Health-related quality of life after stroke: reliability and validity of the Duke Health Profile for use in Vietnam

INTRODUCTION: Health-related quality of life (HRQoL) is commonly used to assess outcomes after stroke. The Duke Health Profile (DHP) has been translated and culturally adapted for use in Vietnam, but its reliability and validity for use with stroke patients in Vietnam or elsewhere have not been assessed.

METHODS: First-ever stroke patients (n = 108) who were admitted to 115 People's Hospital between February and September 2012 and survived for 3 months after stroke had HRQoL assessed using the DHP and a comparison instrument (EQ-5D). Caregivers of 94 patients completed these questionnaires as a proxy. After 1 week, these questionnaires were re-administered to patients and proxies.

RESULTS: The mean differences between test and retest assessments of HRQoL by patients were small and not clinically meaningful and were not consistently associated with sex, age, type of stroke or severity of impairment or disability. Direct assessments by the patient were on average greater than those obtained from the proxy. The ICCs ranged from 0.60 to 0.86 (patient test-retest) and from 0.55 to 0.98 (patient-proxy agreement). The ICCs were greatest for physical functioning components (patient test-retest 0.63-0.86, patient-proxy 0.69-0.98). The correlations between the DHP dimensions and EQ-5D were generally stronger when they measured similar constructs (r = 0.53-0.66) and were lower for less related constructs (r = 0.11-0.43).

CONCLUSION: The DHP has moderate reliability and validity for use with stroke patients in Vietnam even when information is obtained from proxy respondents.