Introduction:
Stroke is a global health problem, and around 62% of stroke patients suffer from malnutrition due to dysphagia, eating speed, or the stress response. This study aimed to develop a Nutritional Risk Screening Scale for Stroke Patients (NRSS-SP).

Material and methods:
In the current study we constructed a theoretical framework by combining stroke characteristics, the risk factors of malnutrition in stroke patients, and clinical experience. Then, using the Delphi method, we formed a pool for entries and combined the opinions and suggestions discussed by experts in a research team. Next, we collected all of the data and information, categorized, merged, and split the pool of entry items’ contents. Finally, we formed a pre test scale comprising 11 items after scoring their importance. A clinical investigation of 100 patients was conducted to test the validation of the NRSS-SP.

Results:
The pre-test NRSS-SP comprised 10 items in three fields: physical, psychological, and independence. A score was assigned to each factor. Disease severity, the serum level of albumin, and dysphagia were assigned 3 points each, and age ≥ 70 years was assigned 1 point. The other indicators were assigned 1–3 points according to the evaluation results. The cumulative effect of four factors (depression, anxiety, serum level of albumin, and body mass index (BMI)) was 65.512%. The item-level content validity index (CVI) of the NRSS-SP ranged from 0.081 to 1.000, and the scale-level CVI was 0.912. The coefficient of Cronbach’s  ranged from 0.822 to 0.911.

Conclusions:
An NRSS-SP (which comprised the National Institutes of Health Stroke Scale score, BMI, serum level of albumin, recent weight loss, recent food intake, dysphagia, age, depression, anxiety, and Barthel index) score ≥ 6.5 was classified as a malnourishment risk; an NRSS-SP score < 6.5 denoted normal nutrition.