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Abstract

Practices for the evaluation and treatment for people with aphasia (PWA) is dominated by an impairment-based view of aphasia. The number of aphasia evaluation tools adapted or developed to reflect PWA's perspective in Turkish is limited. Aphasia Impact Questionnaire-21 (AIQ-21), a tool developed based on the social model of disability, measures the individuals' quality of life from their own perspective. This study sought to adapt and establish the validity and reliability of AIQ-21 in Turkish (AIQ-21-TR) to meet this need. Data from 43 PWA and 61 healthy participants were analysed to determine AIQ-21-TR's construct, criterion, face validity and content validity. Reliability of the scale was assessed using Cronbach's Alpha reliability coefficients and the inter-item and item-total score correlations coefficients. Correlation between AIQ-21-TR and Stroke and Aphasia Quality of Life Scale-39 Turkish (SAQOL-39-TR) was also calculated. The validity analysis indicated that the Turkish adaptation of AIQ-21 has a high level of construct, content, face, and criterion validity. Similarly, the reliability analysis showed that the adapted questionnaire has an excellent reliability coefficient (α = 0.91). Our findings suggested that AIQ-21-TR may be used as a reliable and valid tool with PWA in clinical and research settings.

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... During its development, PWA were actively involved in the selection of the items, and they advised on format, content, and scoring. The AIQ-21 is validated in English [23] and in Turkish [27]. It has been translated into Danish, Catalan, Japanese, Dutch and Slovakian (https://www.aiq-21.net, ...
... The SAQOL-39 is adapted and psychometrically validated in Standard Greek [29,30] and measures QoL after stroke and aphasia from the patients' perspective. The Turkish version of the SAQOL-39 (SAQOL-39-TR) [31] was also used in the validation study of the Turkish version of the AIQ-21 (AIQ-21-TR) [27]. ...
... For this reason, several translations and steps were performed in this work, to ensure language and content validity [40]. This methodology was also applied in the Turkish study for the adaptation of the AIQ [27]. Furthermore, we performed a content validity exercise using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines [41]. ...
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The impact of aphasia on the everyday life of Greek-speaking people with aphasia (PWA) is often underestimated by rehabilitation clinicians. This study explores the adaptation and psychometric properties of the Greek (GR) version of The Aphasia Impact Questionnaire-21 (AIQ-21-GR) to address this issue. The aim of this study is to determine the reliability and validity of the Greek version of the AIQ-21. The AIQ-21-GR was administered to 69 stroke survivors, 47 with aphasia and 22 without aphasia. The data were analyzed to determine reliability and validity. Content validity was based on the Consensus-based Standards for the selection of health Measurement Instruments guidelines. The AIQ-21-GR shows high levels of reliability and validity. The results confirmed high scores of internal consistency (Cronbach’s α = 0.91) and indicated good known—groups validity (Mann–Whitney U = 202, p < 001). Content validity achieved high scores with an overall median score of 4 [Q25 = 4, Q75 = 5]. The psychometric properties of the AIQ-21-GR support the reliability and validity of the tool for investigating the impact of aphasia on the quality of life of Greek-speaking PWA. The AIQ-21-GR can be used for setting functional goals in collaboration with PWA and as a patient reported outcome measure for functional communication training.
... As an illustration, correlation has been recently employed to test the validity of psychometric tools (e.g., Yaşar et al., 2022), computerized tools (Drevon et al., 2017), and even metaanalytic evidence . ...
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Validity of measurement is essential to the scientific endeavor. It refers to how accurately tools measure what they are intended to measure. Researchers rely on statistical approaches to test the validity of their measures. One such approach is correlation analysis. Even though correlation analysis can capture high nonsystematic error between measures, it can often lead to misleading conclusions when observations are measured with systematic error, as can be the case when examining validity. Here, we provide simulated data to demonstrate how correlation analysis is commonly used to test for validity and how this method can fail as a test of validity when the error is systematic. We further propose an alternative to correlation analysis, for cases where the use of a simple statistical test can be justified. Specifically, we suggest the use of the Bayesian one-sample t-test, which can identify both systematic and non-systematic error and moreover provide evidence for the null hypothesis of no differences between two measures. We further provide simulations showcasing the implementation of the Bayesian one-sample t-test and how it can be used to address the limitations of correlation analysis.
... 1. The adaptation process reported in this study did not include the AIQ-21 as this questionnaire was already adapted and studied with Turkish-speaking PWA (see Yaşar et al., 2021). ...
