Cognitive Appraisal of Health Scale: early instrument development in stroke

Stroke, the leading cause of disability in the United States, results in significant limitations for an estimated 5.5 million American adults. The degree of physical limitations does not explain why some individuals with severe impairments adapt well, whereas others with little impairment are severely disabled. The concept of cognitive appraisal may partly explain this apparent contradiction. The purposes of this early instrument development study were to (1) identify appraisals made by community-dwelling stroke survivors and (2) seek evidence of the face and content validity for the 3 subscales of the Appraisal of Health Scale. A cross-sectional design was used to explore the survivors' appraisals. Responses to open-ended questions provided evidence of the face validity for all subscales. Threat and benefit subscales had acceptable evidence of content validity. Further instrument development is warranted and may lead to a more accurate measurement of how stroke survivors appraise the multiple demands of stroke recovery.