Health Services Research & Development

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2007 HSR&D National Meeting Abstract

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National Meeting 2007

3018 — The Reliability and Responsiveness of the Burden of Stroke Scale (BOSS)

Doyle PJ (VA Pittsburgh Healthcare System, GRECC and University of Pittsburgh School of Health & Rehabilitation Sciences) , McNeil MR (VA Pittsburgh Healthcare System and University of Pittsburgh School of Health and Rehabilitation Sciences), Bost JE (University of Pittsburgh School of Medicine), Ross KB (Carl T. Hayden VA Medical Center, Phoenix), Wambaugh JL (VA Salt Lake City Healthcare System, Salt Lake City), Hula WD (VA Pittsburgh Healthcare System)

Objectives:
The Burden of Stroke Scale (BOSS) is a patient-reported assessment of functioning and well-being whose scale properties, factor structure, and known-groups validity have been reported in a sample of chronic, community-dwelling stroke survivors with and without communication disorders (1). This study examined the test-retest reliability, convergent validity, and responsiveness of the BOSS in a sample of stroke survivors during their first year of recovery.

Methods:
Participants (n=178) were assessed twice (T1 and T2) at 3 months post onset (MPO) of stroke and again at 6 (T3) and 12 (T4) MPO. Test-retest reliability of the BOSS was evaluated by calculating 95% confidence intervals of T1-T2 difference scores and intraclass correlation coefficients (ICCs). Convergent validity was evaluated by calculating Pearson product moment correlation coefficients between T1 BOSS scores, and T1 scale scores from the Stroke Impact Scale (2) and MOS SF-36 (3) assessing similar health concepts. The responsiveness of BOSS scale scores at 6 and 12 MPO was evaluated by calculating standardized response means (SRM) and the probability of change statistic (phat) described by Zou (4).

Results:
Evaluation of test-retest reliability revealed ICCs ranging from 0.78 to 0.94. Evaluation of convergent validity for hypothesized scale associations revealed correlation coefficients ranging from -0.57 to -0.86. Evaluation of responsiveness in participants demonstrating clinically meaningful change from 3 to 12 MPO on SF-36 physical (PCS) and mental (MCS) components scales revealed SRMs ranging from .61 to 1.07 for 9 of 12 BOSS domain scales, and from .74 to 1.21 for its composite scales. Phat values ranged from .61 to .85 for BOSS domain scales, and from .77 to .90 for its composite and summary scores.

Implications:
The BOSS provided valid, reliable, and responsive score estimates of functioning and well-being in a sample of community dwelling stroke survivors.

Impacts:
The BOSS is a valid, reliable, and responsive patient-reported assessment of functioning and well-being that may be used to evaluate the consequences of stroke, its treatment, and rehabilitation outcomes.