Symptoms Of Stroke Patients With Spastic Hemiplegia Evaluation And Methodology Discussed

BackgroundApoplexy is a kind of disease that has high incidence rate, high mortality rate and high disability rate. The disability rate of apoplexy is up to 75% in China. Lots of clinic researches about apoplexy report that the western medicine and the Traditional Chinese Medicine both have satisfying therapeutic effect on stroke and apoplexy spastic-paralysis, especially the TCM therapy can improve the symptoms of apoplexy spastic-paralysis patients such as pain, numbness, freeze, etc. However, these symptoms in which the patients and clinic doctors are interested have not aroused the effect valuator's recognition and have not used as index of effect evaluation. The same problem exists in not only the evaluation of apoplexy spastic-paralysis, but also the effect evaluation of TCM treating other chronic and complex diseases. The problem equally exists in other chronic diseases treated with TCM. The symptom improvement cannot be evaluated comprehensively and exactly with the available measuring scale, during recent decades, it has made great progress at the evaluation of Patient-reported Outcomes in the international. It is out of question that the great progression in PRO evaluation provides methodological reference for exploring private prosecution symptoms and develops a brand-new pathway for establishing TCM therapeutic effect evaluation system with its own feature. ObjectiveTo quantize and measure the symptoms reported by apoplexy spastic-paralysis patient. ThinkingEmploying the social research method of collecting information, referring to the technology of Quality of Life (QOL) scale and combining the inquiring of Traditional Chinese Medicine, the research group began with the apoplexy spastic-paralysis patients reported symptoms, confirmed the evaluation index of apoplexy spastic-paralysis at the end of the research and measured the index.MethodBased on the apoplexy spastic-paralysis patient-reported outcomes, our research group operationalized the conception of apoplexy spastic-paralysis patients' clinical symptoms based on the patients' subjective symptoms. Firstly, we collected the self-sensation symptoms of apoplexy spastic-paralysis patients by performing inquiring, open interview and searching literatures;secondly, established item pool and ascertained the index dimensions;then designed the PRO questionnaire. To validate the questionnaire, 93 patients with apoplexy spastic-paralysis were enrolled to answer the questionnaire from fore hospitals to answer the questionnaire from Gang'an men Hospital, the Beijing TCM Hospital, HuGuoSi Hospital, Beijing XuanWu Hospital. Each patient was asked to answer the questionnaire twice in 2 to 3 weeks. The research group used the SPSS software to analyse the reliability, validity and responsibility of the questionnaire .At the same time, compared with the existing Ashworth Spasticity Scale (ASS), it had confirmed "the patient-reported self-sensation symptoms principium questionnaire of apoplexy spastic-paralysis", founded the basic of "the patient-reported self-sensation symptoms scale of apoplexy spastic-paralysis", and summarized the exploring the pathway to found the effect evaluation symptom based on Patient-Reported Outcomes. Result1 Comfirming the index of apoplexy spastic-paralysis patients' reported self-sensation symptoms;2 Designing the "self-evaluating primary questionnaire for apoplexy spastic-paralysis patients";2 93 patients received investigation twice in 2 to 3 weeks, and then researchers analyzed the reliability and validity of the questionnaire. The statistical results suggested that the Cronbach's Reliability Coefficients Alpha of the questionnaire exceeds 0.808, indicating the questionnaire has perfect internal consistency. Reliability of the questionnaire is good .The analysis of validity indicated the validity according with the standard. The questionnaire ultimately was established;3 Performing a small sample pilot study on 93 patients using the confirmed questionnaire. Results show that the indexes change with treatment and suggest good applicability of the questionnaire.Discussion1 Attaching importance to the patients' complaints and quantizing the clinical self-sensation symptoms that collected through inquiring of TCM and transforming it to measurable objective indexes. 2 Patient-reported outcomes are important index with which could reflected the therapy effect, however it is significant for the clinical effect evaluation. 3 Employing the social researching methodology and the knowledge of developing scale ,the group established the questionnaire based on the apoplexy spastic-paralysis patients 'clinical symptoms, which settled the foundation for future measuring scale making, complementing the deficiency of the apoplexy spastic-paralysis' effect evaluation index. 4 Exploring the technology of establishing PRO evaluating system. 5 Analysing the shortage of our research and discussing the possible way to selltle these problems.