| Summary: | 碩士 === 長庚大學 === 復健科學研究所 === 95 === Background and Purpose: The quality of life (QOL) has been considered a comprehensive measure of health outcomes for stroke patients under treatment. The Stroke Impact Scale (SIS) was the most commonly used tools to measure QOL of stroke patients. The purposes of the study were to test the validity and reliability of the original SIS and the SIS plus six supplemental questions which were deemed important by the Chinese stroke patients but not included in the original scale. Besides, predicting factors for the quality of life outcomes of Taiwanese stroke patients will be analyzed. Methods: One hundred and two first-ever stroke patients were recruited in the study. Subjects’ criteria were: (1) first-ever stroke patients, (2) within 6 months after stroke; (3) didn’t have serious diseases that will influence quality of life measure. After record the demographic data and the onset NIHSS (National Institutes of Health Stroke Scale) score, the Quality of Life Scale (Stroke impact scale and supplemental questions), the FIM (Functional Independence Measure), and the GDS (Geriatric Depression Scale) measures were measured for each patient. This study used Pearson’s correlation to test the convergent validity of the SIS, the exploratory factor analysis to test the construct validity of the SIS plus supplemental questions, and the Cronbach’s alpha for the internal consistence of the SIS .Finally, we used the multiple linear regression analysis to find the associated factors of Quality of life for Taiwan stroke patients. Results: The mean age of the 102 patients was 63.49±13.22 (range28-85). Compared with the corresponding FIM sub-score, the Mobility, ADL/IADL, and Communication domains all showed good convergent validity (r=.80 to.90), but not for the strength (r=.53), hand function (r=.52) and participation (r=.19) domains. The emotion domain showed a modest correlation with the GDS (r= -.65) and the memory domain showed a good correlation with the MMSE(r=.88). The exploratory factor analysis revealed 5 factors for the SIS plus supplements, which was similar to the original SIS, and the new model explained 59.91% of the variances, which was lower than the 64.47% of the original SIS. The internal consistence of the SIS was good (Cronbach’s alpha = .89~.96 for 7 domains, emotion (α =0.70)), similarly for the SIS plus supplements (Cronbach’s alpha = .88~.96 for 4 domains, emotion=.76), but slightly increased in the emotion and communication & memory domains. The inter-rater reliability of the SIS was high (r=.94~.99 in 7 domains, r=0.70 for emotion).The functional status was an important factor to predict the quality of life outcome of Taiwanese stroke patients. Other factors included gender, onset NIHSS, stroke type, stroke location and depression individually predicted different domains of the SIS measures. Conclusion: The SIS showed good validity and reliability when applied in Taiwanese stroke patients. It can be used in measuring the QOL in Taiwanese stroke patients, but need a little bit conservative in the emotion and participation domains. When applied to stroke survivor’s onset within 6 months, adding supplemental questions did not increase validity of the SIS. But, internal consistences of the same domains of SIS plus supplements were slightly increased than the original SIS. Further research are needed.
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