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Scaling properties of the subjective index of physical and social outcome after stroke in a study population unselected by age.

Abstract：

OBJECTIVE:To investigate the scaling properties of the Subjective Index of Physical and Social Outcome (SIPSO) after stroke in survivors to hospital discharge, unselected by age. DESIGN:Factor, Mokken, and Rasch analyses of the SIPSO using data from a prospective observational cohort study. SETTING:Three acute care hospitals. PARTICIPANTS:Consecutive admissions (N=312) with acute stroke, unselected by age. INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:Patient- or proxy-reported SIPSO, collected by postal survey 6 months after stroke. RESULTS:Complete SIPSO questionnaires were returned by 166 of 268 survivors (median age, 72y; interquartile range, 66-81y). Factor and Mokken analyses supported both 1- and 2-factor solutions. Fit to the Rasch model for the 10-item scale was poor (χ(2) test for item-trait interaction, χ(2)=69.6; P<.001). Differential item functioning by sex and age was demonstrated for the physical subscore and was dealt with through the creation of 2 super items, resulting in a good fit to the Rasch model (χ(2)=2.35; P=.67), ordered thresholds, good targeting to the latent trait, and reasonable separation reliability (Person-Separation Index, 0.8). For the social subscore, no differential item functioning was demonstrated by age or sex. Local dependence was dealt with through the creation of 2 super items. Thereafter, fit to the Rasch model (χ(2)=5.21; P=.27) and targeting to the latent trait were good, and thresholds ordered. Separation reliability was poor (Person-Separation Index, .67). CONCLUSIONS:The 10-item SIPSO is a valid ordinal scale in a population including older stroke survivors. A physical and social subscale structure is also supported. Subscales can be manipulated to fit the Rasch model, and a conversion table for conversion to an interval scale is provided. The social subscore has poor separation reliability, limiting its use in older stroke survivors.

journal_name

Arch Phys Med Rehabil

journal_title

Archives of physical medicine and rehabilitation

authors

Teale EA,Munyombwe TM,Young JB

doi

10.1016/j.apmr.2013.08.243

subject

Has Abstract

pub_date

2013-12-01 00:00:00

pages

2448-2455

issue

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(13)00894-0

journal_volume

pub_type

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Scaling properties of the subjective index of physical and social outcome after stroke in a study population unselected by age.