title: Assessing reliability and validity of the Chinese version of the stroke scale: scale development.
abstract: BACKGROUND
  The National Institutes of Health Stroke Scale (NIHSS) is a systematic, 15-point evaluation tool, designed to assess neurological deficit in acute stroke patients and written in English. It is used to support important medical and nursing decisions.
  
  
  OBJECTIVE
  To translate the NIHSS into Chinese and establish its psychometric properties using Chinese evaluators.
  
  
  METHODS
  Methodological research design.
  
  
  METHODS
  One medical centre.
  
  
  METHODS
  Using convenience sampling, 48 subjects admitted with acute ischemic stroke were selected.
  
  
  METHODS
  In this study, six clinicians from the Department of Neurology (3 nurses, 3 doctors) assessed the 48 patients using the C-NIHSS, the Glasgow Coma Scale and the Barthel index.
  
  
  RESULTS
  The C-NIHSS content validity index reached 1.00, and the Cronbach's alpha coefficient for internal consistency was 0.92. Of the 15 scale items, two (facial palsy and limb ataxia) had low inter-rater values (k values below 0.39). Kappa (kappa) values were substantial (over 0.60) for all other items. The C-NIHSS has a significantly negative correlation with both Glasgow Coma Scale (r = -0.824, p < 0.01), and Barthel index (r = -0.683, p < 0.01) scores.
  
  
  CONCLUSIONS
  The C-NIHSS is a reliable and valid scale for the clinical assessment of neurological deficit in acute stroke patients.
authors.affiliation: Department of Nursing, Chang Gung Memorial Hospital, Kaohsiung, #123, Ta-Pei Rd, Niao-Sung Hsiang, Kaohsiung County, Taiwan. 2244@adm.cgmh.org.tw
authors.forename: Tzu-Kuan
authors.initials: TK
authors.lastname: Sun
authors.forename: Su-Chen
authors.initials: SC
authors.lastname: Chiu
authors.forename: Shu-Hui
authors.initials: SH
authors.lastname: Yeh
authors.forename: Ku-Chou
authors.initials: KC
authors.lastname: Chang
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications; D003243:Consciousness; D005260:Female; D015577:Geriatric Assessment; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000379:methods* / Q000592:standards; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D015588:Observer Variation; D011594:Psychometrics; D011597:Psychomotor Performance; D012720:Severity of Illness Index; D020521:Stroke / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000451:nursing; D013624:Taiwan; D014175:Translating