脑卒中影响量表的测试研究

目的探讨应用汉化的脑卒中影响量表（SIS）的可行性。方法使用汉化的SIS量表对130例中老年首发脑卒中患者发病后1个月时的生存质量进行评定，并对其中的105例患者在发病后进行为期3个月的随访评定。根据结果对该量表的信度、效度、反应度和可行性进行全面分析。结果SIS量表8个分量表和总量表中表示内部一致性的克朗巴赫α系数（Cronbach’s α）均〉0．8，重测结果的组内相关系数ICC（intraclasscorrelation coefficients，IOC）值均〉0．7（P〈0．05）。各分量表的Pearson相关系数均〉0．5（P〈0．05）。因子分析法提取的8个因子总共解释总体变量的80％。情绪、ADL／IADL、移动能力、参与4个方面及总分方面的变化差异有显著性（P〈0．05）。结论汉化SIS量表具有良好的信度、效度、反应度和可行性，可应用于临床和社区护士对中老年脑卒中患者的生存质量和护理效果的评定。     

四个脑卒中量表信度与效度的对比研究

目的　通过纵向对比,研究比较四个具代表性的脑卒中量表在我国使用的信度和效度。方法　对100例连续住院急性脑卒中患者进行脑卒中量表的评定。信度检验用kappa相关。内容一致性检验用Cronbachα相关。结构效度用Spearman相关。预测效度应用协方差分析和logistic回归。结果　脑卒中患者神经功能缺损评分标准(以下简称“评分标准”)最省时,脑卒中病损评估记录(strokeimpairmentassessmentset,SIAS)最费时。四个量表均有较好的信度、内容一致性、结构效度和预测效度。只有“共济失调”评定者间信度一致性差(k=-0.04)。美国国立卫生研究院卒中量表(theNIHstrokescale,NIHSS)的预测能力最充分,是唯一所含项目均有预测值的量表。NIHSS评定的神经功能缺损范围最大。结论　在多中心的临床研究中,推荐修订后使用NIHSS。     

脑卒中后吞咽困难9个评价量表的信度及效度研究

目的：研究脑卒中后9个吞咽困难量表在国内使用的信度和效度。方法：56例连续住院的神经内科住院患者进行量表的评定及电视透视检查。量表的信度用kappa相关，校标效度用Spearman相关分析，预测效度用分组方差分析、Logistic回归分析及Spearman相关。敏感度采用效应尺度分析，量表间的相关性用Spearman相关分析。结果：所有量表均具有统计学意义的重测信度及评定者间信度。量表2的信度最好(重测信度Kappa值=0．87，P&;lt;0．01；评定者间信度Kappa值=0．665，P&;lt;0．01)，但量表2，5，6，7，9的效度指标(与VF下分级的相关性、误吸预测准确率、与住院期间肺炎和出院时皮脂厚度的相关性)总体来讲不满意，量表1和4的结构及侧重点相似，相关性较好(r=0．728，P&;lt;0．01)，但前者效度优于后者。量表3是9个量表中信度效度均佳的量表。     

脑卒中患者家庭护理质量量表的信、效度研究

目的:修订编制“脑卒中患者家庭护理质量量表”,检验其信、效度。方法:以台湾“家庭照护品质量表”为基础修订量表各维度及条目,遴选7名专家测评其内容效度。通过173例社区脑卒中患者的调查研究,检验量表的结构效度和内在一致性信度;并抽取其中的50例检验其评价者间信度。结果:形成具有5个维度、27个条目的评价量表;Cronbach α系数为0.9135,各维度α系数为0.6461～0.8170;评价者间信度为0.851。结论:修订后的量表具有良好的信度与效度,可用于评价脑卒中患者家庭护理质量。     

脑卒中患者生活质量量表的编制及试测

为获取适合中国文化背景及脑卒中患者实际情况的生活质量评定工具,本研究根据量表编制的理论与方法,参考国外相关量表,在调查研究脑卒中患者的基础上,编制了《脑卒中患者生活质量量表》。量表包含5个方面:工作及经济状况、家务活动、家庭关系、户外及休闲活动、心理状态,共计25项,评定耗时约20～30min。并采用该量表对22例脑卒中患者进行了初步测试,结果显示:量表的信度、效度基本满足心理测验要求。初步估计了脑卒中患者病后1～3周内的生活质量得分区间。     

