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Published in: BMC Neurology 1/2024

Open Access 01-12-2024 | Stroke | Research

Designing and validating of a questionnaire measuring perceived self-care ability (PSCA) in chronic stroke patients at home

Authors: Nasrin Jafari-golestan, Asghar Dalvandi, Mohammadali Hosseini, Masoud Fallahi-Khoshknab, Abbas Ebadi, Mahdi Rahgozar, Sidani Souraya

Published in: BMC Neurology | Issue 1/2024

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Abstract

Background

Patients with a stroke often cannot care for themselves after hospital discharge. Assessment of their self-care ability is the first step in planning post-discharge home care. This study aimed to design and validate a measure of perceived self-care ability (PSCA) in stroke patients.

Methods

A sequential-exploratory mixed method was conducted in Tehran, Iran, in 2020–2021. The qualitative phase involved in-depth semi-structured interviews with 12 participants. Transcripts were content analyzed. The results guided the development of 81 items. psychometric properties such as face validity (Impact Score > 1.5), content validity ratio (CVR > 0.63), content validity index (Item Content Validity Index: ICVI > 0.78, Scale Content Validity Index/Average: SCVI/Ave > 0.8) and Kappa value (Kappa > 0.7), internal consistency (Cronbach’s alpha > 0.7), relative reliability (ICC: inter class correlation coefficient), absolute reliability (Standard Error of Measurement: SEM and Minimal Detectable Changes: MDC), convergent validity (Correlation Coefficient between 0.4–0.7), interpretability, responsiveness, feasibility, and ceiling and floor effects were assessed.

Results

Content analysis of the qualitative interviews yielded 5 major categories and 9 subcategories that reflected "Perceptual stability", "Cognitive fluctuations", "Sensory, Motor and Physical health",” The subjective nature" and "The dynamic nature” of PSCA. Results of face and content validity reduced the number of items to 32, capturing three dimensions of PSCA in chronic stroke patients; these dimensions included perceptual ability, threatened health status, and sensory, motor, and cognitive ability. The findings supported the reliability and validity of the measure.

