title: Instrument development and validation of the stroke pre-hospital delay behavior intention scale in a Chinese urban population.
abstract: BACKGROUND
  Several stroke impairment scales are currently available for stroke patients but none of them provide information regarding the pre-stroke behavioral intentions of high-risk stroke patients and their relatives. This study's objective was to generate and validate a new written tool, the Stroke Pre-hospital Delay Behavior Intention (SPDBI) scale. It is suitable for use with high-risk stroke patients and their relatives to predict the likelihood of pre-hospital delay.
  
  
  METHODS
  From a review of related studies, we formulated a prototype scale. We interviewed ten stroke patients in a semi-structured iterative process that included interviews with experts, high-risk patients, and their family members. Then, we pretested and filtered items. We next used a large sample size and factor analysis to determine the scale's structure. Finally, we checked the reliability and validity of the scale.
  
  
  RESULTS
  We identified five sub-domains (stroke warning signs, non-treatment justification, symptom attributions, habitual response style, and emergency system use). The SPDBI demonstrated good internal consistency and test-retest reliability (Cronbach's α =0.808; Intraclass Correlation Coefficient [ICC] =0.797).
  
  
  CONCLUSIONS
  This SPDBI scale is a reliable, and valid measure of the likeliness of pre-hospital delay in high-risk stroke patients and their family members. It may provide scientific assessment for targeted health education intervention.
authors.affiliation: School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, 246 Xuefu Road, Harbin, HeiLongJiang Province, 150086, China. zhaoqiuli1957@163.com.
authors.forename: Qiuli
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, 246 Xuefu Road, Harbin, HeiLongJiang Province, 150086, China. yang-li81@163.com.
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, 246 Xuefu Road, Harbin, HeiLongJiang Province, 150086, China. zqq_0616@163.com.
authors.forename: Qingqing
authors.initials: Q
authors.lastname: Zuo
authors.affiliation: School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, 246 Xuefu Road, Harbin, HeiLongJiang Province, 150086, China. zhuxuemei1970@hotmail.com.
authors.forename: Xuemei
authors.initials: X
authors.lastname: Zhu
authors.affiliation: School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, 246 Xuefu Road, Harbin, HeiLongJiang Province, 150086, China. 740047429@qq.com.
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Nephrology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, HeiLongJiang Province, 150086, China. 493386959@qq.com.
authors.forename: Yanni
authors.initials: Y
authors.lastname: Wu
authors.affiliation: School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, 246 Xuefu Road, Harbin, HeiLongJiang Province, 150086, China. 564873092@qq.com.
authors.forename: Liu
authors.initials: L
authors.lastname: Yang
authors.affiliation: School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, 246 Xuefu Road, Harbin, HeiLongJiang Province, 150086, China. 395895730@qq.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.affiliation: School of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, 246 Xuefu Road, Harbin, HeiLongJiang Province, 150086, China. 759247139@qq.com.
authors.forename: Minghui
authors.initials: M
authors.lastname: Li
mesh_terms: D000328:Adult; D044466:Asian People; D002681:China / Q000453:epidemiology; D005163:Factor Analysis, Statistical; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D015203:Reproducibility of Results; D020521:Stroke / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires / Q000592:standards*; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data