Development of a Chinese version of the Modified Barthel Index - validity and reliability

Objective: To establish the structural validity of the Chinese version of the Modified Barthel Index and to estimate its inter-rater reliability for use with patients who have had a stroke. Design: Prospective study. Setting: A regional general hospital and a day hospital in Hong Kong. Subjects: One hundred and sixteen older people who had had a stroke (mean age 76.0; SD 7.6) were involved in the establishment of evidence of the structural validity and item quality. Another 15 older people with stroke (mean age 78.0; SD 7.1) participated in estimating the reliability of the instrument. Methods and results: The Modified Barthel Index was translated into Chinese. Factor analyses revealed a two-factor structure that explained 75.7% of the total variance. Factor 1 was found to consist of eight items relating to patients' functional performance. Factor 2 consisted of the two items that focused on patients' 'physiological needs'. The test-retest reliability of the Chinese version at the item level was comparable with that of the original version, with kappa statistics ranging from 0.63 to 1.00 (P<0.001). Conclusion: The Chinese version of the Modified Barthel Index (MBI-C) seems to be valid and reliable for use with older people with stroke. Changes were made to the item content and the rating criteria that were specific to Chinese culture. The structural validity and the reliability of the Chinese version were shown to be robust across the original and Chinese groups.