Development and validation of ‘Cognitive Assessment Scale for Stroke Survivors’

Abstract

Background & Objectives: Stroke is a leading cause of death and it causes significant long-term disabilities. It affects cognition and physical impairment in the patients. Cognitive impairments caused by stroke include loss of memory, disorientation, impaired attention, reasoning, and social perception. It may also lead to interaction deficit and inability to problem-solving, etc. The precise knowledge about the degree of cognitive impairment is essential to address the issue with appropriate measures. We aimed to develop a cognitive measurement scale for stroke patients.

Methodology: The phenomenon was explored through in-depth interviews of 12 stroke survivors in different hospitals in Lahore, Pakistan. Seventeen items were generated. After factor analysis, 15 items were included in the scale and a pilot study was conducted on 15 participants. A sample of 106 patients was selected to administer the scale Cognitive Assessment Scale for Stroke Survivors (CASS) and Mini-Mental State Examination (MMSE) scale for concurrent validity.

Results: The Principal Component Factor Analysis through Varimax rotation yielded three factors, e.g., ‘Social Cognition’, ‘Focus and Attention’, and ‘Orientation’. The results have shown significant values with good psychometric properties. The Cronbach’s Alpha value of the developed scale is 0.88 which indicates it as a highly reliable scale.

Conclusion: This research reported that stroke survivors experience cognitive impairment after the stroke incidents. The developed scale to measure cognitive impairment after a stroke incident was proved to be valid and reliable, and can be used in medical practice.

Abbreviations: CASS – Cognitive Assessment Scale for Stroke Survivors; MMSE – Mini-Mental State Examination.

Citation: Qamar S, Iqbal MN, Rafiq M, Ismat Ullah Cheema IU, Masood K. Development and validation of ‘Cognitive Assessment Scale for Stroke Survivors’. Anaesth. pain intensive care 2022;26(4):663-668.

DOI: 10.35975/apic.v26i4.2025