Conclusions

The PSCA questionnaire was developed and validated within the Iranian culture. It is useful in assessing the self-care of patients with stroke and in informing practice.
Literature
1.
go back to reference Dalvandi A, Khankeh H, Bahrampouri S, Ebadi A, Passandeh H, Sari HN, et al. Designing Iranian pre-hospital stroke scale. Med J Islam Repub Iran. 2014;28:118.PubMedPubMedCentral Dalvandi A, Khankeh H, Bahrampouri S, Ebadi A, Passandeh H, Sari HN, et al. Designing Iranian pre-hospital stroke scale. Med J Islam Repub Iran. 2014;28:118.PubMedPubMedCentral
3.
go back to reference Fiouji H, Namayandeh SM, jam Barsang S, Erfani M. Epidemiologic Study of the Main Risk Factors for one Year Ischemic Stroke and Surivial in Patients admitted to the neurology department of Ghayim Hospital in Mashhad, Iran, 2015. J Tolooebehdasht. 2020. Fiouji H, Namayandeh SM, jam Barsang S, Erfani M. Epidemiologic Study of the Main Risk Factors for one Year Ischemic Stroke and Surivial in Patients admitted to the neurology department of Ghayim Hospital in Mashhad, Iran, 2015. J Tolooebehdasht. 2020.
4.
go back to reference Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart disease and stroke statistics—2021 update. Circulation. 2021;143(8):e254–743.CrossRefPubMed Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart disease and stroke statistics—2021 update. Circulation. 2021;143(8):e254–743.CrossRefPubMed
5.
go back to reference Grant JS, Glandon GL, Elliott TR, Giger JN, Weaver M. Caregiving problems and feelings experienced by family caregivers of stroke survivors the first month after discharge. Int J Rehabil Res. 2004;27(2):105–11.CrossRefPubMed Grant JS, Glandon GL, Elliott TR, Giger JN, Weaver M. Caregiving problems and feelings experienced by family caregivers of stroke survivors the first month after discharge. Int J Rehabil Res. 2004;27(2):105–11.CrossRefPubMed
6.
go back to reference Lorensen M. Psychometric properties of self-care management and life-quality amongst elderly. Clin Eff Nurs. 1998;2(2):78–84.CrossRef Lorensen M. Psychometric properties of self-care management and life-quality amongst elderly. Clin Eff Nurs. 1998;2(2):78–84.CrossRef
7.
go back to reference Bernspang B, Asplund K, Eriksson S, Fugl-Meyer AR. Motor and perceptual impairments in acute stroke patients: effects on self-care ability. Stroke. 1987;18(6):1081–6.CrossRefPubMed Bernspang B, Asplund K, Eriksson S, Fugl-Meyer AR. Motor and perceptual impairments in acute stroke patients: effects on self-care ability. Stroke. 1987;18(6):1081–6.CrossRefPubMed
8.
go back to reference Bernspang B, Viitanen M, Eriksson S. Impairments of Perceptual and motor functions: their influence on self-care ability 4 to 6 years after a stroke. Occup Ther J Res. 1989;9(1):27–37.CrossRef Bernspang B, Viitanen M, Eriksson S. Impairments of Perceptual and motor functions: their influence on self-care ability 4 to 6 years after a stroke. Occup Ther J Res. 1989;9(1):27–37.CrossRef
9.
go back to reference Jafari-Golestan N, Hosseini M, Dalvandi A, Fallahi-Khoshknab M, Ebadi A, Rahgozar M, et al. Determining the consequences of perceived self-care ability in stroke patients living at home: a qualitative study in Iran. Arch Neurosci. 2019;6(4):5.CrossRef Jafari-Golestan N, Hosseini M, Dalvandi A, Fallahi-Khoshknab M, Ebadi A, Rahgozar M, et al. Determining the consequences of perceived self-care ability in stroke patients living at home: a qualitative study in Iran. Arch Neurosci. 2019;6(4):5.CrossRef
10.
go back to reference Sidani S, Doran DI. Development and validation of a self-care ability measure. CJNR (Can J Nurs Res). 2014;46(1):11–25.CrossRefPubMed Sidani S, Doran DI. Development and validation of a self-care ability measure. CJNR (Can J Nurs Res). 2014;46(1):11–25.CrossRefPubMed
11.
go back to reference Jafari-Golestan N, Dalvandi A, Hosseini M, Fallahi-Khoshknab M, Ebadi A, Rahgozar M, et al. Perception of self-care ability among patients with stroke post-discharge: a qualitative descriptive study in Iran: Self-care among patients with stroke post-discharge. Int Health Trends Perspect. 2021;1(3):328–35.CrossRef Jafari-Golestan N, Dalvandi A, Hosseini M, Fallahi-Khoshknab M, Ebadi A, Rahgozar M, et al. Perception of self-care ability among patients with stroke post-discharge: a qualitative descriptive study in Iran: Self-care among patients with stroke post-discharge. Int Health Trends Perspect. 2021;1(3):328–35.CrossRef
12.
go back to reference Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.CrossRefPubMed Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.CrossRefPubMed
13.
go back to reference MacCallum RC, Widaman KF, Zhang S, Hong S. Sample size in factor analysis. Psychol Methods. 1999;4(1):84.CrossRef MacCallum RC, Widaman KF, Zhang S, Hong S. Sample size in factor analysis. Psychol Methods. 1999;4(1):84.CrossRef
14.
