Tele-assessment of activities and participation in chronic phase of stroke: Is use valid and viable in a developing country?

Abstract

Background

SATISPART-Stroke (SATIS-Stroke) is the most complete instrument for the assessment of activity and participation following a stroke. However, its use in a developing country has only been tested through in-person interviews.

Objective

To determine the validity, reproducibility and viability of the SATIS-Stroke scale administered in two tele-assessment modalities: self-assessment of an electronic form versus videoconference.

Methods

Methodological study with Brazilian chronic stroke survivors was conducted. Stage I comprised an in-person interview to apply the SATIS-Stroke and a self-assessment by completing an electronic form to respond to the SATIS-Stroke items. Step II occurred 6 to 8 months after Step I, during which SATIS-Stroke was administered again in-person and via videoconference. The order was randomized.

Results

Ninety-five stroke survivors were recruited, but only 50 answered the electronic form (adherence: 52.6%). Mean scores were higher in the self-administration of electronic form compared to the in-person interview (mean difference = −0.36 ± 0.93; P = 0.009). Adequate reliability was found in the comparison of the in-person and self-assessment of electronic form (ICC_2,1 = 0.66; 95%CI: 0.40–0.81). Fifty stroke survivors participated in Step II, during which adequate reliability was found in the comparison of the in-person administration and videoconference (ICC_2,1 = 0.55; 95%CI: 0.21–0.74) and a moderate correlation was found between the assessment methods (r = 0.43; P = 0.02).

Discussion

Adequate validity and reliability were found in the tele-assessment. Thus, this method is appropriate and viable for use in developing countries. Although reliable, the self-assessment did not have good adherence in the Brazilian population due to internet access problems, lack of familiarity with the digital form and lack of autonomy to answer the questions alone.