Shih-Chieh Lee, PhD, is Postdoctoral Researcher, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, and Adjunct Assistant Professor, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Gong-Hong Lin, PhD, is Assistant Professor, Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan. When this article was submitted, Lin was Postdoctoral Researcher, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Am J Occup Ther. 2021 Mar-Apr;75(2):7502205070p1-7502205070p10. doi: 10.5014/ajot.2021.040659.
The Stroke Impact Scale 3.0 appears to be a promising outcome measure of health-related quality of life (HRQOL) for clients with stroke. However, because the factorial validity of the Stroke Impact Scale 3.0 remains unclear, its validity is limited.
To examine the underlying structure of the Stroke Impact Scale 3.0 by comparing the currently available eight- and four-domain structures simultaneously.
Secondary data analysis of responses to the Stroke Impact Scale 3.0 from a previous psychometric validation study.
Five general hospitals in northern and southern Taiwan.
Two hundred sixty-three patients with stroke from rehabilitation wards (inpatients) and neurology and rehabilitation clinics (outpatients).
Confirmatory factor analysis was used to examine the eight- and four-domain structures of the Stroke Impact Scale 3.0. Four fit indices were considered simultaneously to examine the model fits of both structures.
The eight- and four-domain structures of the Stroke Impact Scale 3.0 were not supported by all four indices (χ²/df = 2.7 and 5.0, comparative fit index = .79 and .86, root mean square error of approximation = .08 and .12, standardized root mean square residual = .08 and .08, respectively). The unidimensionality of each domain in the two structures was not supported.
Neither the eight- nor the four-domain structure of the Stroke Impact Scale 3.0 was supported, suggesting that scores may not provide valid assessments of HRQOL in clients with stroke. Further modification and validation of the Stroke Impact Scale 3.0 are warranted.
Our findings suggest that the eight- and four-domain scores of the Stroke Impact Scale 3.0 may not be valid. Therefore, until more supporting evidence is developed, these scores should be interpreted cautiously in regard to clients' HRQOL; alternatively, other measures could be used.
Stroke Impact Scale 3.0 似乎是一种有前途的脑卒中患者健康相关生活质量（HRQOL）的结局测量工具。然而，由于 Stroke Impact Scale 3.0 的因子有效性尚不清楚，其有效性受到限制。
通过同时比较当前可用的八域和四域结构，来检验 Stroke Impact Scale 3.0 的潜在结构。
对以前的心理测量验证研究中对 Stroke Impact Scale 3.0 的反应进行二次数据分析。
台湾北部和南部的五所综合医院。
来自康复病房（住院患者）和神经病学和康复诊所（门诊患者）的 263 名脑卒中患者。
使用验证性因子分析来检验 Stroke Impact Scale 3.0 的八域和四域结构。同时考虑了四个拟合指数来检验两种结构的模型拟合情况。
Stroke Impact Scale 3.0 的八域和四域结构均不受所有四个指数（χ²/df=2.7 和 5.0，比较拟合指数=0.79 和 0.86，近似均方根误差=0.08 和 0.12，标准化均方根残差=0.08 和 0.08）的支持。两种结构中每个域的单维性也未得到支持。
Stroke Impact Scale 3.0 的八域和四域结构均不支持，这表明评分可能无法对脑卒中患者的 HRQOL 进行有效评估。需要进一步修改和验证 Stroke Impact Scale 3.0。
我们的研究结果表明，Stroke Impact Scale 3.0 的八域和四域评分可能无效。因此，在获得更多支持性证据之前，在评估患者的 HRQOL 时，应谨慎解释这些评分；或者，可以使用其他测量工具。