go back to reference Ebadi A, Zarshenas L, Rakhshan M, Zareiyan A, Sharifnia S, Mojahedi M. Principles of scale development in health science. Tehran: Jame-e-negar; 2017. Ebadi A, Zarshenas L, Rakhshan M, Zareiyan A, Sharifnia S, Mojahedi M. Principles of scale development in health science. Tehran: Jame-e-negar; 2017.
15.
go back to reference Kaiser HF. An index of factorial simplicity. Psychometrika. 1974;39(1):31–6.CrossRef Kaiser HF. An index of factorial simplicity. Psychometrika. 1974;39(1):31–6.CrossRef
16.
go back to reference Comrey AL, Lee HB. A first course in factor analysis. Psychology press; 2013. Comrey AL, Lee HB. A first course in factor analysis. Psychology press; 2013.
17.
go back to reference DiIorio CK. Measurement in health behavior: methods for research and evaluation. John Wiley & Sons; 2006. DiIorio CK. Measurement in health behavior: methods for research and evaluation. John Wiley & Sons; 2006.
18.
go back to reference Hansen BC, Waltz CF, Strickland OL, Lenz. ER (1984). Measurement in nursing research. Philadelphia: Davis, 407 pp., $35.00. Res Nurs Health. 1985;8(1):97–8.CrossRef Hansen BC, Waltz CF, Strickland OL, Lenz. ER (1984). Measurement in nursing research. Philadelphia: Davis, 407 pp., $35.00. Res Nurs Health. 1985;8(1):97–8.CrossRef
19.
go back to reference Mohammadbeigi A, Mohammadsalehi N, Aligol M. Validity and reliability of the instruments and types of measurments in health applied researches. J Rafsanjan Univ Med Sci. 2015;13(12):1153–70. Mohammadbeigi A, Mohammadsalehi N, Aligol M. Validity and reliability of the instruments and types of measurments in health applied researches. J Rafsanjan Univ Med Sci. 2015;13(12):1153–70.
20.
go back to reference Sajadi SA, Ebadi A, Moradian ST, Akbari R. Designing and validation of health-related quality of life inventory for family caregivers of hemodialysis patients. Int J Commun Based Nurs Midw. 2020;8(2):164. Sajadi SA, Ebadi A, Moradian ST, Akbari R. Designing and validation of health-related quality of life inventory for family caregivers of hemodialysis patients. Int J Commun Based Nurs Midw. 2020;8(2):164.
21.
go back to reference Lenz ER. Measurement in nursing and health research. Springer publishing company; 2010. Lenz ER. Measurement in nursing and health research. Springer publishing company; 2010.
22.
go back to reference Yekaninejad M, Zeidi I, Akaberi A, Golshan A, Pakpour A. Validity and reliability of the Kidney Disease Quality of Life Short Form (KDQOL-SF™ 13) in Iranian patients. J North Khorasan Univ Med Sci. 2012;4(2):227–38. Yekaninejad M, Zeidi I, Akaberi A, Golshan A, Pakpour A. Validity and reliability of the Kidney Disease Quality of Life Short Form (KDQOL-SF™ 13) in Iranian patients. J North Khorasan Univ Med Sci. 2012;4(2):227–38.
23.
go back to reference Habibi M, Izanluo B, Khodai E. Implication of factor analysis in weighting the items in comparison to s’redetermined constant weights in psychological and educational measurements. Q Educ Meas. 2012;3(9):81–104. Habibi M, Izanluo B, Khodai E. Implication of factor analysis in weighting the items in comparison to s’redetermined constant weights in psychological and educational measurements. Q Educ Meas. 2012;3(9):81–104.
24.
go back to reference Brown T, Mapleston J, Nairn A, Molloy A. Relationship of cognitive and perceptual abilities to functional independence in adults who have had a stroke. Occup Ther Int. 2013;20(1):11–22.CrossRefPubMed Brown T, Mapleston J, Nairn A, Molloy A. Relationship of cognitive and perceptual abilities to functional independence in adults who have had a stroke. Occup Ther Int. 2013;20(1):11–22.CrossRefPubMed
25.
go back to reference Welmer AK, Von Arbin M, Murray V, Widén Holmqvist L, Sommerfeld DK. Determinants of mobility and self-care in older people with stroke: Importance of somatosensory and perceptual functions. Phys Ther. 2007;87(12):1633–41.CrossRefPubMed Welmer AK, Von Arbin M, Murray V, Widén Holmqvist L, Sommerfeld DK. Determinants of mobility and self-care in older people with stroke: Importance of somatosensory and perceptual functions. Phys Ther. 2007;87(12):1633–41.CrossRefPubMed
27.
go back to reference Pahlman U, Savborg M, Tarkowski E. Cognitive dysfunction and physical activity after stroke: the Gothenburg cognitive stroke study in the elderly. J Stroke Cerebrovasc Dis. 2012;21(8):652–8.CrossRefPubMed Pahlman U, Savborg M, Tarkowski E. Cognitive dysfunction and physical activity after stroke: the Gothenburg cognitive stroke study in the elderly. J Stroke Cerebrovasc Dis. 2012;21(8):652–8.CrossRefPubMed
28.
go back to reference Grimby G, Md P, Andren E, Bsc OT, Daving Y, Msc OT, et al. Dependence and perceived difficulty in daily activities in community-living stroke survivors 2 years after stroke: a study of instrumental structures. Stroke. 1998;29(9):1843–9.CrossRefPubMed Grimby G, Md P, Andren E, Bsc OT, Daving Y, Msc OT, et al. Dependence and perceived difficulty in daily activities in community-living stroke survivors 2 years after stroke: a study of instrumental structures. Stroke. 1998;29(9):1843–9.CrossRefPubMed
