Validação do questionário Duke Activity Status Index (DASI) em indivíduos após acidente vascular cerebral por meio telefônico

Abstract

Introduction: Stroke survivors present several disorders that consequently reflect on mobility and social participation, which directly affect the functional capacity of this population. Therefore, the functional capacity is an important outcome to be assessed once it can portray the functional deficits of individuals. Its assessment can be indirectly acquired by questionnaires, such as the Duke Activity Status Index (DASI). This stands out for being an easy and quick tool, with low cost and able to predict oxygen consumption during activities. Facing the pandemic of COVID-19, health professionals had to adapt and deal with the social distance. In this new context, there was the need to validate instruments by telephone-based administration, as well as those that assess the functional capacity of individuals after stroke. Objective: Investigate the validity of administer the Duke Activity Status Index (DASI) questionnaire to chronic stroke survivors through telephone call. Methods: This is a methodological study, based on the COSMIN recommendations, in which participants with chronic stroke (>1 year), aged ≥ 20 years, and able to walk independently were included. After recruitment, participants were subjected to an initial assessment and subsequently completed the DASI questionnaire in person. After 5 to 7 days, the questionnaire was reapplied by telephone. Student's t-test with 95% confidence interval was used to compare the mean differences in the total scores of the face-to-face and telephone questionnaires to investigate concurrent validity. The intraclass correlation coefficient (ICC) and kappa coefficient were used to verify the agreement between administration in person and by telephone call. Results: Fifty participants were included (52% women), with a mean age of 56 ± 17 years. 66% of the sample had a clinical diagnosis of ischemic stroke. In the results of the total score of the DASI questionnaire administered in person and by telephone call, no statistically significant differences were observed (MD= -0.88; SD=4.14; 95%CI, -2.06 to 0.28; p=0.13) and very high agreement was found between the applications (ICC = 0.99; 95%CI, 0.94 to 0.98; p<0.05). As for the agreement of the individual items, the kappa coefficient ranged from 0.390-1.000, with the first item "take care of yourself" showing the best agreement (k=1.000) and the fourth item "climb a flight of stairs or a slope" showing the most inferior agreement (k=0.390). Conclusion: The DASI questionnaire is valid to assess functional capacity and can be administered through telephone in chronic stroke survivors. O questionário DASI apresentou-se válido para a avaliação da capacidade