Should the Nottingham Health Profile or the Short Form-36 be given preference in stroke?

To compare the usefulness of the Nottingham Health Profile [NHP] and the Short Form 36 [SF-36] as general outcome measures for chronic stroke patients with respect to the response rate, internal consistency reliability, validity analyses, and agreement in similar domains of the 2 instruments. In this prospective study, 90 consecutive stroke patients attending the Neurology outpatient clinic at Erciyes University, Kayseri, Turkey from March 2004 to March 2005 were evaluated for the study. Seventy outpatients who had a stroke 6 months previously were included in the study. As a datacollecting device, SF-36 and NHP scales were used. The prevalence of patients with highest quality of life score [ceiling effect] was higher for the NHP scale [10-35.7%] than for the SF-36 scale [1.4-37.1%]. The prevalence of patients with lowest quality of life score [floor effect] was also higher for the NHP scale [1.4-45.7%] than for the domains of SF-36 [1.4-30%]. The internal consistencies of the subscales of both the SF-36 and the NHP showed satisfactory values. Regarding convergent validity, correlations were found between comparable subscales of the 2 instruments. Limits of agreement in similar domains of the 2 instruments were very large. In all 5 demonstrated Bland-Altman plots, there was agreement of the scales in the measurement of the similar fields of quality of life. Both the SF-36 and the NHP have acceptable degrees of reliability, convergent validity, and response rate. Limits of agreement in similar domains of the 2 instruments were very large

Poststroke depressive symptoms and their relationship with quality of life, functional status, and severity of stroke

The present study aimed to investigate the relationship between depressive symptoms in 6 months after stroke and the quality of life [QOL], clinical and socio-demographical characteristics, functional status, and severity of stroke. Ninety consecutive stroke patients who attended the neurology outpatient clinic at Erciyes University, Kayseri, Turkey from March 2004 to March 2005 were evaluated for the study. Seventy outpatients who had a stroke 6 months previously were included in the study. As a data-collecting device, Short Form 36, Functional Independence Measure [FIM], Canadian Neurological Scale, and Beck Depression Inventory [BDI] were used. In addition, a questionnaire was administered to obtain clinical and socio-demographic data. Seventy patients were included in the study. Depression measured using BDI was identified in 47.1% of the patients. Total FIM scores, especially motor subscale scores, were decreased in the depressive patients. No difference was found in the stroke severity scores of the depressed and non-depressed patients. The QOL subscale scores, such as physical functioning, bodily pain, general health perception, vitality, social functioning, and mental health, were lower in the patient group with high BDI scores. There was a positive correlation between age and BDI scores of the patients. Negative correlations were found between the scores of QOL and FIM in both total and motor subscale scores. Poststroke depression seems to be associated with age, education level, QOL, and functional status