Stroke Social Network Scale: development and psychometric evaluation of a new patient-reported measure

Objective: To describe the development and psychometric evaluation of a new patient-reported measure that assesses a person's social network in the first six months post stroke. Although it is known that the social networks of those with stroke and aphasia are vulnerable to change, there is currently no social network scale that has been validated for this population.

Design and setting: Repeated measures psychometric study, evaluating internal consistency, construct validity, and responsiveness to change of the Stroke Social Network Scale. Participants were interviewed two weeks, three months and six months following a first stroke.

Measures: Stroke Social Network Scale; Medical Outcomes Studies (MOS) Social Support Survey; National Institute of Health Stroke Scale; Stroke and Aphasia Quality of Life Scale-39g; Frenchay Aphasia Screening Test.

Results: 87 participants were recruited, of whom 71 were followed up at six months. Factor analysis was used with the Stroke Social Network Scale to derive five subdomains: satisfaction; children; relatives; friends; and groups, which explained 63% of variance. There was good evidence for the scale's internal consistency (α = 0.85); acceptability; and convergent (r = 0.34; r = 0.53) and discriminant validity (r = -0.10; r = -0.19). It differentiated between those with high versus low perceived social support (p = 0.01). Moderate changes from two weeks to six months supported responsiveness (d = 0.32; standardised response mean (SRM) = 0.46), with the friends factor, as expected, showing more change than the children's factor (friends factor: d = 0.46; SRM = 0.50; children's factor: d = 0.06; SRM = 0.19).

Conclusions: The Stroke Social Network Scale is a new measure that demonstrates good internal consistency, validity and responsiveness to change.