[The development of a scale to evaluate the quality of life in stroke survivors]. / Desarrollo de una escala para evaluar la calidad de vida en supervivientes a un ictus.

INTRODUCTION: The selection of a measure that can be used to evaluate the outcome of therapeutic interventions in stroke patients has had a conceptual problem in that there is a need to detect a wide range of deficiencies, disabilities and handicaps as part of a patient-based model. It has also suffered from a methodological problem due to the lack of systematic attention given to the development of standard instruments. AIMS: We conducted this study with the aim of getting over these limitations by developing a scale to evaluate the quality of life in stroke survivors. SUBJECTS AND METHODS: We followed a methodology that had previously been standardised by other authors based on using the opinion given by patients and caregivers in the generation of the items to be included. This has several stages that include individual interviews with patients, caregivers and experts, focal groups with patients and experts, quantitative and qualitative analyses of these interviews, two panels of experts to actually draw up the instrument, and a pilot test carried out in a sample of 50 patients to reduce and group the items. This reducing and grouping process was performed taking into account the following: 1. The percentage of responses left unanswered; 2. A factorial analysis of the main components; 3. Cronbach's alpha coefficient. RESULTS: We interviewed 20 patients and 12 experts; these results were later used to classify the above mentioned aspects in order of priority according to the frequency with which they appeared in the surveys. Then, we elaborated the questionnaire with four areas or subscales by including the questions or items in these categories: I. Physical status (17 items); II. Emotional status (13 items); III. Activities of daily living (13 items); IV. Social and familial functions (13 items). After the pilot study 38 items were reorganised into eight domains, according to the factorial analysis: 1. Physical problems; 2. Communication; 3. Cognition; 4. Emotions; 5. Feelings; 6. Activities of daily living; 7. Familial functions; 8. Social functions. They displayed high coefficients of internal consistency. CONCLUSIONS: We developed a new scale for evaluating the quality of life for stroke patients and it is now ready to undergo its validation process.

Desarrollo de una escala para evaluar la calidad de vida en supervivientes a un ictus / The development of a scale to evaluate the quality of life in stroke survivors

The selection of a measure that can be used to evaluate the outcome of therapeutic interventions in stroke patients has had a conceptual problem in that there is a need to detect a wide range of deficiencies, disabilities and handicaps as part of a patient-based model. It has also suffered from a methodological problem due to the lack of systematic attention given to the development of standard instruments. AIMS: We conducted this study with the aim of getting over these limitations by developing a scale to evaluate the quality of life in stroke survivors. We followed a methodology that had previously been standardised by other authors based on using the opinion given by patients and caregivers in the generation of the items to be included. This has several stages that include individual interviews with patients, caregivers and experts, focal groups with patients and experts, quantitative and qualitative analyses of these interviews, two panels of experts to actually draw up the instrument, and a pilot test carried out in a sample of 50 patients to reduce and group the items. This reducing and grouping process was performed taking into account the following...(AU)

Desarrollo de una escala para evaluar la calidad de vida en los supervivientes a un ictus / The development of a scale to evaluate the quality of life in stroke survivors

Introducción. La selección de una medida para evaluar el resultado de las intervenciones terapéuticas en los pacientes con ictus ha tenido un problema conceptual en la necesidad de detectar un amplio intervalo de deficiencias, discapacidades y minusvalías, como parte de un modelo basado en el paciente, y un problema metodológico en la falta de atención sistemática para el desarrollo de instrumentos estándares. Objetivo. Para resolver estas limitaciones realizamos este trabajo, con el objetivo de desarrollar una escala para evaluar la calidad de vida en los supervivientes a un ictus. Sujetos y métodos. Seguimos una metodología estandarizada por otros autores, que se basa en la opinión de los pacientes y los cuidadores para generar los ítems a incluir. Ésta tiene varias etapas, que incluyen: entrevistas individuales a pacientes, cuidadores y expertos, grupos focales con pacientes y expertos, análisis cuantitativo y cualitativo de estas entrevistas, dos paneles de consenso para la confección del instrumento y prueba piloto para reducir y agrupar los ítems en una muestra de 50 pacientes. Para reducir y agrupar los ítems tuvimos en cuenta: 1. El porcentaje de respuestas en blanco; 2.El análisis factorial de componentes principales, y 3. El coeficiente de Cronbach. Resultados. Entrevistamos a 20 pacientes y 12 expertos; con esos resultados, ordenamos los aspectos mencionados en orden de prioridad según la frecuencia de aparición en las encuestas. Posteriormente, confeccionamos el cuestionario con cuatro áreas o subescalas, que incluían las preguntas o ítems en las siguientes categorías: I. Estado físico (17 ítems); II. Estado emocional (13 ítems); III. Actividades de la vida diaria (13 ítems); IV. Funciones sociofamiliares (13 ítems). Después del estudio piloto se reorganizaron 38 ítems en ocho dominios, de acuerdo al análisis factorial: 1.Problemas físicos; 2. Comunicación; 3. Cognición; 4. Emociones; 5. Sentimientos; 6. Actividades de la vida diaria; 7. Funciones familiares; 8. Funciones sociales. Mostraron altos coeficientes de consistencia interna. Conclusión. Se ha desarrollado una nueva escala para evaluar la calidad de vida para el ictus, que se encuentra lista para su proceso de validación (AU)