Japanese Adaptation of the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39): Comparative Study among Different Types of Aphasia

A study on the reliability and validity of the Japanese version of the Scenario Test for people with chronic stroke-induced aphasia: A cross-sectional study

BACKGROUND

The Scenario Test is recognised for its effectiveness in assessing the interactive aspects of functional communication in people with post-stroke aphasia (PWA).

AIMS

To develop a Japanese version of the Scenario Test (Scenario Test-JP) and assess its reliability and validity.

METHODS & PROCEDURES

Among 66 participants, we selected 61 individuals: 34 PWA and 27 healthy controls (HCs). We modified the Scenario Test-JP based on the UK version and subsequently evaluated its reliability (internal consistency, test-retest and intra-rater and inter-rater reliabilities) and validity (convergent and discriminant) by comparing PWA and HCs.

OUTCOMES & RESULTS

The Scenario Test-JP showed strong reliability with a Cronbach's α of 0.93, test-retest reliability with an intraclass correlation coefficient (ICC) of 0.97, intra-rater reliability with an ICC of 0.95-1.00, and inter-rater reliability with an ICC of 0.96. The validity of the test was confirmed with concurrent scores ranging from ρ = 0.37 to 0.76 (p < 0.05) and known-groups validity (p < 0.001, r = -0.56).

CONCLUSIONS & IMPLICATIONS

The reliability and validity of the Scenario Test-JP align with those of the original Dutch version and the UK and Greek versions. Additionally, the assessment can now include extended alternative communication methods, such as digital devices, indicating the potential of the Scenario Test-JP for modern Japanese speech-language therapy.

WHAT THIS PAPER ADDS

What is already known on the subject Interactive communication is a facet of functional communication and is crucial for evaluating engagement and participation of people with aphasia (PWA) in speech-language therapy. The Scenario Test provides valuable information for planning speech-language treatment strategies by assessing dialogic communication. What this study adds This study describes the development of the Scenario Test-JP for use with Japanese speakers and Japanese PWA, which is adapted from the Scenario Test UK version. This study evaluated the reliability and validity of this assessment tool and provided supporting evidence. What are the clinical implications of this work? The reliability and validity of the Scenario Test-JP were consistent with those of the Dutch, UK and Greek versions. The Scenario Test-JP contributes to speech-language therapy in Japan, where high-quality support for the activities and participation of PWA is required.

PRACTITIONER POINTS

Insights from the Scenario Test The Scenario Test plays a crucial role in evaluating the functional communication skills of people with post-stroke aphasia (PWA). Enhancing functional communication has been linked to improved social engagement among PWA, which in turn influences their overall quality of life (QOL). Issues addressed by the Scenario Test The Scenario Test aids in delineating rehabilitation objectives for activities and participation among PWA, particularly concerning functional communication. The test facilitates tailored support for PWAs' interactive communication and forms the foundation for appropriate speech-language therapy interventions. Transformation of speech-language therapy (SLT) in Japan through the introduction of the Scenario Test-JP The integration of the Scenario Test-JP could enhance the SLT services provided to PWA in Japan. With Japan experiencing an unprecedented ageing population, the prevalence of social isolation and diminished QOL resulting from communication disorders like stroke-induced aphasia is expected to rise. Consequently, the SLT rehabilitation sector in Japan is actively seeking effective interventions to support functional communication among PWA. Hence, the adoption of the Scenario Test-JP is anticipated to streamline the evaluation of functional communication, facilitating the judicious selection and timely provision of assistance to PWA in SLT, including guidance on communication partner support and communication skill training.

Pre-stroke habitual prolonged sleep as a predictor for post-stroke sleep quality, stroke-related quality of life, and lifestyle values

BACKGROUND

Prolonged sleep is a higher stroke risk, but post-stroke prolonged sleep facilitates stroke recovery. No study has explored the relationship between pre- and post-stroke prolonged sleep and their involvement in stroke-related quality of life (QOL).This study aimed to clarify the role of pre- and post-stroke prolonged sleep in QOL and sleep quality during hospitalization.

METHODS

Fifty-one subacute stroke inpatients were enrolled. QOL was assessed by the Stroke and Aphasia QOL Scale-39-J. Sleep quality and lifestyle values were assessed by original questionnaires.

