Background: In Iran, a Middle-East country, no disability scale has been translated and validated for use in stroke clinical trials. This study was designed to translate the Barthel Index and make its Persian translated form valid and reliable. Methods: All items of the Barthel Index were translated into Persian. Also, the Modified Rankin Scale (MRS) was also translated to Persian. Telephone interview was used as the method of data acquisition. Two interviewers were chosen for this means in order to accelerate data gathering and measure interrater agreement. Samples were selected from Isfahan Cardiovascular Research Center’s Stroke Registry Unit, a WHO collaborating center in the center of Iran. All the patients were registered as stroke or intracerebral hemorrhage (ICH). These patients were inhabitants of Isfahan Province who had suffered from stroke or ICH between 12 and 24 months before data acquisition. Chronbach’s alpha, test-retest reliability, concurrent validity with MRS, interrater agreement and item analysis were done for the translated questionnaire. Results: Translated questionnaires were filled by interview from 459 stroke patients. Their mean age was 68.11 ± 11.59 years. 243 of them were male (52.9%). Cronbach’s alpha was 0.9354. Spearman’s correlation coefficient between translated Barthel Index scores and MRS scores was –0.912. Spearman’s correlation coefficient between 2 scores, to determine test-retest reliability was 0.989. Concordance correlation to determine interrater agreement was 0.994. All corrected item–total correlations were greater than 0.5. Conclusions: The Persian translated version of the Barthel Index is a reliable and valid questionnaire for use in stroke clinical trials.
Background: In Isfahan, a city in the middle of Iran, a community intervention trial has been started for cardiovascular disease prevention and control via reducing its risk factors and improvement of relevant healthy behavior. A surveillance system was needed to monitor vascular diseases, especially stroke, during and following this community intervention program. Methods: A prospective study on hospitalized stroke patients was done in Isfahan, Iran, from 2000 to 2003. All hospitalized stroke events were recorded via a system adopted from the World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease (MONICA) project, yet ignoring the MONICA age limitation. The age-adjusted hospital admission rate was calculated. Patients and/or their families were followed and asked regarding the patients’ survival status. Results: The age-adjusted hospital admission rate in Isfahan was increasing from 2000 to 2003 (rising from 84.16 to 103.23/100,000). The 28-day case fatality rates were nearly the same during these years and were about 32%. Ischemic stroke events made up the majority of cases (about 70%), and intracerebral hemorrhage events had the second highest prevalence (25%). Conclusions: This study showed that the stroke hospital admission rate might be increasing in Isfahan. A community-based stroke incidence study is needed to elucidate stroke epidemiology in Isfahan, Iran, as a Middle East country.
Developing interventions to address special needs of young, obese, smoker male patients who have a lower waist-to-hip ratio and higher clinical risk may be important, especially in attempts to retain this high-risk group in cardiac rehabilitation therapy.
Coping strategies of the population in central Iran were highly influenced by socioeconomic status and life-style factors. Programs aimed at improving healthy life-styles and increasing the socioeconomic status could increase adaptive coping skills and decrease maladaptive ones and consequently lead to a more healthy society.
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