Advertisement

Development and Validation of Participation and Positive Psychologic Function Measures for Stroke Survivors

      Abstract

      Bode RK, Heinemann AW, Butt Z, Stallings J, Taylor C, Rowe M, Roth EJ. Development and validation of participation and positive psychologic function measures for stroke survivors.

      Objective

      To evaluate the reliability and validity of Neurologic Quality of Life (NeuroQOL) item banks that assess quality-of-life (QOL) domains not typically included in poststroke measures.

      Design

      Secondary analysis of item responses to selected NeuroQOL domains.

      Setting

      Community.

      Participants

      Community-dwelling stroke survivors (n=111) who were at least 12 months poststroke.

      Interventions

      Not applicable.

      Main Outcome Measures

      Five measures developed for 3 NeuroQoL domains: ability to participate in social activities, satisfaction with participation in social activities, and positive psychologic function.

      Results

      A single bank was developed for the positive psychologic function domain, but 2 banks each were developed for the ability-to-participate and satisfaction-with-participation domains. The resulting item banks showed good psychometric properties and external construct validity with correlations with the legacy instruments, ranging from .53 to .71. Using these measures, stroke survivors in this sample reported an overall high level of QOL.

      Conclusions

      The NeuroQoL-derived measures are promising and valid methods for assessing aspects of QOL not typically measured in this population.

      Key Words

      List of Abbreviations:

