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Updated: May 1, 2026
Computerized Adaptive Testing System of Functional Assessment of Stroke
Published on: January 7, 2019
Psychometric evaluation of the Stroke Impact Scale 3.0
Ercole Vellone1, Serenella Savini, Roberta Fida
1Ercole Vellone, RN, MSN PhD Student, Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Serenella Savini, RN, MSN PhD Student, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Roberta Fida, PhD Assistant Professor, Department of Psychology, Sapienza University, Rome, Italy. Victoria Vaughan Dickson, PhD, RN Assistant Professor, College of Nursing, New York University. Gail D'Eramo Melkus, EdD, C-NP, FAAN Florence and William Downs Professor in Nursing Research, College of Nursing, New York University. Francisco Javier Carod-Artal, MD, PhD Visiting Professor of Neurology, Medicine and Health Sciences Faculty, Universitat Internacional de Catalunya (UIC), Barcelona, Spain, and Consultant Neurologist, Department of Neurology, Raigmore Hospital, Inverness, United Kingdom. Gennaro Rocco, RN, MSN Director, Center of Excellence for Nursing Scholarship, Rome, Italy. Rosaria Alvaro, RN, MSN Associate Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy.
The Stroke Impact Scale 3.0 (SIS 3.0) was revised to a 4-factor structure, improving its psychometric properties for assessing stroke survivor quality of life. This updated scale demonstrates enhanced reliability and validity for clinical use and research.
Area of Science:
- Rehabilitation medicine
- Psychometrics
- Health outcomes research
Background:
- The Stroke Impact Scale 3.0 (SIS 3.0) is a key tool for measuring quality of life in stroke survivors.
- Previous research has not validated the original 8-factor structure and indicated potential floor/ceiling effects and reliability issues.
Purpose of the Study:
- To evaluate the psychometric characteristics of the SIS 3.0.
- Specifically assessing construct validity (factorial structure, concurrent/contrasting group validity), floor/ceiling effects, and reliability.
Main Methods:
- A cross-sectional study involving 392 stroke survivors across 16 Italian rehabilitation facilities.
- Confirmatory factor analysis was used to test the factorial structure.
- Concurrent/contrasting group validity was assessed using various functional, neurological, cognitive, and quality-of-life scales. Reliability was measured using Cronbach's alpha and test-retest methods.
Main Results:
- Confirmatory factor analysis supported a new 4-factor structure for the SIS 3.0, which demonstrated a superior fit compared to the original 8-factor model.
- The revised 4-factor structure showed strong concurrent and contrasting group validity.
- No floor or ceiling effects were observed, and internal consistency and test-retest reliability were high (0.79–0.98).
Conclusions:
- The 4-factor structure of the SIS 3.0 exhibits improved psychometric properties over the original 8-factor structure.
- These findings support the continued use of the revised SIS 3.0 in clinical practice and research for evaluating stroke survivor outcomes.
