Cross-Cultural Adaptation, Validity and Reliability of the Turkish Version of the Testing Emotionalism After Recent Stroke - Questionnaire (TEARS-Q-TR)

Abstract

Background: The Testing Emotionalism After Recent Stroke-Questionnaire (TEARS-Q) evaluates post-stroke emotionalism by focusing on uncontrolled episodes of crying with a cutoff score compared to other available instruments. There is no Turkish scale to assess emotionalism in acute stroke patients. Objectives: To translate and culturally adapt the TEARS-Q into Turkish and evaluate its validity and reliability. Methods: The researchers used an Exploratory Factor Analysis (EFA) to determine construct validity. They calculated Cronbach's alpha to assess internal consistency, intraclass correlation coefficient (ICC), and standard error of measurement (SEM) to test-retest reliability. They used the Neurological Sciences Centre-Lability Scale (CNS-LS) and the Hospital Anxiety and Depression Scale (HAD) subscales (anxiety and depression) to determine convergent and discriminant validity, respectively. A five-year-experienced physiotherapist conducted assessments at baseline and after 15 days. Results: The study comprised eighty-five acute stroke patients, with a mean age of 65.99 +/- 13.59 years. EFA indicated a unidimensional structure for the TEARS-Q-TR accounting for 56.46% of the total variance. Cronbach's alpha was 0.883 which indicates good consistency. The analysis obtained an ICC of 0.725, indicating moderate reliability. SEM value of the scale was 3.162. There was a moderate positive relationship between TEARS-Q-TR and CNS-LS (r = 0.517) and a weak positive relationship between TEARS-Q-TR and HAD anxiety (r = 0.351) (p < 0.01). TEARS-Q-TR and HAD depression were not correlated (p > 0.01). Conclusions: The researchers recommend TEARS-Q-TR, a valid and reliable scale for clinical use in acute stroke patients to assess emotionalism practically (with 8 items) and mitigate potential issues that may arise from the misdiagnosis of emotionalism.