Claessen Michiel H G, Visser-Meily Johanna M A, de Rooij Nicolien K, Postma Albert, van der Ham Ineke J M
Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.
Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
Arch Clin Neuropsychol. 2016 Dec 1;31(8):839-854. doi: 10.1093/arclin/acw044.
In current stroke care, cognitive problems are usually diagnosed in a stepwise manner. More specifically, screening instruments are first applied to support healthcare professionals in deciding whether a second step (an extensive assessment) would be appropriate. None of the existing screening instruments, however, takes navigation ability into account. This is problematic, as navigation impairment after stroke has been shown to be common, more so than previously thought. The Wayfinding Questionnaire (WQ) is therefore presented as a screening instrument for navigation-related complaints after stroke. The internal validity of the WQ was investigated in two samples of participants to establish the final version.
In Study 1, the WQ was administered in a representative sample of 356 healthy participants. Its factor structure was investigated using a principal component analysis. This procedure resulted in deletion of four items and revealed a three-factor structure: "Navigation and Orientation," "Spatial Anxiety," and "Distance Estimation". In Study 2, a confirmatory analysis was performed to directly verify the factor structure as obtained in Study 1 based on data of 158 chronic mild stroke patients. Fit indices of the confirmatory analysis indicated acceptable model fit. The reliability of the three subscales was found to be very good in both healthy participants and patients.
These studies allowed us to determine the final version of the WQ. The results indicated that the WQ is an internally valid and reliable instrument that can be interpreted using a three-factor structure in both healthy respondents and chronic mild stroke patients.
在当前的中风护理中,认知问题通常采用逐步诊断的方式。更具体地说,首先应用筛查工具来辅助医疗保健专业人员决定是否适合进行第二步(全面评估)。然而,现有的筛查工具均未考虑导航能力。这是个问题,因为中风后的导航障碍已被证明很常见,比之前认为的更为普遍。因此,提出了寻路问卷(WQ)作为中风后与导航相关主诉的筛查工具。在两个参与者样本中对WQ的内部效度进行了调查,以确定最终版本。
在研究1中,对356名健康参与者组成的代表性样本进行了WQ测试。使用主成分分析研究其因子结构。这一过程导致删除了四个项目,并揭示了一个三因子结构:“导航与定向”、“空间焦虑”和“距离估计”。在研究2中,基于158名慢性轻度中风患者的数据进行了验证性分析,以直接验证研究1中获得的因子结构。验证性分析的拟合指数表明模型拟合度可接受。在健康参与者和患者中,三个分量表的信度都非常好。
这些研究使我们能够确定WQ的最终版本。结果表明,WQ是一种内部效度良好且可靠的工具,在健康受访者和慢性轻度中风患者中均可使用三因子结构进行解释。