Translation and Psychometric Evaluation of the Gujarati Version of Participation Scale for Stroke Patients: A Cross-sectional Study

Abstract

Introduction: Social participation is increasingly recognised as fundamental to stroke rehabilitation outcomes and quality of life. However, existing participation measures for stroke often face cultural and linguistic challenges when used with the Gujarati population. The Participation Scale (PS) provides a culturally appropriate, comprehensive tool for evaluating participation restrictions across various conditions but has yet to be validated for Gujarati-speaking stroke patients. Aim: To estimate the reliability and validity of the Gujarati version of the PS-V6.0 among Gujarati-speaking stroke patients. Materials and Methods: This cross-sectional observational study was conducted between February 2022 and December 2022 at the Ashok & Rita Patel Institute of Physiotherapy, Charotar University of Science and Technology (CHARUSAT), Anand, Gujarat, India. The study involved a convenience sample of 86 stroke participants. The Gujarati version of the PS-V6.0, the Modified Rankin Scale (mRS), the Social Domain of Stroke Impact Scale (SIS-S), and the Barthel Index (BI) were administered during the initial visit. The Gujarati PS was administered again after one week. Psychometric testing of the scale included an investigation of internal consistency measured by Cronbach’s alpha, the Intraclass Correlation Coefficient (ICC) for test-retest reliability, and construct validity (known group and convergent validity). Result: The study included 86 stroke patients aged 50.47±14.13 years (59.3% males), with a mean stroke duration of 19.31±20.16 months. The Gujarati PS scale items demonstrated good internal consistency (Cronbach’s alpha=0.875). Test-retest reliability revealed a high correlation (ICC=0.998). Construct validity was confirmed by a moderate correlation with SIS-S (r-value=-0.507, p-value <0.001) and BI (r-value=-0.434, p-value <0.001). The scale differentiated patients with low and high disability severity (with a mean difference of 21.48, 95% CI=13.4 to 29.5). Conclusion: The Gujarati version of the PS is a reliable and valid patient-reported clinical instrument for the assessment of social participation in Gujarati-speaking stroke patients.

Keywords

• construct validity
• known-group validity
• test-retest reliability