Department of Neurology, Laboratory for Experimental Biotechnology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland.
Department of Neurological and Neurosurgical Nursing, Laboratory for Experimental Biotechnology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland.
PLoS One. 2021 Apr 2;16(4):e0249211. doi: 10.1371/journal.pone.0249211. eCollection 2021.
The National Institutes of Health Stroke Scale (NIHSS) is a validated tool for assessing the severity of stroke. It has been adapted into several languages; however, a Polish version with large-scale psychometric validation, including repeatability and separate assessments of anterior and posterior stroke, has not been developed. We aimed to adapt and validate a Polish version of the NIHSS (PL-NIHSS) while focusing on the psychometric properties and site of stroke.
The study included 225 patients with ischemic stroke (102 anterior and 123 posterior circulation stroke). Four NIHSS-certified researchers estimated stroke severity using the most appropriate scales to assess the psychometric properties (including internal consistency, homogeneity, scalability, and discriminatory power of individual items) and ultimately determine the reliability, repeatability, and validity of the PL-NIHSS.
The PL-NIHSS achieved Cronbach's alpha coefficient of 0.6885, which indicates moderate internal consistency and homogeneity. Slightly more than half of the individual items provided sufficient discriminatory power (r > 0.3). A favorable coefficient of repeatability (0.6267; 95% confidence interval: 0.5737-0.6904), narrow limits of inter-rater agreement, and excellent intraclass correlation coefficients or weighted kappa values (> 0.90), demonstrated high reliability of PL-NIHSS. Highly significant correlations with other tools confirmed the validity and predictive value of the PL-NIHSS. In posterior stroke, the PL-NIHSS achieved the required Cronbach's alpha coefficient (0.71070). Additionally, stroke location did not affect other psychometric features or instrument reliability and validity.
We developed a valid and reliable tool for assessing stroke severity in Polish-speaking participants. Moderate psychometric features were emphasized without limiting its clinical applications.
美国国立卫生研究院卒中量表（NIHSS）是一种评估卒中严重程度的有效工具。它已被改编成多种语言版本；然而，尚未开发出具有大规模心理测量验证的波兰语版本，包括重复性和对前循环和后循环卒中的单独评估。我们旨在开发一种波兰语版本的 NIHSS（PL-NIHSS），并重点关注心理测量特性和卒中部位。
该研究纳入了 225 名缺血性卒中患者（102 例前循环和 123 例后循环卒中）。四名 NIHSS 认证的研究人员使用最适合的量表评估卒中严重程度，以评估心理测量特性（包括内部一致性、同质性、可扩展性和个体项目的区分能力），最终确定 PL-NIHSS 的可靠性、可重复性和有效性。
PL-NIHSS 的 Cronbach's alpha 系数为 0.6885，表明具有中等的内部一致性和同质性。略超过一半的个体项目具有足够的区分能力（r > 0.3）。良好的可重复性系数（0.6267；95%置信区间：0.5737-0.6904）、较小的评分者间一致性范围和极好的组内相关系数或加权 Kappa 值（> 0.90），表明 PL-NIHSS 具有高度可靠性。与其他工具的高度显著相关性证实了 PL-NIHSS 的有效性和预测价值。在后循环卒中中，PL-NIHSS 达到了所需的 Cronbach's alpha 系数（0.71070）。此外，卒中部位并未影响其他心理测量特征或仪器的可靠性和有效性。
我们开发了一种用于评估波兰语使用者卒中严重程度的有效且可靠的工具。强调了中等的心理测量特征，而没有限制其临床应用。
