Development and Reliability Test of the Intravenous Thrombolysis Intention Scale for Patients With Acute Ischemic Stroke.

The scale was developed and validated only in Chinese patients with acute ischemic stroke and high-risk stroke populations, so it needs cross-cultural adaptation before use in other countries or health systems. The study tested measurement properties, not whether nurses using the scale changes thrombolysis timing, consent time, complications, or patient outcomes. In real emergencies, many acute ischemic stroke patients lose decision-making capacity and family members give consent, but the scale was not tested in family proxies. The subjective norm dimension had a severe ceiling effect, with 62.21% of participants at the ceiling, so it may not distinguish people who already have strong family or staff influence toward thrombolysis. The sample included 82.95% older adults residing in rural areas, so representativeness beyond these settings is uncertain. The Delphi expert agreement measures were low, with Kendall's coefficients of concordance of 0.176 and 0.113, although the authors considered them statistically acceptable.

The authors declared no conflicts of interest. The work was funded by the General Program of Henan Provincial Natural Science Foundation in 2026 (Grant No. 252300423195), the Key Scientific Research Project of Institutions of Higher Education in Henan Province (Grant No. 26A320053), the Nursing Science Foundation of the First Affiliated Hospital of Zhengzhou University (Grant No. HLKY20230001), and the Stroke Prevention and Treatment Technology Research Project (Grant No. WKZX2023CZ0402).

Do not conclude that using this scale improves thrombolysis timing or patient outcomes, or that it has been tested with family proxies. The study tested how the scale measures intention in Chinese patients and high-risk people, not whether nurse use changes decisions or prognosis.