Reliability of scores between stroke patients and significant others on the Reintegration to Normal Living (RNL) Index.
OBJECTIVE
This study measured reliability between stroke patients' and significant others' scores on items on the Reintegration to Normal Living (RNL) Index and whether there were any scoring biases.


METHODS
The 11-item RNL Index was administered to 57 pairs of patients and significants six months after stroke rehabilitation. The index was scored using a 10-point visual analogue scale. Patient and significant other demographic information and data on patients' clinical, functional and cognitive status were collected. Reliability was measured using the intra-class correlation coefficient (ICC) and percent agreement.


RESULTS
Overall poor reliability was found for the RNL Index total score (ICC=.36, 95% CI .07 to .59) and the daily functioning subscale (ICC=.24, 95% Cl -.003 to .46) and moderate reliability was found for the perception of self subscale (ICC= .55, 95% Cl .28 to .73). There was a moderate bias for patients to rate themselves as achieving better reintegration than was indicated by significant others, although no demographic or clinical factors were associated with this bias. Exact match agreement was best for the subjective items and worse for items reflecting mobility around the community and participation in a work activity.


CONCLUSIONS
Caution is needed when interpreting patient information reported by significant others on the RNL Index. The use of a shorter scale to rate the RNL Index requires investigation.
Tooth
Leigh R
LR
The School of Population Health, The University of Queensland, Australia. L.Tooth@sph.uq.edu.au
McKenna
Kryss T
KT
Smith
Melinda
M
O'Rourke
Peter K
PK
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D004185:Disability Evaluation; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011793:Queensland / Q000453:epidemiology; D015203:Reproducibility of Results; D020521:Stroke / Q000453:epidemiology; D000071939:Stroke Rehabilitation