RESULTS

Patients in pre-stroke prolonged sleep > 8 h had a higher incidence of post-stroke poor sleep quality than those belonging to the normal or shorter hours (OR 5.33, 95% CI 1.30-21.84, p = 0.047). In addition, pre-stroke prolonged sleep was associated with lower scores of psychosocial QOL and lifestyle values of "accepting disability; caring about what other people think of what you do". In contrast, post-stroke prolonged sleep was associated with the lower risk of post-stroke poor sleep quality (OR 0.27, 95% CI 0.08-0.86, p = 0.045). Post-stroke high sleep quality had higher (better) scores of physical and energy QOL, and lifestyle values of "caring about what other people think of what you do; having some places to go out after discharge" compared with post-stroke poor sleep quality. Post-stroke prolonged sleep was derived from pre-stroke not prolonged sleep rather than pre-stroke prolonged sleep (p = 0.039, Chi-square test).

CONCLUSIONS

Pre-stroke prolonged sleep is associated with a higher incidence of post-stroke poor sleep quality and lower scores of QOL and lifestyle values after stroke.

Are People with Aphasia (PWA) Involved in the Creation of Quality of Life and Aphasia Impact-Related Questionnaires? A Scoping Review

BACKGROUND

Quality of Life (QoL) questionnaires are used to describe the impact of aphasia on stroke survivors' life. People with aphasia (PWA) are traditionally excluded from research, potentially leading to a mismatch between the factors chosen in the tools and the realistic needs of PWA. The purpose of this review was to determine the direct involvement of PWA in the creation of QoL and aphasia impact-related questionnaires (AIR-Qs).

METHODS

A scoping review methodology was conducted by an expert librarian and two independent reviewers on health sciences based on the Preferred Reporting Items for Systematic Reviews and Metanalyses extension for Scoping Reviews (PRISMA-ScR) protocol, through a literature search in five databases: Medline Complete, PubMed, PsychINFO, Scopus, and Google Scholar. Search terms included 'stroke', 'people with aphasia', 'communication', 'well-being', and 'quality of life'.

RESULTS

Of 952 results, 20 studies met the eligibility criteria. Of these, only four AIR-Qs studies (20%) were found reporting the direct involvement of PWA, while no QoL tools did so. Evidence showed involvement in the creation phase of AIR-Q, mainly in a consultation role.

CONCLUSIONS

There is an absence of a framework for conducting and reporting the involvement of PWA in qualitative participatory research studies, which limits effectiveness to promote equitable best practice in aphasia rehabilitation.

Cultural Adaptation and Preliminary Validation of the Proxy-Rated Sinhala Version of the Stroke and Aphasia Quality of Life Generic Scale-39

Background:

Health-related quality of life (HRQOL) is an important measure that enables evaluation of rehabilitation outcomes. Stroke and Aphasia Quality of Life Generic Scale–39 (SAQOL-39g) is a disease-specific questionnaire that measures HRQOL of patients with stroke. This study was conducted to adapt the preliminary version of proxy-rated Sinhala version of the SAQOL-39g.

Methods:

The study was conducted with the participation of 115 proxies of the patients with stroke. The SAQOL-39g was translated and back translated, and culturally adapted by evaluating the items of the questionnaire. The culturally adapted scale was evaluated for its internal consistency, test-retest reliability, and validity.

Results:

The mean age of the patients with stroke was 67.07 (standard deviation [SD] = 11.2) years; males comprising two-thirds of the study sample (67% [n = 77]). The proxy-rated Sinhala version of the SAQOL-39g showed excellent internal consistency (α = 0.98 [overall score]), 0.97, 0.96, and 0.95 for physical, communication, and psychosocial domains, respectively. The intraclass correlation coefficient (ICC) was 0.92 for overall, and 0.93, 0.92, and 0.91 for physical, communication, and psychosocial domains, respectively. Factor analysis extracted 3 factors with 72.4% of the variance.

Conclusions:

Proxy-rated Sinhala version of the SAQOL-39g is a psychometrically sound, reliable, and valid tool to assess the post-stroke quality of life of Sinhala-speaking patients with stroke and aphasia.

Translation, adaptation and psychometric properties of the Icelandic stroke and aphasia quality of life scale-39g

BACKGROUND

The overarching aim of aphasia rehabilitation is to improve people's quality of life. The most commonly used quality of life measure developed for use with individuals with aphasia is the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39g).

