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Importance: The Stroke Impact Scale 3.0 appears to be a promising outcome measure of health-related quality of life (HRQOL) for clients with stroke. However, because the factorial validity of the Stroke Impact Scale 3.0 remains unclear, its validity is limited. Objective: To examine the underlying structure of the Stroke Impact Scale 3.0 by comparing the currently available eight- and four-domain structures simultaneously. Design: Secondary data analysis of responses to the Stroke Impact Scale 3.0 from a previous psychometric validation study. Setting: Five general hospitals in northern and southern Taiwan. Participants: Two hundred sixty-three patients with stroke from rehabilitation wards (inpatients) and neurology and rehabilitation clinics (outpatients). Outcomes and Measures: Confirmatory factor analysis was used to examine the eight- and four-domain structures of the Stroke Impact Scale 3.0. Four fit indices were considered simultaneously to examine the model fits of both structures. Results: The eight- and four-domain structures of the Stroke Impact Scale 3.0 were not supported by all four indices (χ2/df = 2.7 and 5.0, comparative fit index = .79 and .86, root mean square error of approximation = .08 and .12, standardized root mean square residual = .08 and .08, respectively). The unidimensionality of each domain in the two structures was not supported. Conclusions and Relevance: Neither the eight- nor the four-domain structure of the Stroke Impact Scale 3.0 was supported, suggesting that scores may not provide valid assessments of HRQOL in clients with stroke. Further modification and validation of the Stroke Impact Scale 3.0 are warranted. What This Article Adds: Our findings suggest that the eight- and four-domain scores of the Stroke Impact Scale 3.0 may not be valid. Therefore, until more supporting evidence is developed, these scores should be interpreted cautiously in regard to clients’ HRQOL; alternatively, other measures could be used.

Importance: The most frequently used measures of facial emotion recognition (FER) are insufficiently comprehensive, reliable, valid, and efficient; moreover, the impact of gender on scoring has not been controlled. Objective: To develop a computerized adaptive test of FER for adults with schizophrenia. Design: First, we selected photographs from a published database. Second, items that fitted well to a Rasch model were used to form the item bank. Third and last, we determined the best administration mode for prospective users to achieve both high reliability and efficiency. Setting: Psychiatric hospitals and the community. Participants: Adults living with schizophrenia (n = 351) and adults without diagnosed mental illness (n = 101). Results: After removal of misfit items (infit or outfit ≥1.4), the remaining 165 items were selected to form an item bank. Among them, 39 showed severe gender bias, so the item difficulties were adjusted accordingly. On the basis of the item bank, two administration modes were recommended for prospective users. The reliable mode required approximately 128 items (nearly 20 min) to achieve reliability (.72–.81), similar to that of the entire item bank. The efficient mode required approximately 73 items (approximate 11 min) to provide acceptable reliability (.69–.73) for the seven domain scores. Conclusions and Relevance: Our newly developed measure provides comprehensive, valid, and unbiased (to examinees’ gender) assessments of FER in adults living with schizophrenia. In addition, the administration modes can be flexibly changed to optimize the reliability or efficiency for prospective users. What This Article Adds: This newly developed FER measure can help occupational therapists identify deficits in recognizing specific basic emotions and plan corresponding interventions to manage the impact on their clients’ social functions.

Date Presented 04/05/19 The Computerized Alternating Attention Test (CAAT) assesses alternating attention regularly in clinic and follow-up assessments in patients with schizophrenia. When performing the CAAT, subjects were required to alternately judge two types of rules: digit and shape. A shorter time for completing the CAAT indicates better alternating attention. Our validation of CAAT indicated that the CAAT had the acceptable test-retest agreement, negligible practice effect, and acceptable concurrent validity. Primary Author and Speaker: Wen-Chyn Lue Contributing Authors: Gong-Hong Lin, Shu-Chun Lee, Ching-Lin Hsieh