Berg平衡量表在脑卒中患者中的内在信度和同时效度

目的：探讨Berg平衡量表在脑卒中患者中的内在信度和同时效度。方法：40例符合入选标准的脑卒中偏瘫患者参与本研究。对患者进行Berg平衡量表、计时起立-步行测验和Barthel指数的评价。结果：Berg平衡量表的Cronbach α系数为0.864,14项目的Cronbach α系数范围为0.844—0.869,Berg平衡量表折半信度系数为0.915。Berg平衡量表与效标工具计时起立-步行测验和Barthel指数之间显著相关。结论：Berg平衡量表在脑卒中患者中具有良好的内在信度和同时效度。     

功能综合评定量表的信度与效度的初步研究

目的应用功能综合评定量表(FCA)和功能独立性测定量表(FIM)对脑卒中患者的功能测定结果进行比较研究,以测定FCA的信度和效度. 方法随机对20例脑卒中后遗症期患者进行FCA和FIM评定,主要内容包括运动功能和认知功能二大项,对10例脑卒中患者进行FCA的组内相关系数的研究. 结果FCA和FIM的比较研究得出t=0.0451,P>0.05,显示FCA与FIM评定结果无显著差别,相关系数r=0.997,P<0.001,呈极显著相关,表明FCA量表的效度较好,FCA的组内相关系数各单项平均为0.929(P<0.001),显示有很好的可重复性. 结论 FCA与FIM相比,同样有较好的效度,FCA也有较好的信度,可供临床医师选择.     

脑卒中患者生存质量量表效度研究

目的：检验脑卒中患者生存质量疾病专表-脑卒中影响量表（SIS）应用于中国脑卒中患者的效度。方法：遵照SIS量表的发行机构MAPI推荐的程序及借鉴中山大学公共卫生学院统计学教研室译制经验编译SIS量表中文版，并使用此中文版对初次脑卒中发病后1个月的住院患者（180例）进行测量，运用相应的统计学方法进行效度分析。结果：SIS量表中文版的8个领域与FCA量表、SF-36量表的相关部分进行Pearson相关性分析，相关系数经统计学检验P〈0．05。结构效度中各公因子所包括的条目基本与原量表相同。结论：中文版SIS量表具有良好的效度，适用于脑卒中患者生存质量的评测。     

中文版改良躯干损伤量表在脑卒中患者中的信度与效度研究

目的:翻译挪威版改良躯干损伤量表(the Trunk Impairment Scale-modified to Norwegian Version,mTIS),并探讨其在脑卒中患者应用中的信度与效度,为其临床应用提供客观依据.方法:将挪威版mTIS翻译为中文版mTIS.共入组30例病例,在入组第一天,评定者A与B同时但...     

脑卒中后失能综合评估量表的汉化与信效度检验

目的 对脑卒中后失能综合评估量表进行汉化及信效度检验,探索该量表在国内的临床适用性。方法 采用Brislin双人直译-回译法、专家评议、预调查对量表进行文化调适,便利抽取203名脑卒中患者进行调查,对中文版量表进行项目分析,并验证其重测信度、评定者间信度、内容效度、效标关联效度。结果 脑卒中后失能综合评估量表重测信度相关性分析结果显示相关系数为0.988;评定者间信度Kappa系数为0.846（95%置信区间为0.793~0.899）,P<0.001;各条目内容效度指数均在0.833~1.000之间,量表内容效度指数为0.935;以改良Rankin量表为标准,效标关联效度系数为0.896。结论 中文版脑卒中后失能综合评估量表具有良好的信效度,可作为我国临床脑卒中失能评估工具。     

脑卒中患者生存质量量表中文版反应度研究

目的：检验脑卒中患者生存质量疾病专表脑卒中影响量表（SIS）应用于中国脑卒中患者的反应度。方法：遵照SIS量表的发行机构MAPI推荐的程序及借鉴中山大学公共卫生学院统计学教研室译制经验编译SIS量表中文版．并使用此中文版对初次脑卒中发病后1个月的住院患者180例及对照组51例进行测量及分析。结果：卒中影响量表8个领域中的6个领域，以及总体均分领域。康复治疗前后得分差异均有显著性意义。表明SIS量表可敏感地反映出患者治疗前后生存质量的变化。8个领域中的7个领域。以及总体均分领域对照组与观察组的差异均有显著性意义。说明SIS量表亦具有区别脑卒中患者与其他人群的能力。结论：中文版SIS量表具有良好的反应度．与信度、效度分析相结合，可适用于中国脑卒中患者生存质量的评测。     

