Taylor-Rowan Martin, Eton David T, McLeod Hamish J, Rizeq Jala, Kidd Lisa, Currie Grace, Quinn Terry J, Mair Frances S, Gallacher Katie I
School of Health and Wellbeing (M.T.-R., H.J.M., J.R., F.S.M., K.I.G., G.C.), University of Glasgow, United Kingdom.
Division of Cancer Control and Population Sciences, Outcomes Research Branch, Healthcare Delivery Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD (D.T.E.).
Stroke. 2025 Aug;56(8):2021-2032. doi: 10.1161/STROKEAHA.125.051398. Epub 2025 May 29.
Treatment burden is the workload of health care for people with long-term conditions and the impact on wellbeing. A validated measure of treatment burden for use as an outcome measure in stroke trials is needed. We adapted a patient-reported measure of treatment burden in multimorbidity, Patient Experience With Treatment and Self-Management (PETS), version 2.0, to create a stroke-specific measure, PETS-stroke, and examined its psychometric properties.
We conducted an observational cohort study. Stroke and transient ischemic attack survivors were recruited between February 2022 to June 2023 from 10 hospitals in the United Kingdom and through the Scottish Health Research Register. Participants completed the PETS-stroke questionnaire along with 3 other patient-reported measures (the Stroke Southampton Self-Management Questionnaire, the Satisfaction With Stroke Care Measure, and the Shortened Stroke Impact Scale). We performed confirmatory factor analysis to test the factor structure of the PETS-stroke. We assessed Spearman rank correlations between PETS-stroke and other patient-reported measures to determine convergent validity. An intraclass correlation coefficient was performed to assess test-retest reliability. Proportions of missing data along with feedback from qualitative interviews were used to determine feasibility. T-tests were conducted to examine variations in PETS-stroke scores based on multimorbidity and socioeconomic factors.
Three hundred eighty-one participants were included (mean age, 68.2 [SD, 11.2] years; female, 43.3%). The best fit was achieved with a 9-factor structure, and internal consistency was good (Omega values, 0.729-0.921). The factor loadings for the individual indicator items across 8 of the 9 domains were moderate to strong. All domains of PETS-stroke showed moderate to strong correlations with at least one other patient-reported measure. Test-retest reliability was good for all domains (intraclass correlation coefficient >0.7). Qualitative feedback on feasibility was positive: participants found the questionnaire to be easy and quick to complete, and missing data were within acceptable limits for 7 domains. PETS-stroke scores significantly differed based on multimorbidity in 3 domains and in 8 domains based on socioeconomic status.
Psychometric performance suggests that PETS-stroke is a valid and feasible measure of treatment burden after stroke.
治疗负担是指长期疾病患者的医疗保健工作量及其对幸福感的影响。在中风试验中，需要一种经过验证的治疗负担测量方法作为结果指标。我们对多病症患者报告的治疗负担测量方法“治疗与自我管理患者体验”（PETS）2.0版本进行了调整，以创建一种针对中风的测量方法“PETS-中风”，并检验了其心理测量特性。
我们进行了一项观察性队列研究。2022年2月至2023年6月期间，从英国的10家医院以及通过苏格兰健康研究登记册招募了中风和短暂性脑缺血发作幸存者。参与者完成了“PETS-中风”问卷以及其他3项患者报告的测量方法（南安普顿中风自我管理问卷、中风护理满意度测量方法和简化中风影响量表）。我们进行了验证性因素分析以测试“PETS-中风”的因素结构。我们评估了“PETS-中风”与其他患者报告的测量方法之间的斯皮尔曼等级相关性，以确定收敛效度。进行了组内相关系数分析以评估重测信度。利用缺失数据的比例以及定性访谈的反馈来确定可行性。进行了t检验以检查基于多病症和社会经济因素的“PETS-中风”得分的差异。
纳入了381名参与者（平均年龄68.2[标准差11.2]岁；女性占43.3%）。9因素结构实现了最佳拟合，内部一致性良好（欧米伽值为0.729 - 0.921）。9个领域中8个领域的各个指标项目的因素负荷为中等至较强。“PETS-中风”的所有领域与至少一项其他患者报告的测量方法显示出中等至较强的相关性。所有领域的重测信度良好（组内相关系数>0.7）。关于可行性的定性反馈是积极的：参与者发现问卷易于且快速完成，7个领域的缺失数据在可接受范围内。基于多病症，“PETS-中风”得分在3个领域存在显著差异；基于社会经济状况，在8个领域存在显著差异。
心理测量性能表明，“PETS-中风”是中风后治疗负担的有效且可行的测量方法。