      CAT (computerized adaptive test), FAI (Frenchay Activities Index), IRT (informed response theory), LSQ (Life Satisfaction Questionnaire), NeuroQOL (Neurologic Quality of Life), NHP (Nottingham Health Profile), PCA (principal component analysis), QOL (quality of life), SIP (Sickness Impact Profile)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • World Health Organization
        International Classification of Functioning, Disability, and Health (ICF).
        WHO, Geneva2001
        • Atherton P.J.
        • Sloan J.A.
        Rising importance of patient-reported outcomes.
        Lancet Oncol. 2006; 7: 883-884
        • Leidy N.K.
        • Beusterien K.
        • Sullivan E.
        • Richner R.
        • Muni N.I.
        Integrating the patient's perspective into device evaluation trials.
        Value Health. 2006; 9: 394-401
        • Ware Jr, J.E.
        • Sherbourne C.D.
        The MOS 36-Item Short-Form Health Survey (SF-36).
        Med Care. 1992; 30: 473-483
        • Lynch E.B.
        • Butt Z.
        • Heinemann A.
        • et al.
        A qualitative study of quality of life after stroke: the importance of social relationships.
        J Rehabil Med. 2008; 40: 518-523
        • Hamilton B.
        • Granger C.
        • Sherwin F.
        • Zielezny M.
        • Tashman J.
        A uniform national data system for medical rehabilitation.
        in: Fuhrer M. Rehabilitation outcomes: analysis and measurements. Brookes, Baltimore2003: 137-147
        • Schuling J.
        • de Haan R.
        • Limburg M.
        • Groenier K.H.
        The Frenchay Activities Index.
        Stroke. 1993; 24: 1173-1177
        • Visser M.C.
        • Koudstaal P.J.
        • Erdman R.A.
        • et al.
        Measuring quality of life in patients with myocardial infarction or stroke: a feasibility study of four questionnaires in the Netherlands.
        J Epidemiol Community Health. 1995; 49: 513-517
        • Carlsson M.
        • Hamrin E.
        Measurement of quality of life in women with breast cancer.
        Qual Life Res. 1996; 5: 265-274
        • Lynch E.B.
        • Butt Z.
        • Heinemann A.W.
        • et al.
        Stroke-related quality of life: insight from focus groups with patients and caregivers.
        J Rehabil Med. 2008; 40: 518-523
        • Rothwell P.M.
        • Coull A.J.
        • Giles M.F.
        • et al.
        Change in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study).
        Lancet. 2004; 363: 1925-1933
        • Salter K.L.
        • Foley N.C.
        • Jutai J.W.
        • Teasell R.W.
        Assessment of participation outcomes in randomized controlled trials of stroke rehabilitation interventions.
        Int J Rehabil Res. 2007; 30: 339-342
        • Noreau L.
        • Desrosiers J.
        • Robichaud L.
        • Fougeyrollas P.
        • Rochette A.
        • Viscogliosi C.
        Measuring social participation: reliability of the LIFE-H in older adults with disabilities.
        Disabil Rehabil. 2004; 26: 346-352
        • Daniel K.
        • Wolfe C.D.
        • Busch M.A.
        • McKevitt C.
        What are the social consequences of stroke for working-aged adults?.
        Stroke. 2009; 40 (Epub 2009 Apr 23): e431-e440
        • Salter K.L.
        • Foley N.C.
        • Jutai J.W.
        • Teasell R.W.
        Assessment of participation outcomes in randomized controlled trials of stroke rehabilitation interventions.
        Int J Rehabil Res. 2007; 30: 339-342
        • Hays R.D.
        • Morales L.S.
        • Reise S.P.
        Item response theory and health outcomes measurement in the 21st century.
        Med Care. 2000; 38: II28-II42
        • Cella D.
        • Chang C.H.
        A discussion of item response theory and its applications in health status assessment.
        Med Care. 2000; 38: II66-II72
        • Embretson S.E.
        • Reise S.P.
        Item response theory for psychologists.
        Erlbaum, Mahwah2000
        • Embretson S.E.
        The continued search for nonarbitrary metrics in psychology.
        Am Psychol. 2006; 61: 50-55
        • Weiss D.J.
        Computerized adaptive testing for effective and efficient measurement in counseling and education.
        Meas Eval Counseling Dev. 2004; 37: 70-84
        • Ottenbacher K.J.
        • Hsu Y.
        • Granger C.V.
        • Fiedler R.C.
        The reliability of the Functional Independence Measure: a quantitative review.
        Arch Phys Med Rehabil. 1996; 77: 1226-1232
        • Heinemann A.W.
        • Linacre J.M.
        • Wright B.D.
        • Hamilton B.B.
        • Granger C.V.
        Measurement characteristics of the Functional Independence Measure.
        Top Stroke Rehabil. 1994; 1: 1-15
        • Petrella R.J.
        • Overend T.
        • Chesworth B.
        FIM after hip fracture: is telephone administration valid and sensitive to change?.
        Am J Phys Med Rehabil. 2002; 81: 639-644
        • Post M.W.
        • de Witte L.P.
        Good inter-rater reliability of the Frenchay Activities Index in stroke patients.
        Clin Rehabil. 2003; 17: 548-552
        • Wann-Hansson C.
        • Klevsgard R.
        • Hagell P.
        Cross-diagnostic validity of the Nottingham Health Profile Index of Distress (NHPD).
        Health Qual Life Outcomes. 2008; 6: 47-59
        • von Steinbuechel N.
        • Richter S.
        • Morawetz C.
        • Riemsma R.
        Assessment of subjective health and health-related quality of life in persons with acquired or degenerative brain injury.
        Curr Opin Neurol. 2005; 18: 681-691
        • Hartman-Maeir A.
        • Soroker N.
        • Ring H.
        • Avni N.
        • Katz N.
        Activities, participation and satisfaction one-year post stroke.
        Disabil Rehabil. 2007; 29: 559-566
        • Carlsson M.
        • Hamrin E.
        • Lindqvist R.
        Psychometric assessment of the Life Satisfaction Questionnaire (LSQ) and a comparison of a randomised sample of Swedish women and those suffering from breast cancer.
        Qual Life Res. 1999; 8: 245-253
        • Rasch G.
        Probabilistic models for some intelligence and attainment tests.
        Danmarks Paedogogiske Institut, Copenhagen1960
        • Wright B.D.
        • Masters G.
        Rating scale analysis.
        MESA Pr, Chicago1982
        • Linacre J.M.
        Dimensionality: contrasts and variance.
        (WINSTEPS Online User Manual) (Accessed September 16, 2009)
        • Bond T.G.
        • Fox C.M.
        Applying the Rasch model: fundamental measurement in the human sciences.
        1st ed. Lawrence Erlbaum, Mahwah2001
      1. Bode R, Hahn E, DeVellis R, Cella D. Measuring social participation: the PROMIS experience. Presented to the Measurement of Participation in Rehabilitation Research Symposium, October 15, 2008, Toronto, Canada; 2008.

        • Cahill S.
        • Foa E.
        Psychological theories of PTSD.
        in: Friedman M. Keane T. Resick P. Handbook of PTSD: science and practice. Guilford Pr, New York2007: 55-77
        • Diener E.
        • Suh E.
        • Lucas R.
        • Smith H.
        Subjective well-being: three decades of progress.
        Psychol Bull. 1999; 125: 276-302
        • Bode R.K.
        • Rychlik K.
        • Heinemann A.W.
        • Lovell L.
        • Modla L.
        Reconceptualizing poststroke activity level using the Frenchay Activities Index.
        Top Stroke Rehabil. 2003; 9: 82-91