Vellone Ercole, Savini Serenella, Fida Roberta, Dickson Victoria Vaughan, Melkus Gail D'Eramo, Carod-Artal Francisco Javier, Rocco Gennaro, Alvaro Rosaria
Ercole 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.
J Cardiovasc Nurs. 2015 May-Jun;30(3):229-41. doi: 10.1097/JCN.0000000000000145.
The Stroke Impact Scale 3.0 (SIS 3.0) is widely used to measure quality of life in stroke survivors; however, previous studies have not tested the original 8-factor structure of the scale. In addition, previous studies have shown floor and ceiling effect and weak reliability within the scale.
The aim of this study was to evaluate the psychometric characteristics of the SIS 3.0, including its construct validity (factorial structure, concurrent and contrasting group validity), floor and ceiling effect, and reliability.
A cross-sectional design was used to study 392 stroke survivors enrolled in 16 rehabilitation facilities across Italy. Factorial structure of the SIS 3.0 was tested with confirmatory factor analysis. Concurrent and contrasting group validities were evaluated with other scales measuring functional capacities, neurological functions, cognition, anxiety, depression, and generic quality of life. Floor and ceiling effects were evaluated by determining the percentages of patients with the minimum and the maximum score at SIS 3.0. Reliability was determined by Cronbach's α and test-retest.
Participants were 71 years old on average (SD, 11 years); 55% were men. Confirmatory factor analysis revealed a new 4-factor structure that fitted the data better than the original 8-factor structure did. Concurrent and contrasting group validity of the new 4-factor structure was supportive and no floor and ceiling effects were found. Internal consistency and test-retest reliability ranged between 0.79 and 0.98.
The new factorial structure of the SIS 3.0 with 4 factors showed better psychometric properties than the original 8-factor structure did. This evidence supports further use of the SIS 3.0 in clinical practice and research.
卒中影响量表3.0（SIS 3.0）被广泛用于评估卒中幸存者的生活质量；然而，以往研究尚未对该量表最初的8因子结构进行检验。此外，以往研究表明该量表存在地板效应和天花板效应，且信度较低。
本研究旨在评估SIS 3.0的心理测量学特征，包括其结构效度（因子结构、同时效度和对比组效度）、地板效应和天花板效应以及信度。
采用横断面设计，对意大利16家康复机构的392例卒中幸存者进行研究。用验证性因子分析检验SIS 3.0的因子结构。用其他测量功能能力、神经功能、认知、焦虑、抑郁和一般生活质量的量表评估同时效度和对比组效度。通过确定SIS 3.0得分最低和最高的患者百分比来评估地板效应和天花板效应。用Cronbach's α系数和重测法确定信度。
参与者的平均年龄为71岁（标准差11岁）；55%为男性。验证性因子分析显示，新的4因子结构比最初的8因子结构更符合数据。新4因子结构的同时效度和对比组效度得到支持，未发现地板效应和天花板效应。内部一致性和重测信度在0.79至0.98之间。
新的4因子SIS 3.0结构比最初的8因子结构显示出更好的心理测量学特性。这一证据支持在临床实践和研究中进一步使用SIS 3.0。