Article
Background and Aim Cross-linguistic adaptations of aphasia assessment tools in Turkey are needed to improve aphasia assessment and rehabilitation with individuals speaking languages other than well-resourced languages. Aligned with this need, we conducted several studies to propose an adaptation of “The Comprehensive Aphasia Test” (CAT) into Turkish. Methods During this adaptation process; (a) lexical/linguistic and visual stimuli in CAT’s Language Battery subtests were evaluated by examining their imageability, familiarity, and name agreement features through rating studies, and two pilot studies for (b) Cognitive Screening and (c) Language Battery sections were carried out. In the stimuli norming studies, 71 undergraduate students (aged 20–24) rated 236 words in the Imageability and Familiarity tasks; 40 participants (aged 30–60) named 244 pictures in the Name Agreement task. Two sections of the CAT-TR were administered to different groups of subjects with aphasia (PWA) and matched controls. Fourteen PWA (and 14 controls) were presented the Cognitive Screening section, and a different group (PWA = 20, controls = 20) completed the Language Battery section. Results The imageability and familiarity ratings of 236 words and name agreement (% – H statistic) values of 244 pictures were calculated. Imageability and familiarity ratings of the words had a positive strong correlation with each other. Items with a name agreement of 85% or more were considered high name agreement. As anticipated, the control groups both in the Cognitive Screening and the Language Battery sections performed better than the PWA group. As a result, no further adaptive changes were suggested for these sections. Conclusion Results of these studies have shown that the Comprehensive Aphasia Test-Turkish is culturally and linguistically appropriate for Turkish speakers with aphasia. Therefore, future studies should assess its validity and reliability, and establish norms for its clinical interpretation.
Article
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Aphasia assessment is the initial step of a well-structured language therapy. Therefore, it is reasonable to underline that the assessment tools need to consider the typological and cultural characteristics of the language. A group of international researchers in the Collaboration of Aphasia Trialists have been adapting the Comprehensive Aphasia Test (CAT) into 14 languages spoken in Europe including Turkish. Thus, the aim of this study was to perform the validity and reliability analyses of the Language Battery section of CAT-TR to ensure the assessment of Turkish-speaking people with aphasia (PWA). The test included 21 sub-tests and yielded six modality scores (spoken language comprehension, written language comprehension, repetition, naming, reading, writing). Ninety PWA (Mean AGE = 61.07) and 200 controls (Mean AGE = 54.89) involved in the analyses. The participants were stratified into two education and three age groups. The analyses belonging to content, construct and criterion validity were performed, while the reliability analyses included internal consistency, test-retest and inter-rater reliability. Education influenced all the modality scores of the controls, while age-related differences were significant among all the modality scores except reading. It has to be underlined that Education did not hold any significant effects on the language performance of PWA, whereas those younger than 60 showed statistically better performance in the Spoken and Written Language Comprehension modality scores. The cut-off scores for each modality and Language Battery were presented with high sensitivity and specificity values. Compared to the psychometric characteristics of the adapted versions of CAT and aphasia tests utilized in Turkey, CAT-TR is an appropriate test for the language assessment of Turkish-speaking adults with aphasia.
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Background and purpose Prediction of stroke impact provides essential information for healthcare planning and priority setting. We aim to estimate 30-year projections of stroke epidemiology in the European Union using multiple modeling approaches. Methods Data on stroke incidence, prevalence, deaths, and disability-adjusted life years in the European Union between 1990 and 2017 were obtained from the global burden of disease study. Their trends over time were modeled using 3 modeling strategies: linear, Poisson, and exponential regressions―adjusted for the gross domestic product per capita, which reflects the impact of economic development on health status. We used the Akaike information criterion for model selection. The 30-year projections up to 2047 were estimated using the best fitting models, with inputs on population projections from the United Nations and gross domestic product per capita prospects from the World Bank. The technique was applied separately by age-sex-country groups for each stroke measure. Results In 2017, there were 1.12 million incident strokes in the European Union, 9.53 million stroke survivors, 0.46 million deaths, and 7.06 million disability-adjusted life years lost because of stroke. By 2047, we estimated an additional 40 000 incident strokes (+3%) and 2.58 million prevalent cases (+27%). Conversely, 80 000 fewer deaths (–17%) and 2.31 million fewer disability-adjusted life years lost (–33%) are projected. The largest increase in the age-adjusted incidence and prevalence rates are expected in Lithuania (average annual percentage change, 0.48% and 0.7% respectively), and the greatest reductions in Portugal (–1.57% and –1.3%). Average annual percentage change in mortality rates will range from −2.86% (Estonia) to −0.08% (Lithuania), and disability-adjusted life years’ from −2.77% (Estonia) to −0.23% (Romania). Conclusions The number of people living with stroke is estimated to increase by 27% between 2017 and 2047 in the European Union, mainly because of population ageing and improved survival rates. Variations are expected to persist between countries showing opportunities for improvements in prevention and case management particularly in Eastern Europe.
