AI Article Synopsis
- - Rising stroke rates in Sri Lanka necessitate a new quality of life (QOL) tool specifically designed for stroke survivors, as current tools are mainly based on high-income country populations, which may not represent local conditions.
- - A new Post-stroke Quality of Life Index (PQOLI) was developed through systematic methods including expert input and feedback from survivors, leading to a draft tool with 21 items and validated through a study involving 180 participants.
- - The PQOLI identified four key factors: physical and social function, environment, financial independence, and pain/emotional well-being, with strong correlation to established QOL measures, demonstrating its reliability and validity for assessing stroke survivors' quality of life in a resource-limited context
Article Abstract
Background: Burden of stroke is rising due to the demographic and epidemiological transitions in Sri Lanka. Assessment of success of stroke-management requires tools to assess the quality of life (QOL) of stroke survivors. Most of currently used QOL tools are developed in high-income countries and may not reflect characteristics relevant to resource-constrained countries. The aim was to develop and validate a new QOL tool for stroke survivors in Sri Lanka.
Methods: The COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist was referred. A conceptual framework was prepared. Item generation was done reviewing the existing QOL tools, inputs from experts and from stroke survivors. Non-statistical item reduction was done for the 36 generated items with modified-Delphi technique. Retained 21 items were included in the draft tool. A cross sectional study was done with 180 stroke survivors. Exploratory Factor Analysis was done and identified factors were subjected to varimax rotation. Further construct validity was tested with 6 a-priori hypothesis using already validated tools (SF-36, EQ-5D-3 L) and a formed construct. Internal consistency reliability was assessed with Cronbach alpha.
Results: Four factors identified with principal-component-analysis explained 72.02% of the total variance. All 21 items loaded with a level > 0.4. The developed tool was named as the Post-stroke QOL Index (PQOLI). Four domains were named as "physical and social function", "environment", "financial-independence" and "pain and emotional-wellbeing". Four domain scores of PQOLI correlated as expected with the SF-36, EQ-5D Index and EQ-5D-VAS scores. Higher domain scores were obtained for ambulatory-group than the hospitalized-group. Higher scores for financial-independence domain were obtained for the group without financial-instability. Five a-priori hypothesis were completely proven to be true. Cronbach-alpha level ranged from 0.682 to 0.906 for the four domains.
Conclusions: There is first evidence for sufficient construct validity of the PQOLI as a valid QOL tool for measuring the QOL of stroke survivors with satisfactory internal consistency reliability.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370468 | PMC |
| http://dx.doi.org/10.1186/s12955-020-01436-7 | DOI Listing |
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