Validity and Reliability of the Persian Versions of National Institute of Health Stroke Scale and Modified National Institute of Health Stroke Scale in Hospitalized Patients

  • Reza Dehghani 1. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2. Department of Pharmacology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  • Afshin Borhanihaghighi 1. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2. Department of Neurology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  • Abdolhamid Shariat 1. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2. Department of Neurology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  • Mohammad Nami 1. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2. Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
  • Masoume Nazeri 1. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2. Department of Neurology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  • Amin Abolhasani Foroughi 1. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2. Department of Radiology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  • Samrad Mehrabi Sleep Disorders Laboratory, Division of pulmonology, Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  • Masoumeh Emamghoreishi 1. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2. Department of Pharmacology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran 3. Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
DOI: https://doi.org/10.31661/gmj.v8i0.1188
Keywords: National Institute of Health Stroke Scale, Modified National Institute of Health Stroke Scale, Persian Version, Stroke

Abstract

Background: National Institute of Health Stroke Scale (NIHSS) and Modified National Institute of Health Stroke Scale (mNIHSS) are two valid and reliable questionnaires that assess stroke severity. This study aimed to examine and compare the validity and reliability of Persian versions of NIHSS and mNIHSS in hospitalized patients. Materials and Methods: The English versions of NIHSS and mNIHSS were translated to Persian (forward and backward), and three neurologists examined the face and content validity of both questionnaires. The Persian versions of NIHSS and mNIHSS were used in75 hospitalized stroke patients (hemorrhagic and obstructive) admitted to Namazi teaching hospital, Shiraz, Iran.The reliability and validity of the Persian versions were examined by Cronbach's alpha coefficient and convergent validity. Result: The values of Cronbach's alpha for Persian versions of NIHSS and mNIHSS were 0.81 and 0.86, respectively. The scaling success of convergent validity in NIHSS and mNIHSS were 80% and 100%, respectively. Conclusion: The Persian versions of NIHSS and mNIHSS were reliable and valid. However, mNIHSS was more valid and reliable than NIHSS. Persian version of mNIHSS can be suggested to be used for assessing stroke severity in hospitalized stroke patients by neurologists and researchers. [GMJ. 2019;8:e1188] 

References

Goldstein LB, Samsa GP. Reliability of the National Institutes of Health Stroke Scale. Extension to non-neurologists in the context of a clinical trial. Stroke; a journal of cerebral circulation. 1997;28(2):307-10.

https://doi.org/10.1161/01.STR.28.2.307

Adams HP, Jr., Davis PH, Leira EC, Chang KC, Bendixen BH, Clarke WR et al. Baseline NIH Stroke Scale score strongly predicts outcome after stroke: A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Neurology. 1999;53(1):126-31.

https://doi.org/10.1212/WNL.53.1.126

PMid:10408548

Kasner SE, Chalela JA, Luciano JM, Cucchiara BL, Raps EC, McGarvey ML et al. Reliability and validity of estimating the NIH stroke scale score from medical records. Stroke; a journal of cerebral circulation. 1999;30(8):1534-7.

https://doi.org/10.1161/01.STR.30.8.1534

Goldstein LB, Bertels C, Davis JN. Interrater reliability of the NIH stroke scale. Archives of neurology. 1989;46(6):660-2.

https://doi.org/10.1001/archneur.1989.00520420080026

PMid:2730378

De Haan R, Horn J, Limburg M, Van Der Meulen J, Bossuyt P. A comparison of five stroke scales with measures of disability, handicap, and quality of life. Stroke; a journal of cerebral circulation. 1993;24(8):1178-81.

https://doi.org/10.1161/01.STR.24.8.1178

Meyer BC, Hemmen TM, Jackson CM, Lyden PD. Modified National Institutes of Health Stroke Scale for use in stroke clinical trials: prospective reliability and validity. Stroke; a journal of cerebral circulation. 2002;33(5):1261-6.

https://doi.org/10.1161/01.STR.0000015625.87603.A7

Meyer BC, Lyden PD. The Modified National Institutes of Health Stroke Scale (mNIHSS): Its Time Has Come. International journal of stroke : official journal of the International Stroke Society. 2009;4(4):267-73.

https://doi.org/10.1111/j.1747-4949.2009.00294.x

PMid:19689755 PMCid:PMC2729912

Siniscalchi A, Sztajzel R, Malferrari G, Gallelli L. The National Institutes of Health Stroke Scale: Its Role in Patients with Posterior Circulation Stroke. Hospital topics. 2017:1-3.

https://doi.org/10.1080/00185868.2017.1322888

Daneshfard B, Izadi S, Shariat A, Toudaji MA, Beyzavi Z, Niknam L. Epidemiology of stroke in Shiraz, Iran. Iranian Journal of Neurology. 2015;14(3):158-63.