Measuring stroke impact with the stroke impact scale: telephone versus mail administration in veterans with stroke

OBJECTIVES: The purpose of this study was to examine response rate, mode effects, and reliability of the Stroke Impact Scale (SIS) in a veteran stroke population using mail and telephone modes of administration. METHODS: Patients who had suffered a stroke were identified using national VA administrative data and International Classification of Diseases, 9th Revision codes in 13 participating Veterans Affairs hospital. Stroke was confirmed by reviewing electronic medical records. Patients were randomized to SIS administration by mail or telephone at 12-weeks after their stroke. Comparison of response rate, nonresponse bias, domain scores, administration costs, and instrument reliability were performed. RESULTS: Four hundred fifty-eight patients with stroke were identified, validated, and randomly assigned into 2 administration groups. No significant cluster effect was observed. Response rates for mail and telephone were 45% and 69%, respectively. Mail nonresponders were more likely to have had severe stokes, cognitive deficits, and be unmarried. No difference was observed between telephone responders and nonresponders. Responders in mail and telephone modes were not different, and the SIS score distribution did not indicate the presence of mode effects. Test-retest reliability was good to excellent in the mail group (0.77-0.99) except social participation (0.62). Test retest reliability was excellent in the telephone mode (0.90-0.99) except emotion (0.68). CONCLUSIONS: Telephone mode of survey administration yielded a higher response rate, less bias in responder selection, and higher test-retest reliability. The cost of telephone administration was 2 times the cost of mail. Mode effects in SIS score distribution were not observed in this study but additional research with larger sample sizes is needed to provide more definitive evidence.     

Developing and testing the beliefs about caregiving scale

Four studies were conducted to refine and test a newly developed instrument designed to identify caregivers who are at high risk for providing poor-quality care to a dependent elder in the home: the Beliefs About Caregiving Scale (BACS). The BACS was tested for internal consistency, stability, and construct validity. Results suggest strong evidence for internal consistency and for construct validity using the multitrait method as well as moderate evidence for construct validity using predictive modeling. Although further refinements are required, initial tests suggest that the BACS is potentially useful for both research and clinical applications.     

健康调查简表和脑卒中影响量表在脑卒中康复临床中应用情况的调查分析

摘要 目的：了解健康调查简表（SF-36）和脑卒中影响量表（SIS）在我国脑卒中康复临床的使用情况以及被认可程度。 方法：采用自行设计的网络问卷对国内三甲医院中从事脑卒中康复临床工作且具有一定资历的康复医师和康复治疗师进行调查。 结果：共回收有效问卷151份。SF-36和SIS在脑卒中康复中的临床使用率分别为31.13%和22.52%。同一量表在不同工作岗位的康复医师和（或）治疗师之间的使用率比较,差异无显著性意义（P>0.05）。临床对SIS的总体认可度高于SF-36（P<0.05）,主要表现在量表的测试结果对诊断疾病及制定临床方案和出院计划的帮助三个方面。 结论：SF-36和SIS在我国脑卒中康复临床的生存质量评定中尚未获得普及应用,需增强患者的全面康复意识,加强对康复医师及治疗师的规范化培训,适时对量表进行修订使其更适用于我国脑卒中患者的生存质量评定。     

血清胆红素与脑卒中之间的相关性研究

目的：探讨血清胆红素水平与脑卒中（脑梗死、脑出血等）之间的关系,为脑卒中的预防与治疗提供科学依据。方法：对2009年3月-2011年5月经临床确诊的360例脑卒中患者以及同期120例健康对照者,采用全自动生化仪检测血清胆红素浓度。结果：脑卒中患者血清胆红素水平显著低于健康对照者（P〈O．05）。结论：低血清胆红素水平是脑卒中发生的危险因素,血清胆红素是防止脑卒中发生的有效保护因子。     

Development of a computerized adaptive testing system of the Fugl-Meyer motor scale in stroke patients

