This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hamedani, A. G. Articles by Horwitz, R. I. Search for Related Content PubMed PubMed Citation Articles by Hamedani, A. G. Articles by Horwitz, R. I. Pubmed/NCBI databases Medline Plus Health Information Stroke Related Collections Behavioral/psychosocial - stroke Acute Cerebral Hemorrhage Intracerebral Hemorrhage Stroke in Children and the Young Other Stroke

(Stroke. 2001;32:687.)
© 2001 American Heart Association, Inc.

Original Contributions

A Quality-of-Life Instrument for Young Hemorrhagic Stroke Patients

Azita G. Hamedani, MD, MPH; Carolyn K. Wells, MPH; Lawrence M. Brass, MD; Walter N. Kernan, MD; Catherine M. Viscoli, PhD; J. Nozipo Maraire, MD; Issam A. Awad, MD Ralph I. Horwitz, MD

From the Departments of Internal Medicine (C.K.W., W.N.K., C.M.V., R.I.H.), Neurology (L.M.B.), and Neurosurgery (J.N.M., I.A.W.), Yale University School of Medicine (A.G.H.), New Haven, and VA Connecticut Healthcare Systems, West Haven (L.M.B.), Conn.

Correspondence to Issam A. Awad, MD, Department of Neurosurgery, University of Colorado School of Medicine, 4200 East 9th Ave, C307, Denver, CO 80262. E-mail issam.awad{at}uchsc.edu

Background and Purpose—Hemorrhagic stroke has a high initial mortality rate. While survivors often recover motor function, many experience significant changes in their quality of life (QOL). Available outcome measures assess neurological impairment, disability, or handicap, yet often inadequately characterize the full impact of a stroke on patients’ lives. In this study, we develop and validate a QOL instrument specific for young patients with hemorrhagic strokes.

Methods—Methodological guidelines for instrument development were initially established. Based on the content of 40 open-ended patient interviews, a 54-item instrument (HSQuale) was developed. The reliability (test-retest and internal consistency) and validity (content and construct) of HSQuale were assessed in another 71 patients (18 to 49 years of age, 63% women, 77% white), at 1 year after their hemorrhagic stroke. Comparisons were made between HSQuale and other commonly used outcome measures.

Results—HSQuale demonstrated reproducibility (test-retest , 0.40 to 0.96) and internal consistency (Cronbach 0.80 for 5 of 7 domains). HSQuale scores had broad frequency distributions (33% of subjects scored in any single score decile), avoided ceiling effects found for other outcome measures (Barthel Index and Short Form-36), and discriminated among clinically distinct subject groups (eg, intracerebral versus subarachnoid hemorrhage patients).

Conclusions—HSQuale is a reliable and valid QOL instrument. Compared with other outcome measures, it assesses a broader range of deficits and is better able to discriminate among subgroups of hemorrhagic stroke survivors.

Key Words: cerebral hemorrhage • cerebrovascular disorders • outcome assessment • prognosis • quality of life

This article has been cited by other articles:

				NINDS ICH Workshop Participants Priorities for Clinical Research in Intracerebral Hemorrhage: Report From a National Institute of Neurological Disorders and Stroke Workshop Stroke, March 1, 2005; 36(3): e23 - e41. [Abstract] [Full Text] [PDF]

				K. J. Greenlund, W. H. Giles, N. L. Keenan, J. B. Croft, G. A. Mensah, and S. L. Huston Physician Advice, Patient Actions, and Health-Related Quality of Life in Secondary Prevention of Stroke Through Diet and Exercise * The Physician's Role in Helping Patients to Increase Physical Activity and Improve Eating Habits Stroke, February 1, 2002; 33(2): 565 - 571. [Abstract] [Full Text] [PDF]