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Assessing reliability and validity of the Chinese version of the stroke scale: scale development
Tzu-Kuan Sun1, Su-Chen Chiu, Shu-Hui Yeh
1Department of Nursing, Chang Gung Memorial Hospital, Kaohsiung, #123, Ta-Pei Rd, Niao-Sung Hsiang, Kaohsiung County, Taiwan. 2244@adm.cgmh.org.tw
Background:
The National Institutes of Health Stroke Scale (NIHSS) is a systematic, 15-point evaluation tool, designed to assess neurological deficit in acute stroke patients and written in English. It is used to support important medical and nursing decisions.
Objectives:
To translate the NIHSS into Chinese and establish its psychometric properties using Chinese evaluators.
Design:
Methodological research design.
Setting:
One medical centre.
Participants:
Using convenience sampling, 48 subjects admitted with acute ischemic stroke were selected.
Methods:
In this study, six clinicians from the Department of Neurology (3 nurses, 3 doctors) assessed the 48 patients using the C-NIHSS, the Glasgow Coma Scale and the Barthel index.
Results:
The C-NIHSS content validity index reached 1.00, and the Cronbach's alpha coefficient for internal consistency was 0.92. Of the 15 scale items, two (facial palsy and limb ataxia) had low inter-rater values (k values below 0.39). Kappa (kappa) values were substantial (over 0.60) for all other items. The C-NIHSS has a significantly negative correlation with both Glasgow Coma Scale (r = -0.824, p < 0.01), and Barthel index (r = -0.683, p < 0.01) scores.
Conclusions:
The C-NIHSS is a reliable and valid scale for the clinical assessment of neurological deficit in acute stroke patients.