The reliability and validity of developing a Chinese Version of a New Toileting Tasks

Abstract

Abstract Background: Stroke has become an increasingly serious public health issue worldwide,The assessment of stroke patients' ability to use the toilet can help medical staff master the recovery of patients' daily living ability.This study aimed to present study developed a Chinese version of the toileting tasks assessment form (TTAF) for toileting capacity assessment of patients with Hemiparetic Stroke in China. Methods: This work was carried out strictly in accordance with the Brislin translation model. After which, the reliability and validation of the new developed scale was estimated. 200 hemiparetic stroke patients (149 females, mean age 66.5 ± 9.5 years) were recruited from the first affiliated hospital of the University of Science and Technology of China to complete the scales. The reliability analysis methods included homogeneity reliability, split-half reliability and test-retest reliability. And the reliability was estimated with intraclass correlation coefficient [ICC], internal consistency (Cronbach’s α). The validity analysis was evaluated by surface validity, content validity and construct validity, and Spearman’s rank correlation coefficients was applied. Afterwards, exploring factor analysis and item analysis method were adopted to screen out the potential items within the scale. We used item analysis method and exploring factor analysis to screen the items. Results: The Chinese version of TTAF covered 3 dimensions and 24 items: factor 1 (Starting movement of upper limbs, 6 items), factor 2 (Starting movement of lower limbs, 11 items）, factor 3 (Starting movement of Squats, 7 items). The TTAF showed excellent internal consistency (Cronbach’s α = 0.943) and substantial test-retest reliability (ICC = 0.92, 95% confidence interval（CI）: 0.87-0.95). Fleiss’ κ coefficient for inter-rater reliability for each form item was 0. 78 to 1.00. Cohen’s κ coefficient for intra-rater reliability for each item was 0.68 to 0.96. Spearman’s rank correlation coefficients for the mean score on our form and Barthel Index (BI) score for “toileting” ranged from 0.631- 0.893 (p < 0.001). The results of confirmatory factor analysis showed that the load values of 14 items were 0.547-0.858 (p < 0.01). The fitting indexes of the final model are as follows: χ2/df=1.131, RMSEA=0.084, CFI=0.911, NFL=0.861. The results showed that the model fit well. Conclusion: The Chinese version of the TTAF scale had relatively high reliability and validity. It provides a reference basis for analyzing the influencing factors of metastasis disorder in stroke patients and formulating prevention and intervention measures through scale evaluation.