Theofanidis Dimitrios
a Nursing Department , Alexandreio Technological Educational Institute of Thessaloniki , Thessaloniki , Greece.
Top Stroke Rehabil. 2017 Apr;24(3):214-221. doi: 10.1080/10749357.2016.1238136. Epub 2016 Sep 29.
Improving stroke outcomes by educating nurses in state-of-the-art stroke nursing skills is essential, but unfortunately, to date, there are limited validated stroke assessment scales for routine clinical and research use in Greece.
The aim of this paper is to validate and culturally adapt three internationally recognised stroke scales for use in Greece.
A critical appraisal of the international literature was undertaken to identify suitable scales to assess stroke impact: neurological, functional status and level of dependence. We identified: Scandinavian Stroke Scale (SSS), Barthel Index (BI) and modified Rankin Scale (mRS). They were formally translated and culturally adapted from English to Greek. Their validity was tested using Cronbach's alpha and Median Discrimination Index, while construct validity was checked by Principal Component Analysis (PCA). These were used on 57 consecutively selected patients with stroke from a Greek hospital, mean age 67.7 (±6.7 SD) years, range 54-85 years, length of stay, 8.5 (±2.7 SD) days.
All three scales show high internal consistency. The Cronbach's α on admission/ discharge for the SSS ranged from 0.86 to 0.88. The BI's reliability ranged from 0.95 to 0.93. The Median Discrimination Index was 0.70 (SSS) and 0.83 (BI). PCA showed that although a significant general factor (F1) explains most of the variance (57.0% on admission and 56.4% on discharge) a second factor (F2) of less significance was also highlighted. The convergent validity of the three scales was confirmed.
The stroke tools selected showed high reliability and validity, thus making these suitable for use in Greek clinical/academic environments. All three scales used are almost routinely undertaken in stroke studies internationally and form a backdrop for bio-statistical, functional and social outcome post-stroke.
The Greek version of the stroke tools show that both SSS and BI have high internal consistency and reliability and together with the mRS could be used in any Greek stroke care delivery setting.
通过培训护士掌握最新的中风护理技能来改善中风治疗效果至关重要，但遗憾的是，迄今为止，在希腊用于常规临床和研究的经过验证的中风评估量表有限。
本文旨在验证并对三种国际认可的中风量表进行文化调适，以便在希腊使用。
对国际文献进行批判性评估，以确定用于评估中风影响的合适量表：神经功能、功能状态和依赖程度。我们确定了：斯堪的纳维亚中风量表（SSS）、巴氏指数（BI）和改良Rankin量表（mRS）。它们从英语正式翻译并进行文化调适为希腊语。使用Cronbach's α和中位数鉴别指数测试其效度，同时通过主成分分析（PCA）检查结构效度。这些量表应用于希腊一家医院连续选取的57例中风患者，平均年龄67.7（±6.7标准差）岁，年龄范围54 - 85岁，住院时间8.5（±2.7标准差）天。
所有三种量表均显示出较高的内部一致性。SSS入院/出院时的Cronbach's α范围为0.86至0.88。BI的信度范围为0.95至0.93。中位数鉴别指数为0.70（SSS）和0.83（BI）。主成分分析表明，虽然一个显著的一般因素（F1）解释了大部分方差（入院时为57.0%，出院时为56.4%），但也突出了一个重要性较低的第二个因素（F2）。证实了这三种量表的收敛效度。
所选的中风工具显示出高可靠性和效度，因此适用于希腊的临床/学术环境。国际上在中风研究中几乎都常规使用这三种量表，它们构成了中风后生物统计学、功能和社会结局的背景。
中风工具的希腊语版本表明，SSS和BI都具有高内部一致性和可靠性，并且与mRS一起可用于希腊任何中风护理提供环境。
