Department of Occupational Therapy, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan
| | - Chien-Yu Huang
- Department of Occupational Therapy, I-Shou University, Kaohsiung County, Taiwan
| | - Yi-Jing Huang
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan
| | - Gong-Hong Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan
| | - Sheau-Ling Huang
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei City, Taiwan
| | - Shu-Chun Lee
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Ching-Lin Hsieh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei City, Taiwan
- Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung City, Taiwan
- * E-mail:
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11
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Odetunde MO, Akinpelu AO, Odole AC. Validity and reliability of a Nigerian-Yoruba version of the stroke-specific quality of life scale 2.0. Health Qual Life Outcomes 2017; 15:205. [PMID: 29052510 PMCID: PMC5649048 DOI: 10.1186/s12955-017-0775-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 10/02/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Psychometric evidence is necessary to establish scientific integrity and clinical usefulness of translations and cultural adaptations of the Stroke-Specific Quality of Life (SS-QoL) scale. However, the limited evidence on psychometrics of Yoruba version of SS-QoL 2.0 (SS-QoL(Y)) is a significant shortcoming. This study assessed the test-retest reliability, internal consistency, convergent, divergent, discriminant and known-group validity of the SS-QoL(Y). METHODS Yoruba version of the WHOQoL-BREF was used to test the convergent and divergent validity of the SS-QoL(Y) among 100 consenting stroke survivors. The WHOQoL-BREF and SS-QoL(Y) was administered randomly in order to eliminate bias. The test-retest reliability of the SS-QoL(Y) was carried out among 68 of the respondents within an interval of 7 days. All respondents were purposively recruited from selected secondary and tertiary health facilities in South-west Nigeria. Data were analysed using descriptive statistics of mean and standard deviation, and inferential statistics of Spearman correlation, Cronbach's alpha, Intra-class Correlation Coefficient (ICC), Independent t-test and One-way ANOVA. Alpha level was set at p < 0.05. RESULT The physical health, psychological health, social relationship and environment domains on WHOQoL-BREF with correlation coefficient that ranged from 0.214 to 0.360 showed significant correlation with similar domains on SS-QoL(Y). Dissimilar domains between the two scales had r values from 0.035 to 0.366. Discriminant validity of SS-QoL(Y) showed that items' r value ranged from 0.711 to 0.920 with their hypothesized domains. The scale demonstrated moderate to strong test-retest reliability with Intra-class correlation coefficient (ICC) for the domains and overall scores (r = 0.47 to 0.81) and moderate to high internal consistency (Cronbach's alpha =0.61 to 0.82) for domains scores. These correlations were also significant for the domains and overall scores (p < 0.05). There were no significant differences across different age groups or gender for the domains or overall scores of SS-QoL(Y). CONCLUSIONS Discriminant and known-group validity, test-retest reliability and internal consistency of the Yoruba version of the Stroke Specific Quality of Life 2.0 are adequate while the convergent and divergent validity are low but acceptable. The SS-QoL(Y) is recommended for assessing health-related quality of life among Yoruba stroke survivors.
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Wong GKC, Mak JSY, Wong A, Zheng VZY, Poon WS, Abrigo J, Mok VCT. Minimum Clinically Important Difference of Montreal Cognitive Assessment in aneurysmal subarachnoid hemorrhage patients. J Clin Neurosci 2017; 46:41-44. [PMID: 28887072 DOI: 10.1016/j.jocn.2017.08.039] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/15/2017] [Indexed: 11/17/2022]
Abstract
Cognitive impairment is a major factor contributing to poor functional outcome after subarachnoid hemorrhage caused by a ruptured cerebral aneurysm (aSAH). Montreal Cognitive Assessment (MoCA) has been shown to be superior to the Mini-Mental State Examination in screening for cognitive domain deficit and correlating to functional outcome in aSAH patients. The aim of the current study was to determine the Montreal Cognitive Assessment (MoCA) score change that was associated with change of health in general in an aSAH patient cohort. We recruited aSAH patients from a regional neurosurgical center over a 3-year period. Patient assessments including MoCA and global rating of change (GRoC) were carried out at at 3 and 12months after aSAH. Anchor-based and distribution-based approaches were adopted to calculate the Minimum Clinically Important Difference (MID). One hundred and seventy-five aSAH patients completed both 3-month and 1-year assessments and consented for participation. Employing the distribution-based approach for the 3-month and 1-year MoCA scores, the MID estimates equated to a change of 2.0 and 1.1 respectively. Employing the anchor-based approach (with GRoC), the MID estimate of MoCA (median, IQR) was 2, 1-4. In conclusion, we found that the MID of MoCA score associated with change of health in general in aSAH patients was 2. The MID provides guidance for future clinical trial design targeting on cognitive dysfunction after aSAH.
