Measuring stroke impact with SIS: construct validity of SIS telephone administration.
OBJECTIVE
The purpose of this study was to examine the construct validity of the Stroke Impact Scale (SIS) using telephone mode of administration.


METHODS
Stroke patients were identified using national VA administrative data and ICD-9 codes in 13 participating VA hospitals. Stroke was confirmed by reviewing electronic medical records. Patients were administered SIS by telephone at 12-weeks post-stroke, and administered the Functional Independence Measure (FIM) and SF-36V at 16 weeks post-stroke. The instrument's convergent validity and its ability to differentiate between groups of stroke patients with different disability levels were examined using Pearson's correlations and Kruskal-Wallis one way ANOVA tests.


RESULTS
All the relevant relationships yielded high correlation coefficients with statistical significance: 0.86 for FIM-motor vs. SIS-ADL, and 0.77 for PF in SF-36V vs. SIS-PHYSICAL. The SIS presented better score discrimination and distribution for different severity of stroke than FIM and SF-36V without severe ceiling and floor effects. Kruskal-Wallis tests showed the Physical Component Score of SF-36V did not discriminate any disability levels. Physical functioning (PF) in SF-36V, FIM-motor, SIS-PHYSICAL, SIS-16, and SIS-ADL showed better discrimination in person's functioning. The pairwise comparisons showed that SIS-PHYSICAL, SIS-16, and SIS-ADL discriminated more Rankin levels than FIM-motor and PF in SF-36V.


CONCLUSIONS
SIS telephone survey had superior convergent validity and was better at differentiating between groups of stroke patients with different disability levels than the FIM and SF-36V with no evidence of ceiling and floor effects. Telephone administration of SIS would be a useful and cost-effective method to follow-up community dwelling veterans with stroke.
Kwon
Sooyeon
S
Rehabilitation Outcomes Research Center (RORC), HSR&D and RR& D Center of Excellence, Department of Veterans Affair, Gainesville, FL 32608, USA. sooyeon.kwon@med.va.gov
Duncan
Pamela
P
Studenski
Stephanie
S
Perera
Subashan
S
Lai
Sue Min
SM
Reker
Dean
D
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D020521:Stroke / Q000503:physiopathology*; D011795:Surveys and Questionnaires / Q000592:standards*; D013689:Telephone; D014481:United States