AIMS

We aimed to translate and adapt the SAQOL-39g into Icelandic, and examine its psychometric properties. Furthermore, this study aimed to gather preliminary information on the health-related quality of life (HRQOL) of stroke patients in Iceland.

METHOD

A traditional back-translation approach was applied to translate the SAQOL-39g into Icelandic. We recruited 20 poststroke patients, thereof ten with aphasia, for evaluation of the psychometric properties of the translated instrument. Acceptability was based on missing data, and floor and ceiling effects, internal consistency was measured by Cronbach's α and correlation between test items and overall score, and test-retest reliability was measured by intraclass correlation coefficient (ICC) for overall and domain scores.

RESULTS

The back-translation led to reviewing of eight test items for the final translation. No test items required cultural adaptation. The acceptability of the translation met criteria for both proportion of missing data (0%) and floor and ceiling effects for test items and domains (<80%). Internal consistency also met criteria, both for overall score (α = 0.94) and domains: physical domain (α = 0.93), psychosocial domain (α = 0.93) and communication domain (α = 0.89). Correlation between test items and overall score ranged from 0.30 to 0.82. Test-retest reliability met criteria both for overall score (0.95) and domains: physical domain (0.94), psychosocial domain (0.95), and communication domain (0.95). The mean total score was significantly lower for participants with aphasia compared to participants without aphasia (3.73 vs. 4.20; p < 05).

CONCLUSIONS

The Icelandic SAQOL-39g demonstrated good psychometric properties. Preliminary evidence suggests that the HRQOL of people with aphasia is significantly worse than of people without aphasia after stroke.

Factors Influencing Quality of Life in Stroke Patients: Focus on Eating Habits

BACKGROUND

Adherence to healthy lifestyle factors has been shown to improve outcomes after stroke. This study aimed to identify lifestyle factors about eating habits that may affect the quality of life (QOL) in elderly stroke patients.

METHODS

Fifty elderly patients with a first-ever stroke were enrolled. QOL was assessed by the Stroke and Aphasia QOL Scale-39-J. Lifestyle factors about eating habits were collected using questionnaires (Questions 1-17) for the intake of salt, calcium, magnesium, potassium, taurine, fiber, and protein, and the frequency of breakfast.

RESULTS

QOL of physical, communication, and psychosocial subdomains was better in the low (healthy) tertile of poststroke eating habits (Questions 1-17) compared with the high tertile of post-troke eating habits (Questions 1-17). This relationship appeared in eating habits except for salt intake but not in eating habits of salt intake and directly measured salt intake. Compared with prestroke eating habits score, poststroke eating habits score was decreased (improved) in 36 patients concerning eating habits of salt intake, but only in 12 patients concerning eating habits except for salt intake (P < .05 by chi-square test). Poststroke eating habits of calcium and magnesium were associated with better psychosocial QOL and better physical or energy QOL, respectively.

CONCLUSIONS

Poststroke eating habits of calcium and magnesium were associated with QOL in elderly patients with a first-ever stroke. Since eating habits except for salt intake was poorly improved after stroke, intensive interventions regarding eating habits might be important.

Acceptability, reliability, and validity of the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39) across languages: a systematic review

OBJECTIVES

This systematic review aimed to explore the acceptability, reliability, and validity of the Stroke and Aphasia Quality of Life-39 (SAQOL-39) scale across languages.

DATA SOURCES

We employed a systematic search of the online databases including MEDLINE (Pubmed), Science direct, Web of science, Psychinfo, Scopus, ProQuest, Google Scholar, and Cochrane library published between 2003 and 2016.

REVIEW METHODS

We used PRISMA guidelines for conducting and reporting this review. Subsequently, screening of the titles and abstracts, extraction of data as well as the appraisal of the quality of relevant studies were carried out.

RESULTS

The initial search returned 8185 studies. Subsequent screening and study selection processes narrowed them to 20, needing detailed review. Forward-backward translation scheme was the preferred method for translation of the SAQOL-39 from English to other languages. Mainly, the socio-cultural and linguistic adaptations were performed in the translated versions. Most versions of the SAQOL-39 showed high test-retest reliability and internal consistency. However, several psychometric properties including the validity and responsiveness were seldom reported in these versions.

CONCLUSION

The SAQOL-39 scale showed high acceptability, and reliability across the languages reviewed in this study. Future translations may additionally focus on reporting the validity and responsiveness of the instrument.