Validation of the Stroke Specific Quality of Life scale in patients with aneurysmal subarachnoid haemorrhage

Background and purpose Disease specific quality of life measures have been validated for patients with ischaemic stroke and intracerebral haemorrhage, but not for patients with aneurysmal subarachnoid haemorrhage (SAH). The aim of this study was to validate the Stroke Specific Quality of Life (SS-QoL) scale for patients with SAH. Methods Cross sectional survey of 141 aneurysmal SAH patients. Construct and criterion validity were studied and various ways to merge the 12 SS-QoL domains into a limited number of subtotal scores were explored. Statistics included assessing score distributions, Cronbach's alpha, principal components analysis (PCA) and Spearman correlations between SS-QoL and the Glasgow Outcome Scale (GOS), Cognitive Failures Questionnaire (CFQ), Life Satisfaction-9 (LiSat-9) and Hospital Anxiety and Depression Scale (HADS). Results PCA revealed two components reflecting physical health and psychosocial health with a mutual correlation of 0.73. A ceiling effect was present for 10 out of 12 domains and for the physical component. Internal consistency was good for all 12 domains (alpha >= 0.80), two components (a >= 0.95) and the total score (0.97). Physical SS-QoL scores showed weak to moderate correlations (0.24-0.32) with the GOS. All SS-QoL scores showed moderate to strong correlations (0.35-0.72) with the CFQ, LiSat-9 and HADS. Conclusions The SS-QoL is a valid measure to assess quality of life in patients after aneurysmal SAH. Using physical and psychosocial SS-QoL summary scores simplifies the use of this measure without concealing differences in outcomes on different quality of life domains.