PMid:26622981 PMCid:PMC4662689

Tran J, Mirzaei M, Anderson L, Leeder SR. The epidemiology of stroke in the Middle East and North Africa. Journal of the neurological sciences. 2010;295(1-2):38-40.

https://doi.org/10.1016/j.jns.2010.05.016

PMid:20541222

Ghandehari K. Epidemiology of Stroke in Iran. Galen Medical Journal. 2016;5(S1):3-9.

Azarpazhooh MR, Etemadi MM, Donnan GA, Mokhber N, Majdi MR, Ghayour-Mobarhan M et al. Excessive incidence of stroke in Iran: evidence from the Mashhad Stroke Incidence Study (MSIS), a population-based study of stroke in the Middle East. Stroke; a journal of cerebral circulation. 2010;41(1):e3-e10.

https://doi.org/10.1161/STROKEAHA.109.559708

PMid:19926844

Kazemnejad-Leili E, Rezaei S, Hosseini-Nejad M, Bakhshayesh-Eghbali B, Saberi A, Keshavarz P. The Applicability, Concurrent Validity and Internal Consistency Reliability of the Persian Version of the National Institutes of Health Stroke Scale (NIHSS): Evidences for Gender Differences. gums-cjns. 2016;2(4):18-28.

https://doi.org/10.18869/acadpub.cjns.2.4.18

Fayers PM, Machin D. Sample Sizes. Quality of Life. John Wiley & Sons, Ltd; 2007. p. 247-69.

https://doi.org/10.1002/9780470024522.ch11

Parvizi MM, Amini M, Dehghani MR, Jafari P, Parvizi Z. Psychometric properties of the Persian version of the Ambulatory Care Learning Educational Environment Measure (ACLEEM) questionnaire, Shiraz, Iran. Advances in Medical Education and Practice. 2016;7:559-66.

https://doi.org/10.2147/AMEP.S112861

PMid:27729824 PMCid:PMC5047736

Tavakol M, Dennick R. Making sense of Cronbach's alpha. International Journal of Medical Education. 2011;2:53-5.

https://doi.org/10.5116/ijme.4dfb.8dfd

PMid:28029643 PMCid:PMC4205511

Sim J, Arnell P. Measurement validity in physical therapy research. Physical therapy. 1993;73(2):102-10; discussion 10-5.

https://doi.org/10.1093/ptj/73.2.102

PMid:8421716

Sun TK, Chiu SC, Yeh SH, Chang KC. Assessing reliability and validity of the Chinese version of the stroke scale: scale development. International journal of nursing studies. 2006;43(4):457-63.

https://doi.org/10.1016/j.ijnurstu.2005.07.004

PMid:16146632

Pezzella FR, Picconi O, De Luca A, Lyden PD, Fiorelli M. Development of the Italian version of the National Institutes of Health Stroke Scale: It-NIHSS. Stroke; a journal of cerebral circulation. 2009;40(7):2557-9.

https://doi.org/10.1161/STROKEAHA.108.534495

PMid:19520997

Dominguez R, Vila JF, Augustovski F, Irazola V, Castillo PR, Rotta Escalante R et al. Spanish cross-cultural adaptation and validation of the National Institutes of Health Stroke Scale. Mayo Clinic proceedings. 2006;81(4):476-80.

https://doi.org/10.4065/81.4.476

PMid:16610567

Berger K, Weltermann B, Kolominsky-Rabas P, Meves S, Heuschmann P, Bohner J et al. [The reliability of stroke scales. The german version of NIHSS, ESS and Rankin scales]. Fortschritte der Neurologie-Psychiatrie. 1999;67(2):81-93.

https://doi.org/10.1055/s-2007-993985

PMid:10093781

Kwah LK, Diong J. National Institutes of Health Stroke Scale (NIHSS). Journal of physiotherapy. 2014;60(1):61.

https://doi.org/10.1016/j.jphys.2013.12.012

PMid:24856948

Kasner SE, Cucchiara BL, McGarvey ML, Luciano JM, Liebeskind DS, Chalela JA. Modified National Institutes of Health Stroke Scale can be estimated from medical records. Stroke; a journal of cerebral circulation. 2003;34(2):568-70.

https://doi.org/10.1161/01.STR.0000052630.11159.25

Lyden PD, Lu M, Levine SR, Brott TG, Broderick J, Group NrSS. A modified National Institutes of Health Stroke Scale for use in stroke clinical trials: preliminary reliability and validity. Stroke; a journal of cerebral circulation. 2001;32(6):1310-7.

https://doi.org/10.1161/01.STR.32.6.1310

Published
2019-01-25
How to Cite
Dehghani, R., Borhanihaghighi, A., Shariat, A., Nami, M., Nazeri, M., Abolhasani Foroughi, A., Mehrabi, S., & Emamghoreishi, M. (2019). Validity and Reliability of the Persian Versions of National Institute of Health Stroke Scale and Modified National Institute of Health Stroke Scale in Hospitalized Patients. Galen Medical Journal, 8, e1188. https://doi.org/10.31661/gmj.v8i0.1188
Issue
Vol. 8 (2019): 2019
Section
Original Article

Authors who publish with this journal agree to the following terms:

  • Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
  • Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
  • Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).