title: Validation of the short-form Health Literacy Scale in patients with stroke.
abstract: OBJECTIVE
  We aimed to validate a Mandarin version of the short-form Health Literacy Scale (SHEAL) in patients with stroke.
  
  
  METHODS
  Each patient with stroke was interviewed with the SHEAL. The Public Stroke Knowledge Quiz (PSKQ) was administered as a criterion for examining the convergent validity of the SHEAL. The discriminative validity of the SHEAL was determined with age and education level as independent grouping variables.
  
  
  RESULTS
  A total of 87 patients with stroke volunteered to participate in this prospective study. The SHEAL demonstrated sufficient internal consistency reliability (alpha=0.82) and high correlation with the PSKQ (r=0.62). The SHEAL scores between different age groups and education level groups were significantly different. The SHEAL, however, showed a notable ceiling effect (24.1% of the participants), indicating that the SHEAL cannot differentiate level of health literacy between individuals with high health literacy.
  
  
  CONCLUSIONS
  The internal consistency reliability, convergent validity, and discriminative validity of the SHEAL were adequate. However, the internal consistency reliability and ceiling effect of the SHEAL need to be improved.
  
  
  CONCLUSIONS
  The SHEAL has shown its potential for assessing the health literacy of patients with stroke for research purposes. For clinical usage, however, the SHEAL should be used with caution.
authors: School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors: Yi-Jing
authors: YJ
authors: Huang
authors: Rehabilitation Department, Chi Mei Medical Center, Tainan, Taiwan; Department of Sports Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
authors: Yu-Lin
authors: YL
authors: Wang
authors: School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors: Tzu-Yi
authors: TY
authors: Wu
authors: Center for Teacher Education, National Tsing Hua University, Hsinchu, Taiwan.
authors: Cheng-Te
authors: CT
authors: Chen
authors: Center for Evidence-Based Medicine, Taipei Medical University, Taipei, Taiwan.
authors: Ken N
authors: KN
authors: Kuo
authors: Department of Physical Medicine and Rehabilitation, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
authors: Sheng-Shiung
authors: SS
authors: Chen
authors: Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan; School of Gerontology and Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan. Electronic address: houwh@tmu.edu.tw.
authors: Wen-Hsuan
authors: WH
authors: Hou
authors: School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
authors: Ching-Lin
authors: CL
authors: Hsieh
mesh_terms: D000328:Adult; D000368:Aged; D004521:Educational Measurement / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011594:Psychometrics; D012372:ROC Curve; D015203:Reproducibility of Results; D020521:Stroke / Q000175:diagnosis; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Health literacy; Measurement; Psychometrics; Stroke; Validation