Content comparisons of stroke-specific quality of life based upon the international classification of functioning, disability, and health.

PURPOSE: To link the concepts underlying the Stroke-Specific Quality of Life (SS-QOL) scale with those of the International Classification of Functioning, Disability, and Health (ICF), which are two different perspectives to consider functioning and health. This will facilitate the understanding of the relationships between the SS-QOL and the ICF. One of the purposes of the ICF is to be used as a common terminology and a clinical problem-solving tool in clinical and research settings. The ICF concept of functioning can also serve as the basis for the operationalization of the health-related quality of life. Thus, efforts should be made to allow the concurrent use of the ICF and health measurements in both clinical and research settings.

METHODS: Linking of the SS-QOL concepts with the ICF categories was carried out by two independently trained health care professionals who applied the standardized eight linking rules that were specifically developed and updated for this purpose. The degree of agreement between the health care professionals was determined by kappa coefficients.

RESULTS: Of the 49 items of the SS-QOL, 54 concepts were identified. The level of agreement between the health care professionals showed that the kappa coefficients ranged from 0.75 to 1.00. Three concepts (5.5%) could not be linked to the ICF and were coded as not covered. Fifty-one were linked to the ICF categories for the following components: 22 (41%)-body functions; 26 (48%)-activities and participation; and three (5.5%)-environmental factors. Eleven ICF chapters were identified.

CONCLUSIONS: Several categories of the ICF were linked to the items of the SS-QOL, with acceptable levels of agreement. These categories were specific and meaningful for stroke subjects, since the majority of the identified concepts were included in the comprehensive ICF core set for stroke. The findings indicated that the ICF provided a useful framework for the conceptual understanding of the SS-QOL, which demonstrated multiple representations of the ICF categories and covered a broad range of the ICF components that were meaningful for the stroke subjects.