title: Development and validation of NEWSQOL, the Newcastle Stroke-Specific Quality of Life Measure.
abstract: BACKGROUND
  A review of stroke-specific quality of life (QOL) measures indicated little evidence of their validity/reliability.
  
  
  OBJECTIVE
  To describe the development/validation of a new measure - the Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL).
  
  
  METHODS
  Phase I: qualitative interviews (28 stroke patients) determined QOL issues for inclusion in the measure. Initial items/response categories were pre-tested (30 patients). Administration of the NEWSQOL in the item reduction stage (100 patients) identified poorly performing items and factor analysis showed likely domains. Internal consistency was examined. Phase II: NEWSQOL and comparator measures were administered (106 patients) to examine validity/test-retest reliability.
  
  
  RESULTS
  Phase I: 140 items were identified for initial inclusion. Qualitative pre-testing led to an extensive revision. Item reduction resulted in a final measure of 56 items in 11 domains (feelings, activities of daily living/self-care, cognition, mobility, emotion, sleep, interpersonal relationships, communication, pain/sensation, vision, fatigue; Cronbach's alpha = 0.71-0.90). Phase II: NEWSQOL domain scores, except cognition, were moderately/highly correlated (0.45-0.76) with relevant comparator measures. NEWSQOL domains feelings, communication and cognition low/moderately correlated with Barthel Index scores (-0.49 to -0.28), as predicted. Test-retest reliability was high (intraclass correlation coefficient range 0.78-0.92).
  
  
  CONCLUSIONS
  NEWSQOL is an acceptable, patient-derived, interviewer-administered, stroke-specific QOL measure with evidence of reliability and validity, making it a promising instrument for assessing QOL after stroke. Involvement of relevant patients in determining the content and format considerably enhances confidence in its validity.
authors.affiliation: Department of Primary Care, University of Liverpool, UK. dbuck@liverpool.ac.uk
authors.forename: Deborah
authors.initials: D
authors.lastname: Buck
authors.forename: Ann
authors.initials: A
authors.lastname: Jacoby
authors.forename: Anna
authors.initials: A
authors.lastname: Massey
authors.forename: Nick
authors.initials: N
authors.lastname: Steen
authors.forename: Anil
authors.initials: A
authors.lastname: Sharma
authors.forename: Gary A
authors.initials: GA
authors.lastname: Ford
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000175:diagnosis / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D004185:Disability Evaluation; D004401:Dysarthria / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care; D011788:Quality of Life; D015203:Reproducibility of Results; D020521:Stroke / Q000175:diagnosis* / Q000523:psychology*; D011795:Surveys and Questionnaires