29.
go back to reference Casey D, Murphy K, Cooney A, O’Shea E. Patient perceptions having suffered a stroke in Galway. Br J Community Nurs. 2008;13(8):384–90.CrossRefPubMed Casey D, Murphy K, Cooney A, O’Shea E. Patient perceptions having suffered a stroke in Galway. Br J Community Nurs. 2008;13(8):384–90.CrossRefPubMed
30.
go back to reference Matsui M, Capezuti E. Perceived autonomy and self-care resources among senior center users. Geriatr Nurs. 2008;29(2):141–7.CrossRefPubMed Matsui M, Capezuti E. Perceived autonomy and self-care resources among senior center users. Geriatr Nurs. 2008;29(2):141–7.CrossRefPubMed
31.
go back to reference Hoyle M, Gustafsson L, Meredith P, Ownsworth T. Participation after stroke: Do we understand all the components and relationships as categorised in the ICF? Brain Impairment. 2012;13(1):4–15.CrossRef Hoyle M, Gustafsson L, Meredith P, Ownsworth T. Participation after stroke: Do we understand all the components and relationships as categorised in the ICF? Brain Impairment. 2012;13(1):4–15.CrossRef
32.
go back to reference Müller E, Wustmann Seiler C, Perren S, Simoni H. Young children’s self-perceived ability: development, factor structure and initial validation of a self-report instrument for preschoolers. J Psychopathol Behav Assess. 2015;37(2):256–73.CrossRef Müller E, Wustmann Seiler C, Perren S, Simoni H. Young children’s self-perceived ability: development, factor structure and initial validation of a self-report instrument for preschoolers. J Psychopathol Behav Assess. 2015;37(2):256–73.CrossRef
33.
go back to reference Woodman P, Riazi A, Pereira C, Jones F. Social participation post stroke: a meta-ethnographic review of the experiences and views of community-dwelling stroke survivors. Disabil Rehabil. 2014;36(24):2031–43.CrossRefPubMed Woodman P, Riazi A, Pereira C, Jones F. Social participation post stroke: a meta-ethnographic review of the experiences and views of community-dwelling stroke survivors. Disabil Rehabil. 2014;36(24):2031–43.CrossRefPubMed
34.
go back to reference Kristensen MAT, Hølge-Hazelton B, Waldorff FB, Guassora AD. How general practitioners perceive and assess self-care in patients with multiple chronic conditions: a qualitative study. BMC Fam Pract. 2017;18(1):109.CrossRefPubMedPubMedCentral Kristensen MAT, Hølge-Hazelton B, Waldorff FB, Guassora AD. How general practitioners perceive and assess self-care in patients with multiple chronic conditions: a qualitative study. BMC Fam Pract. 2017;18(1):109.CrossRefPubMedPubMedCentral
35.
go back to reference Söderhamn U, Dale B, Söderhamn O. The meaning of actualization of self-care resources among a group of older home-dwelling people—A hermeneutic study. Int J Qual Stud Health Well Being. 2013;8(1):20592.CrossRef Söderhamn U, Dale B, Söderhamn O. The meaning of actualization of self-care resources among a group of older home-dwelling people—A hermeneutic study. Int J Qual Stud Health Well Being. 2013;8(1):20592.CrossRef
36.
go back to reference Söderhamn O. Self-care activity as a structure: a phenomenological approach. Scand J Occup Ther. 2000;7(4):183–9.CrossRef Söderhamn O. Self-care activity as a structure: a phenomenological approach. Scand J Occup Ther. 2000;7(4):183–9.CrossRef
38.
go back to reference Franchignoni F, Tesio L, Martino M, Benevolo E, Castagna M. Length of stay of stroke rehabilitation inpatients: prediction through the functional independence measure. Annali-Istituto Superiore Di Sanita. 1998;34:463–8. Franchignoni F, Tesio L, Martino M, Benevolo E, Castagna M. Length of stay of stroke rehabilitation inpatients: prediction through the functional independence measure. Annali-Istituto Superiore Di Sanita. 1998;34:463–8.
39.
go back to reference Stanko E, Goldie P, Nayler M. Development of a new mobility scale for people living in the community after stroke: content validity. Aust J Physiother. 2001;47(3):201–8.CrossRefPubMed Stanko E, Goldie P, Nayler M. Development of a new mobility scale for people living in the community after stroke: content validity. Aust J Physiother. 2001;47(3):201–8.CrossRefPubMed
40.
go back to reference Pierce LL, Finn MG, Steiner V. Families dealing with stroke desire information about self-care needs. Rehabil Nurs. 2004;29(1):14–7.CrossRefPubMed Pierce LL, Finn MG, Steiner V. Families dealing with stroke desire information about self-care needs. Rehabil Nurs. 2004;29(1):14–7.CrossRefPubMed
Metadata
Title
Designing and validating of a questionnaire measuring perceived self-care ability (PSCA) in chronic stroke patients at home
Authors
Nasrin Jafari-golestan
Asghar Dalvandi
Mohammadali Hosseini
Masoud Fallahi-Khoshknab
Abbas Ebadi
Mahdi Rahgozar
Sidani Souraya
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Stroke
Published in
BMC Neurology / Issue 1/2024
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-024-03612-4

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