Quality of Life Measurement After Stroke

Abstract

Background and Purpose-The Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) is widely used to measure health status after stroke. However, a fundamental assumption for its valid use after stroke has not been comprehensively tested: is it legitimate to generate scores for 8 scales and 2 summary measures using the standard algorithms? We tested this assumption. Methods-SF-36 data from 177 people after stroke were examined (71% male; mean age, 62). We tested 6 scaling criteria to determine the legitimacy of generating the 8 SF-36 scale scores using Likert's method of summed ratings, and we tested 2 scaling criteria to determine the appropriateness of the standard SF-36 algorithms for weighting and combining scale scores to generate 2 summary measures (physical and mental). Results-Scaling assumptions were fully satisfied for 6 of the 8 scales, but 3 of these 6 scales had notable floor and/or ceiling effects. Assumptions for generating 2 SF-36 summary measures were not satisfied. Conclusions-In this sample, 5 of the 8 SF-36 scales had limited validity as outcome measures after stroke, and the reporting of physical and mental summary scores was not supported. Results raise questions about the use of the SF-36 in stroke, and the SF-12 that is developed from it, and highlight the importance of testing scaling assumptions when applying existing scales to new populations.

Psychometric Properties of the Brazilian 12-Item Short-Form Health Survey Version 2 (SF-12v2)

“…The mental and physical health subscales were positively and moderately associated. This result corroborates previous findings suggesting the interconnection between physical and mental health, and more precisely, between the PCS and MHS factors of the SF scales (Hobart, Williams, Moran, & Thompson, 2002;Montazeri et al, 2011;Simon, Revicki, Grothaus, & Vonkorff, 1998). Both PCS and MCS subscales also presented adequate convergent validity with the external measures (SHS, SWLS, GHQ-12, and ASAS-R).…”

The Stroke Impact Scale 3.0

“…6 Nevertheless, some SF-36 dimensions may have important floor (eg, physical role) and ceiling (eg, bodily pain and emotional role) effects in stroke patients. 7 The Stroke Impact Scale (SIS) is a specific HRQoL tool that was developed by Duncan et al 8 at the University of Kansas Medical Center to measure multidimensional consequences of stroke.…”

Escalas utilizadas para la medición de la calidad de vida en pacientes con enfermedad cerebrovascular

“…Es un cuestionario autoadministrado, puede realizarse vía entrevistador o a través de vía telefónica o informática, con un puntaje que va de 0 a 100; un puntaje alto indica mejor salud 17 , aunque los dominios de salud general y función social muestran escaso poder discriminativo, validez e imprecisión en estudios de pacientes con ACV 18 , y en pacientes con compromiso severo deja de ser tan especí-fico; sin embargo, permite valorar de forma adecuada la calidad de vida. Existe además una versión acortada, el SF-12, que reproduce de forma adecuada los resultados en cuanto al componente físico y emocional y disminuye la sensación de carga porque es posible contestarla en menos tiempo 17,[19][20][21] .…”