Article

Psychometric properties of the Dutch SAQOL-39NL in a generic stroke population

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  • HU University of Applied Sciences Utrecht
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Abstract

Background: The psychometric properties of the Dutch version of the Stroke and Aphasia Quality Of Life-scale (SAQOL-39NL) have previously been assessed for people with aphasia after stroke, but not yet for stroke survivors without aphasia. Objective: The objective is to evaluate the psychometric properties of the SAQOL-39NL in a stroke sample with and without aphasia. Methods: The SAQOL-39NL was administered to survivors of stroke (N = 141) who received rehabilitation in specialized rehabilitation facilities, 3 and 6 months after the start of rehabilitation. Acceptability was explored by assessing floor and ceiling effects and missing items. For internal consistency, Cronbach’s alpha and item-total correlations were computed. For internal validity, intercorrelations between domains, and between domains and total score, were assessed. Convergent validity was evaluated by correlation with EuroQoL-5D scores. Responsiveness to change was investigated using d′ and SRM-scores. Results: Mean age was 60.4 years (SD = 11.1), 62.4% were male. Mean total SAQOL-39NLg score was 3.94 (SD = 0.68, scale 1–5). No floor or ceiling effects and 2.4% missing data were found. Internal consistency was excellent (Cronbach’s alpha = 0.96). Intercorrelations between domains and total scale were moderate to excellent (r = 0.57–0.88). Intercorrelations between domains were low to moderate (r = 0.22–0.63). The correlation with the EQ-5D was moderate (r = 0.57). Only small changes in SAQOL-39NLg scores were found between 3 and 6 months. Conclusions: These data provide further evidence for the acceptability, internal consistency, and initial promising data on validity of the SAQOL-39NLg. Further research on structural validity and responsiveness to change is needed.

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... This version consists of the same items as the SAQOL-39, but items are grouped into three rather than four domains (physical, psychosocial, and communication) (Hilari et al., 2009). The scale has recently been translated into Dutch, and its psychometric properties were evaluated for PWA (Van Ewijk, Versteegde, Raven-Takken, & Hilari, 2016) and people without aphasia (Van Ewijk, Ter Wal, Okx, Goossens, & Groeneveld, 2018). ...
Article
Background. Quality of life (QOL) is an important outcome in health care, usually captured by self-reported questionnaires. The Stroke Aphasia Quality Of Life Scale (SAQOL-39; SAQOL-39g) was developed by Hilari and colleagues specifically for people with aphasia (PWA), who often struggle with the linguistic complexity of QOL scales. It has since been translated into many languages, including Dutch (SAQOL-39NLg). Some level of (language) comprehension ability is however still required to fill out the SAQOL-39g reliably. So far, little research has been done to evaluate the minimum level of language comprehension needed to fill in the SAQOL-39g. Aim. The aim of this project was to find the minimum level of comprehension needed for PWA to complete the Dutch version of the SAQOL-39g, the SAQOL-39NLg reliably. Methods & procedures. PWA in the chronic phase were asked to fill in the SAQOL-39NLg twice. SLT students supported the PWA during administration. We hypothesized that if PWA comprehend the questions, scores at T1 and T2 should be similar and thus Intraclass Correlation Coefficients would be high. Aphasia severity and language comprehension were assessed at T1 by means of the Token Test, the word and sentence comprehension part of the Comprehensive Aphasia Test- Dutch version (CAT-NL) and the Semantic Association Test (SAT). ICC, Standard Error of Measurement (SEM) and SEM% of the results of the two SAQOL-39NLg administrations were calculated for groups of PWA grouped and ranked based on the results of the language assessments. Outcomes & results. For this study, sixty PWA were included. All of them had some level of comprehension difficulties, the majority moderate to severe. No correlation was found between results on any of the language tests, and difference scores of the two administrations of the SAQOL-39NLg. The ICC between SAQOL-39NLg administrations was above 0.73 when clustered on SAT scores, and above 0.80 for groups clustered based on Token Test and CAT-NL scores. For all repeated measurements, SEM% was between 5% and 10%, and therefore acceptable. Conclusions. We conclude that it is possible for PWA to answer the SAQOL-39NLg reliably, when he or she is able to perform language tests. This finding strongly suggests that PWA should not be excluded from scientific research, when questionnaires are used.
Article
Background In clinical practice and in research, aphasia measurement instruments are used for many reasons: to screen and diagnose, to identify deficits and strengths, and to measure outcomes. A proliferation in available measurement instruments presents challenges to both the aphasia clinician and researcher and forms a barrier to optimal practice. There is a need for a comprehensive review of measurement instruments to identify the diversity of constructs measured by available tools and their cultural and linguistic applicability to the international aphasia community. Aims (1) To identify all available standardised measurement instruments which have been developed or tested with people with aphasia; and (2) To describe the construct/s measured, method of report, structure (components and scoring system), and availability of cultural/linguistic adaptations, of identified instruments. Methods and Procedures This scoping review is reported in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Studies were identified through searches of PUBMED, EMBASE, and CINAHL databases. Secondary searches of individual measurement instruments and hand searching were also undertaken. Two reviewers independently assessed titles, abstracts, and full-text articles. Inclusion criteria: studies reporting psychometric properties of measurement instruments, participants with aphasia (or their proxies), English language full-text journal articles. Data extracted: purpose, structure, and method of report of each instrument. The construct(s) reported to be measured by each instrument was classified according to the International Classification of Functioning, Disability and Health (ICF). Outcomes and Results A total of 3642 articles were identified through database searches. Following the removal of duplicates, 2879 articles were screened by title and abstract; with 334 articles undergoing full-text review. Secondary searches of individual measurement instruments and hand searching identified a further 99 publications. In total, 284 references for 143 measurement instruments were included in this review. Measurement instruments were classified by ICF component; the majority were reported to be measures of Body Functions (n = 94); followed by Activity/Participation (n = 23); Environmental Factors (n = 5); and quality of life/other constructs not within the ICF (n = 16). Five measured multiple ICF components. Conclusions and Implications This review identified 143 measurement instruments, developed or tested with people with aphasia. Classified according to the ICF, these instruments primarily measure Body Functions (n = 94). Some measurement instruments have undergone extensive cultural and linguistic translation/adaptation, however most have not. The resulting corpus of instruments provides a basis for the selection of measurement instruments in clinical and research settings.
Article
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Article
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Praktijkvariatie in de CVA-revalidatie. Onderzoeksopzet met analyse van structuur, proces en uitkomsten. (Practice variation in stroke rehabilitation
  • I F Groeneveld
  • Jjl Meesters
  • H J Arwert
  • Rambaran Mishre
  • Vliet Vlieland
  • Tpm Goossens