Evaluation of proxy responses to the Stroke Impact Scale
Evaluation of proxy responses to the Stroke Impact Scale
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DOI：
10.1161/01.str.0000034395.06874.3e
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发表时间：
2002-11-01
期刊：
影响因子：
8.3
通讯作者：
Studenski, S
中科院分区：
文献类型：
--
作者：
Duncan, PW;Lai, SM;Studenski, S
背景和目的-本研究的目的是比较代理-患者对中风影响量表（SIS）和SIS-16的每个领域的反应，估计偏差，并评估代理scores. Methods的有效性二百八十七患者和代理对从堪萨斯城中风登记参加了这项研究。所有患者均在卒中后90 - 120天在家中或护理机构接受评估，使用改良兰金量表运动指数（强度）、Barthel指数（日常生活活动）、Lawton评估（工具性日常生活活动）、Folstein简易精神状态检查（认知）和SIS。合格的代理人是年龄大于或等于18岁，认识患者至少1年，每周至少见患者一次的个人。所有代理访谈进行7天内（之前或之后）的病人interview. Results-Thirty七百七十七例患者从堪萨斯城中风登记处有资格参加这项研究。77名患者或代理人拒绝参与。13名同意的患者-代理人对中的患者因失语症或认知障碍而无法完成访谈，并从研究中退出。在SIS-16和完整SIS的8个领域中的7个领域（5个在α =0.05时具有统计学显著性），代理人对患者的评分比患者自己的评分更严重。随着中风严重程度的增加，高估患者病情严重程度的代理偏倚倾向于增加。然而，患者和代理平均值之间的偏倚幅度（通过效应量测量）很小（范围为-0.1至0.4）。代理人和患者之间的一致性强度（通过组内相关系数测量）范围为0.50至0.83。协议是最好的可观察的物理域。所有领域的患者和代理评分在兰金分类中均存在显著差异。并行有效性与Folstein微型精神状态检查，Barthel指数，劳顿工具的日常生活活动，和Motricity指数的患者和代理的相关性是良好的优秀（范围，0：37至0.78）。结论-代理提供有效的信息，评估中风的结果。患者和代理人报告SIS域和SIS-16之间存在显著差异。然而，观察到的偏倚很小，没有临床意义。
Background and Purpose-The purposes of this study were to compare proxy-patient responses on each domain of the Stroke Impact Scale (SIS) and the SIS-16, estimate the bias, and evaluate the validity of proxy scores.Methods-Two hundred eighty-seven patient and proxy pairs from the Kansas City Stroke Registry participated in the study. All patients were assessed in their home or nursing facility between 90 and 120 days after stroke with the use of the modified Rankin Scale Motricity Index (strength), Barthel Index (activities of daily living), Lawton assessment (instrumental activities of daily living), Folstein Mini-Mental State Examination (cognition), and the SIS. Eligible proxies were individuals who were aged greater than or equal to18 years, had known the patient for at least I year, and saw the patient at least once each,week. All proxy interviews were conducted within 7 days of (before or after) the patient's interview.Results-Three hundred seventy-seven patients from the Kansas City Stroke Registry were eligible for the study. Seventy-seven patients or proxies refused participation. Thirteen patients of the consenting patient-proxy pairs were too aphasic or cognitively impaired to complete the interviews and were dropped from the study. Proxies scored patients as more severely affected than patients scored themselves on the SIS-16 and in 7 of 8 domains of the full SIS (5 were statistically significant at alpha=0.05). The proxy bias toward overrating the severity of the patient's condition tended to increase as the severity of the stroke increased. However, the magnitude of the biases between patient and proxy means, as measured by effect size, was small (range, -0.1 to 0.4). The strength of the agreement, as measured by intraclass correlation coefficients, between proxy and patient ranged from 0.50 to 0.83. Agreement was best for the observable physical domains. Both patient and proxy scores in all domains were significantly different across Rankin categories. Concurrent validity for both patient and proxy correlations with the Folstein Mini-Mental State Examination, Barthel Index, Lawton instrumental activities of daily living, and Motricity Index was good to excellent (range, 0:37 to 0.78).Conclusions-Proxies provide valid information for assessment of stroke outcomes. There are significant differences between patient and proxy reporting on SIS domains and the SIS-16. However, the observed biases are small and not clinically meaningful.