Supplementary Material for: Which Is More Valid for Stroke Patients: Generic or Stroke-Specific Quality of Life Measures?

<i>Background:</i> It remains unclear whether a generic or specific health-related quality of life (HRQOL) measure is more valid for stroke. <i>Aim: </i>The aim of this study is to compare the validity of SF-36, a generic measure, and HRQOL in stroke patients (HRQOLISP), a stroke-specific measure, for assessing post-stroke HRQOL. <i>Methods:</i> The validity of HRQOLISP and SF-36 was compared in a cross-sectional study of 100 stroke survivors. The Stroke Levity Scale and modified Rankin Scale were applied to measure stroke severity and disability, respectively. <i>Results:</i> Both measures exhibited adequate ‘known-groups’ and construct validity. However, the SF-36 lacked content validity for the cognitive domain and personal constructs including spiritual functioning. Most SF-36 subscales had substantial floor or ceiling effects. The HRQOLISP demonstrated better content and internal consistency validity and no significant floor or ceiling effect. <i>Conclusions:</i> Like other stroke-specific measures, HRQOLISP was better than SF-36 in most parameters of validity considered. The SF-36 is designed for comparison among different diseases and may not be suitable for clinical trials or studies of internal adaptation, cognitive or spiritual functioning in stroke. This is because it lacks content validity for these domains and may underestimate health changes in most subscales.

<i>背景：</i>目前尚不清楚通用型健康相关生活质量（Health-related Quality of Life, HRQOL）评估工具，抑或是卒中特异性健康相关生活质量评估工具，对卒中患者而言更具效度。<i>目的：</i>本研究旨在比较通用型评估工具SF-36与卒中特异性评估工具卒中患者健康相关生活质量量表（Health-related Quality of Life in Stroke Patients, HRQOLISP）在评估卒中后健康相关生活质量时的效度。<i>方法：</i>本研究纳入100名卒中幸存者开展横断面研究，比较HRQOLISP与SF-36的效度。分别采用卒中严重程度量表（Stroke Levity Scale）与改良Rankin量表（modified Rankin Scale）评估卒中严重程度与残疾状态。<i>结果：</i>两类评估工具均展现出良好的已知群组效度与结构效度。但SF-36在认知领域及包括精神功能在内的个人维度上缺乏内容效度；多数SF-36分量表存在显著的地板效应或天花板效应。HRQOLISP则展现出更优的内容效度与内部一致性效度，且无明显地板或天花板效应。<i>结论：</i>与其他卒中特异性评估工具一致，HRQOLISP在多数考察的效度指标上均优于SF-36。SF-36原本设计用于跨疾病人群的比较，或并不适用于卒中患者的临床试验、内部适应性研究，以及认知或精神功能相关研究。究其原因，该量表在上述维度缺乏内容效度，且多数分量表可能低估健康状态的变化。