Development and validation of NEWSQOL, the Newcastle Stroke-Specific Quality of Life Measure

Cerebrovasc Dis. 2004;17(2-3):143-52. doi: 10.1159/000075783. Epub 2003 Dec 23.


Background: A review of stroke-specific quality of life (QOL) measures indicated little evidence of their validity/reliability.

Purpose: To describe the development/validation of a new measure - the Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL).

Methods: Phase I: qualitative interviews (28 stroke patients) determined QOL issues for inclusion in the measure. Initial items/response categories were pre-tested (30 patients). Administration of the NEWSQOL in the item reduction stage (100 patients) identified poorly performing items and factor analysis showed likely domains. Internal consistency was examined. Phase II: NEWSQOL and comparator measures were administered (106 patients) to examine validity/test-retest reliability.

Results: Phase I: 140 items were identified for initial inclusion. Qualitative pre-testing led to an extensive revision. Item reduction resulted in a final measure of 56 items in 11 domains (feelings, activities of daily living/self-care, cognition, mobility, emotion, sleep, interpersonal relationships, communication, pain/sensation, vision, fatigue; Cronbach's alpha = 0.71-0.90). Phase II: NEWSQOL domain scores, except cognition, were moderately/highly correlated (0.45-0.76) with relevant comparator measures. NEWSQOL domains feelings, communication and cognition low/moderately correlated with Barthel Index scores (-0.49 to -0.28), as predicted. Test-retest reliability was high (intraclass correlation coefficient range 0.78-0.92).

Conclusions: NEWSQOL is an acceptable, patient-derived, interviewer-administered, stroke-specific QOL measure with evidence of reliability and validity, making it a promising instrument for assessing QOL after stroke. Involvement of relevant patients in determining the content and format considerably enhances confidence in its validity.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aphasia / diagnosis
  • Aphasia / psychology
  • Cognition Disorders / diagnosis
  • Cognition Disorders / psychology
  • Disability Evaluation
  • Dysarthria / diagnosis
  • Dysarthria / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient-Centered Care
  • Quality of Life*
  • Reproducibility of Results
  • Stroke / diagnosis*
  • Stroke / psychology*
  • Surveys and Questionnaires*