• Tzu-Kuan Sun, Su-Chen Chiu, Shu-Hui Yeh, and Ku-Chou Chang.
• Department of Nursing, Chang Gung Memorial Hospital, Kaohsiung, #123, Ta-Pei Rd, Niao-Sung Hsiang, Kaohsiung County, Taiwan. 2244@adm.cgmh.org.tw
• Int J Nurs Stud. 2006 May 1; 43 (4): 457-63.

BackgroundThe National Institutes of Health Stroke Scale (NIHSS) is a systematic, 15-point evaluation tool, designed to assess neurological deficit in acute stroke patients and written in English. It is used to support important medical and nursing decisions.ObjectivesTo translate the NIHSS into Chinese and establish its psychometric properties using Chinese evaluators.DesignMethodological research design.SettingOne medical centre.ParticipantsUsing convenience sampling, 48 subjects admitted with acute ischemic stroke were selected.MethodsIn this study, six clinicians from the Department of Neurology (3 nurses, 3 doctors) assessed the 48 patients using the C-NIHSS, the Glasgow Coma Scale and the Barthel index.ResultsThe C-NIHSS content validity index reached 1.00, and the Cronbach's alpha coefficient for internal consistency was 0.92. Of the 15 scale items, two (facial palsy and limb ataxia) had low inter-rater values (k values below 0.39). Kappa (kappa) values were substantial (over 0.60) for all other items. The C-NIHSS has a significantly negative correlation with both Glasgow Coma Scale (r = -0.824, p < 0.01), and Barthel index (r = -0.683, p < 0.01) scores.ConclusionsThe C-NIHSS is a reliable and valid scale for the clinical assessment of neurological deficit in acute stroke patients.

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