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Affiliation(s)
- George Kwok Chu Wong
- Division of Neurosurgery, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.
| | - Jodhy Suk Ying Mak
- Division of Neurosurgery, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Adrian Wong
- Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Vera Zhi Yuan Zheng
- Division of Neurosurgery, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Wai Sang Poon
- Division of Neurosurgery, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Jill Abrigo
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Vincent Chung Tong Mok
- Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
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An TG, Kim SH, Kim KU. Effect of transcranial direct current stimulation of stroke patients on depression and quality of life. J Phys Ther Sci 2017; 29:505-507. [PMID: 28356641 PMCID: PMC5361020 DOI: 10.1589/jpts.29.505] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 12/01/2016] [Indexed: 01/10/2023] Open
Abstract
[Purpose] The aim of this study was to assess the effects of transcranial direct current
stimulation (tDCS) on depression and quality of life (QOL) in patients with stroke, by
conducting conventional occupational therapy with and without tDCS on 20 patients each.
[Subjects and Methods] The experimental group (N=20) received both tDCS and conventional
occupational therapy, while the control group (N=20) received false tDCS and conventional
occupational therapy. The treatment was conducted 20 times over a four-week period; each
session was 30 minutes long. The Beck Depression Inventory (BDI) was administered to score
the depression levels in patients before and after the intervention, while the
stroke-specific quality of life (SS-QOL) was measured to compare the QOL. [Result]
Following the intervention, the patients in the experimental group showed a significant
decrease in depression and an increase in the QOL. In contrast, the control group showed
no significant changes in depression or QOL. Our findings indicate that tDCS decreased
depression while increasing QOL in patients with stroke. [Conclusion] In other words, our
study confirmed that the application of tDCS during stroke rehabilitation improves the
depression symptoms and QOL in patients.
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Affiliation(s)
- Tae-Gyu An
- Rehabilitation Science, Daegu University, Republic of Korea
| | - Soo-Han Kim
- Department of Physical Therapy, College of Health Medicine, Kaya University, Republic of Korea
| | - Ko-Un Kim
- Rehabilitation Science, Daegu University, Republic of Korea
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Wong GK, Lee A, Wong A, Ho FL, Leung SL, Zee BC, Poon WS, Siu DY, Abrigo JM, Mok VC. Clinically important difference of Stroke-Specific Quality of Life Scale for aneurysmal subarachnoid hemorrhage. J Clin Neurosci 2016; 33:209-212. [DOI: 10.1016/j.jocn.2016.05.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 05/05/2016] [Indexed: 11/24/2022]
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Lo SHS, Chang AM, Chau JPC. Establishing equivalence of a Chinese version of the stroke specific quality of life measure for stroke survivors. Disabil Rehabil 2016; 39:1079-1086. [PMID: 27216634 DOI: 10.1080/09638288.2016.1178348] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION The Stroke Specific Quality of Life Scale is a stroke-specific measure of health-related quality of life. However, there has been no Chinese (Hong Kong) version of the scale. METHODS A descriptive study was conducted to examine the reliability, validity and factor structure of the translated version (SSQOL-C) among stroke survivors. Participants completed SSQOL-C, and the Chinese versions of the Medical Outcomes Study Short-Form Health Survey (SF-36), Stroke Self-Efficacy Questionnaire (SSEQ-C) and Frenchay Activities Index (FAI). Thirty of these participants completed the same questionnaires after 4 weeks. RESULTS A total of 135 stroke survivors (mean age 58.90 ± 9.75) were recruited. SSQOL-C had good internal consistency with Cronbach's alphas for each domain ranging from 0.63 to 0.90. Most domains had moderate to high correlations with similar dimensions of SF-36, SSEQ-C, FAI and Barthel ADL Index total scores (Spearman's rho: 0.40-0.77, p < 0.01), suggesting acceptable convergent validity. Principal component analyses suggested an 11-factor model in contrast to the 12-factor model for the original scale with six new factors emerging and five original factors retained. DISCUSSION The results suggest SSQOL-C is a reliable and valid tool for measuring Chinese stroke survivors' health-related quality of life. More studies are needed to confirm the 11-factor model of the scale. Implications for rehabilitation The translated Chinese version of the Stroke Specific Quality of Life Scale is a reliable and valid tool for measuring Chinese stroke survivors' health-related quality of life. An 11-factor model in contrast to the 12-factor model for the original scale with six new factors emerging and five original factors retained.
