Localization And Evaluation Of The Nottingham Extended Activities Of Daily Living Scale

ObjectiveThe purpose of this study was to localize and cross-cultural adapt the Nottingham Extended Activities of Daily Living Scale(NEADL),evaluate the reliability and validity of the Chinese version of the NEADL scale.Analyze the status quo of instrumental activities of daily living and explore the influencing factors of instrumental activities of daily living in stroke patients.To provide research tools and theoretical basis for the effect evaluation of rehabilitation nursing for stroke patients.MethodsIn this study,the English version of Nottingham Extended Activities of Daily Living Scale was translated,translated back and culturally adjusted by adopting Brislin double translating reversion method.Finally,the Chinese version of the NEADL scale was obtained.509 stroke patients from two top three hospitals in Jinzhou City and Chaoyang City of Liaoning Province were selected as the research objects by convenience sampling method.The general information questionnaire,the Chinese version of the NEADL scale and Modified Barthel Index Rating scale(MBI)were used for questionnaire investigation.SPSS25.0and AMOS23.0 were used to analyze the general data,reliability,validity and influential factors of instrumental activities of daily living level.Cronbach’sαcoefficient,split half reliability,retest reliability and the reliability of the calibrated item-total correlation were used to evaluate the reliability of the scale.Item analysis was performed by item-total score correlation coefficients and discriminant validity was evaluated by item critical ratio value(CR).The validity of the scale was evaluated by content validity,structure validity and criterion correlation validity.Variance analysis,independent sample t-test,descriptive analysis and multiple linear regression were used to analyze the differences of instrumental daily living level among different variables and the influence factors of instrumental activities of daily living level in stroke patients.Results1.General Information:In this study,a total of 520 questionnaires were distributed and 509 valid questionnaires were collected.The effective recovery rate 97.88%.There were 293 males and 216 females.The age ranged from 18to 94 years and the average age was(64.32±12.33).2.Reliability:The Cronbach’sαof the Chinese version of the NEADL scale was 0.950,the split-half Cronbach’sαwas 0.964 and the test-retest reliability coefficient was 0.916.The corrected item-total correlation range was 0.345 to0.797.3.Item analysis and discrimination:Correlation coefficient of each item-total score of the Chinese version of the NEADL scale was 0.386-0.821.The discriminant validity was statistically analyzed using the critical ratio of items(CR)as the standard,and the results showed that the discriminant validity of each item was good(P<0.01).4.Validity:For content validity,the item level content validity index(I-CVI)ranged from 0.833 to 1.000,the scale level content validity index(S-CVI/UA)was 0.818,and the average scale level content validity index(S-CVI/AVE)was0.969.In criterion correlation validity,there was a significant positive correlation between the total score of the Chinese version of the NEADL scale and the total score of MBI(P<0.01),and the correlation coefficient r was 0.709.In the construct validity,exploratory factor analysis obtained four common factors,and the cumulative contribution rate of variance was 66.574%.The confirmatory factor analysis showed thatx~2/df was 1.777,CFI was 0.965,GFI was 0.887,AGFI was 0.855,RMR was 0.048,RMSEA was 0.056.5.Analysis of the status quo of instrumental activities of daily living in stroke patients:The results of this study showed that the level of instrumental activities of daily living(IADL)of stroke patients decreased with age.In addition,the scores of patients who had received rehabilitation treatment were higher than those who had not received rehabilitation treatment,and the overall scores of patients with ischemic stroke were higher than those of patients with hemorrhagic stroke.There were also significant differences in scores among different caregivers.The scores of patients whose primary caregivers were children and employees were lower than those whose spouse was the primary caregiver.Conclusions1.The Chinese version of NEADL scale had good reliability and good internal consistency,and the validity of Chinese version of NEADL scale was good,and all indicators of confirmatory factor analysis met the acceptable fit standard.The correlation coefficient with MBI scale reached a good level.It could be used as a tool to assess the level of instrumental activities of daily living of Chinese stroke patients.2.The instrumental activities of daily living level of stroke patients measured by the Chinese version of NEADL scale was affected by age,stroke type,whether or not they had received rehabilitation treatment,primary caregivers.It can improve the instrumental activities of daily living level by improving the influencing factors of instrumental activities of daily living level.More attention should be paid to the rehabilitation of patients’instrumental activities of daily living.