Hou W-H, Shih C-L, Chou Y-T, Sheu C-F, Lin J-H, Wu H-C, Hsueh I-P, Hsieh C-L. Development of a computerized adaptive testing system of the Fugl-Meyer motor scale in stroke patients.ObjectiveTo develop a computerized adaptive testing system of the Fugl-Meyer motor scale (CAT-FM) to efficiently and reliably assess motor function in patients with stroke.DesignFirst, a simulation study was used to develop and examine the psychometric properties of the CAT-FM. Second, a field study was employed to determine the administration efficiency of the CAT-FM.SettingOne medical center and 1 teaching hospital.ParticipantsPatients' responses (n=301) were used for the simulation study; 49 patients participated in the field study.InterventionsNot applicable.Main Outcome MeasuresThe 2 CAT-FM item banks (upper extremity and lower extremity) include 37 items from the original Fugl-Meyer scale. The reliability, validity, and responsiveness of the CAT-FM were determined by the simulation study.ResultsTwo stopping rules (reliability ≥0.9 or an increase of reliability <.01 after testing an item) were used. The simulation study showed that the CAT-FM had high reliability (≥.93 for upper-extremity and lower-extremity subscales) and concurrent validity (Pearson r≥.91 for the upper-extremity and lower-extremity subscales and motor scale). The responsiveness was moderate (standardized response mean for the upper extremity=.67, lower extremity=.79, and motor=.77) for the 226 patients who completed both assessments at 14 and 90 days after stroke. The field study found that, on average, the time needed to administer the CAT-FM was 242 seconds with 4.7 items.ConclusionsThe CAT-FM is an efficient, reliable, valid, and responsive clinical tool for assessing motor function in patients with stroke.     

Brunel平衡量表:一种新型的脑卒中平衡量表

目的:介绍一种新型的脑卒中平衡量表-Brunel平衡量表,为促进脑卒中患者平衡功能的恢复、推动康复治疗的发展,寻找一种理想的评价方法。方法:检索和参考相关文献,介绍Brunel平衡量表的具体内容和使用方法,分析和归纳其实用性、可信性和有效性。结果:Brunel平衡量表具有快速、简便、测试灵活的特点,耗时少、测量工具简单;具有高度的敏感性,能对平衡水平的细微改变做出反应;该量表相比于过去的量表,未包含主观的、不够精确的内容,从而具有100%的可靠性;同时,具有很高的有效性,与许多常用量表中平衡部分的相关系数都具有统计学意义。结论:Brunel平衡量表作为目前最新型的脑卒中平衡评价量表,按残损程度分级衡量,具有简便、可靠、有效、敏感的特点,克服了通用量表的不敏感性和一般的行为功能测评的狭窄性,完全符合临床和科研的需要,适用于广泛的脑卒中患者和康复治疗室。     

The stroke impact scale: performance as a quality of life measure in a community-based stroke rehabilitation setting

Purpose: The objective of this study was to assess the psychometric properties of the Stroke Impact Scale (SIS). Methods: Data was derived from a study assessing a community-based stroke rehabilitation program. Patients were administered the SIS and Euroqol-5D (EQ-5D-5L) on admission to the study, and at six month and 12 month follow-up. The psychometric performance of each domain of the SIS was assessed at each time point. Results: A total of 164 patients completed outcome measures at baseline, 108 patients at six months and 37 patients at 12 months. Correlation of the SIS domains with the EQ-5D-5L suggested that the dimensions of health contributing to a patient’s perception of health-related quality of life changes over time. Conclusion: The SIS performed well in a sample of patients undergoing stroke rehabilitation in the community. Our findings suggest that the multidimensionality of the SIS may allow health professionals to track patient progress and tailor rehabilitation interventions to target the dimensions of health that are most important to a patient’s overall health and perceived quality of life over time.

• Implications for Rehabilitation

• There is an increased need for valid and reliable measures to evaluate the outcomes of patients recovering from stroke in the community.

• The Stroke Impact Scale (SIS) measures multiple domains of health and is well-suited for use in patients recovering from stroke in the community.

• There is a high level of internal consistency in the eight SIS domains with no evidence of floor effects; ceiling effects were noted for several domains.

• Correlation of the SIS with the Euroqol-5D suggested that the dimensions of health contributing to a patient’s perception of health related quality of life changes over time.