Assessing reliability and validity of the Chinese version of the stroke scale: scale development.

BACKGROUND

The National Institutes of Health Stroke Scale (NIHSS) is a systematic, 15-point evaluation tool, designed to assess neurological deficit in acute stroke patients and written in English. It is used to support important medical and nursing decisions.

OBJECTIVES

To translate the NIHSS into Chinese and establish its psychometric properties using Chinese evaluators.

DESIGN

Methodological research design.

SETTING

One medical centre.

PARTICIPANTS

Using convenience sampling, 48 subjects admitted with acute ischemic stroke were selected.

METHODS

In this study, six clinicians from the Department of Neurology (3 nurses, 3 doctors) assessed the 48 patients using the C-NIHSS, the Glasgow Coma Scale and the Barthel index.

RESULTS

The C-NIHSS content validity index reached 1.00, and the Cronbach's alpha coefficient for internal consistency was 0.92. Of the 15 scale items, two (facial palsy and limb ataxia) had low inter-rater values (k values below 0.39). Kappa (kappa) values were substantial (over 0.60) for all other items. The C-NIHSS has a significantly negative correlation with both Glasgow Coma Scale (r = -0.824, p < 0.01), and Barthel index (r = -0.683, p < 0.01) scores.

CONCLUSIONS

The C-NIHSS is a reliable and valid scale for the clinical assessment of neurological deficit in acute stroke patients.