title: The Wayfinding Questionnaire as a Self-report Screening Instrument for Navigation-related Complaints After Stroke: Internal Validity in Healthy Respondents and Chronic Mild Stroke Patients.
abstract: OBJECTIVE
  In current stroke care, cognitive problems are usually diagnosed in a stepwise manner. More specifically, screening instruments are first applied to support healthcare professionals in deciding whether a second step (an extensive assessment) would be appropriate. None of the existing screening instruments, however, takes navigation ability into account. This is problematic, as navigation impairment after stroke has been shown to be common, more so than previously thought. The Wayfinding Questionnaire (WQ) is therefore presented as a screening instrument for navigation-related complaints after stroke. The internal validity of the WQ was investigated in two samples of participants to establish the final version.
  
  
  RESULTS
  In Study 1, the WQ was administered in a representative sample of 356 healthy participants. Its factor structure was investigated using a principal component analysis. This procedure resulted in deletion of four items and revealed a three-factor structure: "Navigation and Orientation," "Spatial Anxiety," and "Distance Estimation". In Study 2, a confirmatory analysis was performed to directly verify the factor structure as obtained in Study 1 based on data of 158 chronic mild stroke patients. Fit indices of the confirmatory analysis indicated acceptable model fit. The reliability of the three subscales was found to be very good in both healthy participants and patients.
  
  
  CONCLUSIONS
  These studies allowed us to determine the final version of the WQ. The results indicated that the WQ is an internally valid and reliable instrument that can be interpreted using a three-factor structure in both healthy respondents and chronic mild stroke patients.
authors: Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.|Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
authors: Michiel H G
authors: MHG
authors: Claessen
authors: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
authors: Johanna M A
authors: JMA
authors: Visser-Meily
authors: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
authors: Nicolien K
authors: NK
authors: de Rooij
authors: Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.
authors: Albert
authors: A
authors: Postma
authors: Department of Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands.
authors: Ineke J M
authors: IJM
authors: van der Ham
keywords: Neuropsychological practice; Questionnaire; Screening instrument; Spatial anxiety; Spatial navigation; Stroke