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Affiliation(s)
- Suzanne Hoi Shan Lo
- a School of Nursing , Faculty of Health, Queensland University of Technology , Brisbane , Queensland , Australia.,b The Nethersole School of Nursing , Faculty of Medicine, The Chinese University of Hong Kong , Shatin , Hong Kong
| | - Anne Marie Chang
- a School of Nursing , Faculty of Health, Queensland University of Technology , Brisbane , Queensland , Australia
| | - Janita Pak Chun Chau
- b The Nethersole School of Nursing , Faculty of Medicine, The Chinese University of Hong Kong , Shatin , Hong Kong
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Quality of Life after Brain Injury (QOLIBRI) Overall Scale for patients after aneurysmal subarachnoid hemorrhage. J Clin Neurosci 2014; 21:954-6. [DOI: 10.1016/j.jocn.2013.09.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 09/11/2013] [Accepted: 09/12/2013] [Indexed: 11/18/2022]
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Development of a short form of Stroke-Specific Quality of Life Scale for patients after aneurysmal subarachnoid hemorrhage. J Neurol Sci 2013; 335:204-9. [PMID: 24120271 DOI: 10.1016/j.jns.2013.09.033] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 09/11/2013] [Accepted: 09/25/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND The identification of aneurysmal subarachnoid hemorrhage (aSAH) patients with a decrease in health-related quality of life (HRQOL) is challenging. Stroke-Specific Quality of Life (SS-QOL) Scale is one of the commonest disease-specific quality of life measures initially developed and validated for ischemic stroke patients. A disadvantage is subject burden and a short form is more practical to use in clinical and research setting. AIM This study aimed to develop a short form (12-item) of a Chinese version of Stroke-Specific Quality of Life Scale for aSAH (SSQOL-a) for clinical and research applications. METHODS We carried out a prospective observational assessor-blinded multi-center study in Hong Kong. The study was registered at ClinicalTrials.gov of the U.S. National Institutes of Health (NCT01038193), and was approved by hospital ethics committees. RESULTS One hundred and eighty-six aSAH patients were recruited over a 30 month period during admission. One hundred (54%) aSAH patients completed the 12-month assessment battery and were included into the current study. The total score, physical component score, and psychosocial score of the 12-item Chinese version showed satisfactory internal consistency and explained high percentages of variance of the full Chinese version (92% to 96%). The 12-item Chinese version showed significant correlations with neurological, functional, generic quality of life, psychiatric, and cognitive outcome measures at 12 months. Chinese version calculated physical subscore had better discrimination in detecting complete recovery than the Dutch version calculated physical subscore in our Chinese population. CONCLUSIONS The 12-item Chinese version of SSQOL-a has a satisfactory internal consistency and criterion validity for SAH patients at 12 month assessments.
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Visser-Meily JMA, Rinkel GJE, Vergouwen MDI, Passier PECA, van Zandvoort MJE, Post MWM. Post-traumatic stress disorder in patients 3 years after aneurysmal subarachnoid haemorrhage. Cerebrovasc Dis 2013; 36:126-30. [PMID: 24029667 DOI: 10.1159/000353642] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 06/06/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Subarachnoid haemorrhage (SAH) from a ruptured intracranial aneurysm accounts for approximately 5% of all strokes. Post-traumatic stress disorder (PTSD) is common in the early phase after recovery from aneurysmal SAH. The aim of our study was to examine the prevalence of PTSD 3 years after SAH, its predictors, and relationship with health-related quality of life (HRQoL) in patients living independently in the community. METHODS From a prospectively collected cohort of 143 patients with aneurysmal SAH who visited our outpatient clinic 3 months after SAH, 94 patients (65.7%) completed a mailed questionnaire 3 years after SAH. We assessed PTSD with the Impact of Event Scale and HRQoL with the Stroke-Specific Quality of Life Scale (SS-QoL). The χ(2) and t tests were used to investigate if patients who returned the questionnaires were different from those who did not reply. Non-parametric tests (χ(2) and Mann-Whitney tests) were used to test for differences between patients with and without PTSD. Relative risks and 95% confidence intervals were calculated. RESULTS No relevant differences in demographic (age, sex, education) or SAH characteristics (clinical condition on admission, complication, location of aneurysm, Glasgow Outcome Scale score at 3 months) were seen between participants and drop-outs. In 24 patients (26%), Impact of Event Scale scores indicated PTSD. Passive coping style (relative risk, 5.7; 95% confidence interval, 2.1-15.3), but none of the demographic or SAH-related factors, predicted PTSD. The mean SS-QoL total score was 4.2 (SD 1.1), indicative of a relatively satisfactory HRQoL. PTSD was associated with lower HRQoL (p < 0.001), a mean SS-QoL score of 4.4 (SD 1.0) without PTSD, and a mean SS-QoL score of 3.5 (SD 1.1) with PTSD. CONCLUSIONS Even 3 years after SAH, 1 out of 4 patients had PTSD, which was associated with reduced HRQoL. Passive coping style was the most important predictor. There is a need to organize SAH care with more attention to and treatment of PTSD. Strategies shown to reduce PTSD in other conditions should be tested for effectiveness in SAH patients.
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Affiliation(s)
- J M A Visser-Meily
- Brain Center Rudolf Magnus and Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht and De Hoogstraat, Utrecht, The Netherlands
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