RESUMO
INTRODUCTION: The stroke-specific quality of life scale (ECVI-38) is the first Spanish-language instrument for evaluating the quality of life in individuals who have survived a stroke. AIM: To evaluate the psychometric properties of the third version of the ECVI-38. PATIENTS AND METHODS: A total of 243 stroke survivors were interviewed 2 months-2 years after the event; 61 of them were surveyed again 7-14 days later and 74 others were interviewed on beginning and ending a two-month period of rehabilitation. Gold standard methods for this type of research were used to evaluate the psychometric properties (acceptability, reliability, validity and sensitivity to change). RESULTS. The ECVI was acceptable, with means close to the medians, a high degree of variability of the sample and a ceiling/floor effect below 20%, except for the odd exception. It displayed good reliability with internal consistence, with a Cronbach's alpha value of between 0.79 and 0.95, and a test-retest with intraclass correlation coefficients between 0.81 and 0.96. It satisfied the validity criteria both in analyses within the scale and in analyses against external criteria: it distinguishes well between different degrees of neurological, emotional and cognitive compromise. Sensitivity to change, at eight weeks after rehabilitation, was between moderate and high in most domains: there were significant differences between the scores for the domains, and the size of the effect was above 0.5. CONCLUSIONS: The ECVI-38 is acceptable, valid and reliable for evaluating the spectrum of consequences and recovery from a stroke, and its result changes in proportion to recovery.
Assuntos
Qualidade de Vida , Acidente Vascular Cerebral/diagnóstico , Inquéritos e Questionários , Estudos Transversais , Humanos , Psicometria , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
INTRODUCTION: The selection of a measure that can be used to evaluate the outcome of therapeutic interventions in stroke patients has had a conceptual problem in that there is a need to detect a wide range of deficiencies, disabilities and handicaps as part of a patient-based model. It has also suffered from a methodological problem due to the lack of systematic attention given to the development of standard instruments. AIMS: We conducted this study with the aim of getting over these limitations by developing a scale to evaluate the quality of life in stroke survivors. SUBJECTS AND METHODS: We followed a methodology that had previously been standardised by other authors based on using the opinion given by patients and caregivers in the generation of the items to be included. This has several stages that include individual interviews with patients, caregivers and experts, focal groups with patients and experts, quantitative and qualitative analyses of these interviews, two panels of experts to actually draw up the instrument, and a pilot test carried out in a sample of 50 patients to reduce and group the items. This reducing and grouping process was performed taking into account the following: 1. The percentage of responses left unanswered; 2. A factorial analysis of the main components; 3. Cronbach's alpha coefficient. RESULTS: We interviewed 20 patients and 12 experts; these results were later used to classify the above mentioned aspects in order of priority according to the frequency with which they appeared in the surveys. Then, we elaborated the questionnaire with four areas or subscales by including the questions or items in these categories: I. Physical status (17 items); II. Emotional status (13 items); III. Activities of daily living (13 items); IV. Social and familial functions (13 items). After the pilot study 38 items were reorganised into eight domains, according to the factorial analysis: 1. Physical problems; 2. Communication; 3. Cognition; 4. Emotions; 5. Feelings; 6. Activities of daily living; 7. Familial functions; 8. Social functions. They displayed high coefficients of internal consistency. CONCLUSIONS: We developed a new scale for evaluating the quality of life for stroke patients and it is now ready to undergo its validation process.
Assuntos
Qualidade de Vida , Acidente Vascular Cerebral , Inquéritos e Questionários , Atividades Cotidianas , Pessoas com Deficiência , Humanos , Reprodutibilidade dos Testes , Perfil de Impacto da Doença , Acidente Vascular Cerebral/patologia , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/terapia , SobreviventesRESUMO
The selection of a measure that can be used to evaluate the outcome of therapeutic interventions in stroke patients has had a conceptual problem in that there is a need to detect a wide range of deficiencies, disabilities and handicaps as part of a patient-based model. It has also suffered from a methodological problem due to the lack of systematic attention given to the development of standard instruments. AIMS: We conducted this study with the aim of getting over these limitations by developing a scale to evaluate the quality of life in stroke survivors. We followed a methodology that had previously been standardised by other authors based on using the opinion given by patients and caregivers in the generation of the items to be included. This has several stages that include individual interviews with patients, caregivers and experts, focal groups with patients and experts, quantitative and qualitative analyses of these interviews, two panels of experts to actually draw up the instrument, and a pilot test carried out in a sample of 50 patients to reduce and group the items. This reducing and grouping process was performed taking into account the following...(AU)
Assuntos
Humanos , Qualidade de Vida , Inquéritos e Questionários , Reprodutibilidade dos Testes , Perfil de Impacto da Doença , Acidente Vascular Cerebral , Acidente Vascular Cerebral/tratamento farmacológicoRESUMO
OBJECTIVE: We made a study of the 79 patients who were discharged from the Instituto Nacional de Neurología (La Havana, Cuba) during 1998, with the diagnosis of cerebral infarct, with the objective of analysing their behavior. PATIENTS AND METHODS: In this analysis we considered: the previous clinical history of factors and illnesses of risk, the certainty of the diagnosis in the emergency room, presenting symptoms, clinical signs, vascular territory, etiopathogenic category and results of cranial computerized axial tomography (CAT). RESULTS AND CONCLUSIONS: Arterial hypertension, smoking, cerebrovascular disease and ischemic cardiopathy were the commonest clinical features seen. There was close agreement between the diagnosis made in the emergency room and the final diagnosis. The presenting symptoms and clinical signs found in these patients were related to the vascular territory and motor involvement was the most constant. There was predominance of the carotid territory, especially of the left side. We also found predominance of atherothrombotic etiopathogenesis, with fewer cardio-embolic or unknown causes. There were few abnormal cranial CAT findings in patients with lacunar infarcts or infarcts localized to the posterior territory.