Validation of the Stroke-specific Quality of Life for patients after aneurysmal subarachnoid hemorrhage and proposed summary subscores

Abstract

Background: The identification of aneurysmal subarachnoid hemorrhage (aSAH) patients with a decrease in health-related quality of life (HRQOL) is challenging. Failure of clinical trials has been partially attributed to lack of sensitivity in outcome measures. Stroke-specific Quality of Life (SS-QOL) is a disease-specific HRQOL tool widely applied in ischemic stroke researches, but not in aSAH. Aim: This study aimed to validate a Chinese version of SSQOL (SS-QOL-CH) for aSAH patients and proposed summary scores for clinical application. Methods: We carried out a prospective observational assessor-blinded multi-center study in Hong Kong. One hundred and four Chinese adults were recruited into the current study, and assessments of the outcome of aSAH patients were made 3 months after ictus. Results: Internal consistency was good and supported convergent validity for 12 domains of the SS-QOL-CH, with Cronbach's α coefficients ranging from 0.73 to 0.98. Principal component analyses suggested a two-component solution to explain a total of 65% variance. The two-component solution showed no significant floor or ceiling effects in our aSAH population. Validity of the criteria for the physical and psychosocial subtotal scores showed relevant and distinct correlations with other outcome measures. Conclusions: Dichotomization of physical and psychosocial subtotal scores is valid and can simplify applications of the scale. © 2012 Elsevier B.V.