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Background: There are many validated and widely used assessments within aphasiology. Few, however, describe language and life with aphasia from the perspective of the person with aphasia. Across healthcare, patient experience and user involvement are increasingly acknowledged as fundamental to person-centred care. As part of this movement, Patient Reported Outcome Measures (PROMs) are being used in service evaluation and planning. Aims: This paper reports the quantitative aspects of a mixed methods study that developed and validated a concise PROM, the Aphasia Impact Questionnaire (AIQ), co-produced with People with Aphasia (PWA). Methods & Procedures: The AIQ was developed within the social model of disability and all stages of the development of the AIQ were performed in partnership with PWA. It was adapted from a pre-existing and lengthier PROM for PWA, the Communication Disability Profile. The first iterations of the AIQ focused on domains of communication, participation and well-being/emotional state. Subsequently the AIQ was extended to include additional items relating to reading and writing (AIQ-21). The research design was iterative. Initially, concurrent validity, internal consistency, and sensitivity of the AIQ-prototype were obtained. The AIQ-prototype was modified to become the AIQ-21. Statistical testing with a new group of PWA was performed, investigating internal consistency and concurrent validity of the AIQ-21. Outcomes & Results: Results for both the AIQ-prototype and AIQ-21 showed statistically significant concurrent validity and good internal consistency. Repeated measurement using the AIQ-prototype demonstrated statistically significant change after PWA accessed a community intervention. Conclusions: The AIQ-21 is a PROM that has great potential to be one of the core set of aphasia tests for clinical and research use. Results can be used alongside language assessment to enable person-centred goal setting and partnership working for people with aphasia.
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Covering an array of evidence-based content, including aphasia, traumatic brain injury, dementia, and language in aging, Aphasia and Other Acquired Neurogenic Language Disorders: A Guide for Clinical Excellence is a must-have textbook for clinicians and students studying to be speech-language pathologists. This clinical guide strategically addresses scientific foundations, service delivery, international and multicultural perspectives, assessment, and treatment. Key features include: • A rigorous approach to the art and science of clinical practice, integrating diverse theoretical perspectives for a global readership • Guidance on advocacy, ethics, reimbursement, legal aspects, and counseling • An emphasis on person-centered, empowering approaches to maximize life participation • Extensive assessment resources and a process analysis approach for analyzing communicative performance and interpreting assessment results • How-to content on over 50 intervention approaches • Diagrams, charts, illustrations, summary tables, a substantial glossary, a detailed index, and rich up-to-date references • Complementary online materials with links to videos and other teaching/learning resources • Systematic queries that enliven clear learning objectives Organized to maximize adult learning, the book is adaptable for multiple pedagogic methods for classroom-based courses, independent study, and online learning. Aphasia and Other Acquired Neurogenic Language Disorders: A Guide for Clinical Excellence provides clinicians and students a clear pathway for quality and effectiveness in clinical practice.
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OBJECTIVE: Aphasia assessment is the first step towards a well- founded language therapy. Language tests need to consider cultural as well as typological linguistic aspects of a given language. This study was designed to determine the standardization, validity and reliability of Language Assessment Test for Aphasia, which consists of eight subtests including spontaneous speech and language, auditory comprehension, repetition, naming, reading, grammar, speech acts, and writing. METHODS: The test was administered to 282 healthy participants and 92 aphasic participants in age, education and gender matched groups. The validity study of the test was investigated with analysis of content, structure and criterion-related validity. For reliability of the test, the analysis of internal consistency, stability and equivalence reliability was conducted. The influence of variables on healhty participants’ sub-test scores, test score and language score was examined. According to significant differences, norms and cut-off scores based on language score were determined. RESULTS: The group with aphasia performed highly lower than healthy participants on subtest, test and language scores. The test scores of healthy group were mostly affected by age and educational level but not affected by gender. According to significant differences, age and educational level for both groups were determined. Considering age and educational levels, the reference values for the cut-off scores were presented. CONCLUSION: The test was found to be a highly reliable and valid aphasia test for Turkish- speaking aphasic patients either in Turkey or other Turkish communities around the world.
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Objective: This study aimed to investigate the effect of various sample sizes and different correlations between items on the factor structures. Material and Methods: A total of 21 combinations including seven different correlation structures and three different sample sizes were created. There were four factors each with 5 items in each of the seven scales in these combinations. The factor structure of the samples was analyzed with confirmatory factor analysis of the scales. Results: In case of high or moderate correlation within factors and zero correlation between factors in the population, the factor structure of the sample was not changed when the factor loadings were rotated. The sample size did not have an effect on these results. However, when the correlation between factors in the population was other than zero, the factor structure of the sample changed when the factor loadings were rotated. When the population correlation matrix was a heterogeneous structure, the structure of the factors showed significant variations depending on the sample size. Conclusion: The structure of correlation matrix between items in the population were affected the results of factor analysis in the sample. In addition some items have been observed in a different factor than expected for some conditions. Factor structure is clearer with increasing sample size. Furthermore, factor structure may be changed by environmental factors such as sociodemographic characteristics and many cultural factors that affect the correlations that determine factor structure.
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Introduction: Cognitive-communication disorders are common in individuals with traumatic brain injury (TBI) and can have a major impact on long-term outcome. Guidelines for evidence-informed rehabilitation are needed, thus an international group of researchers and clinicians (known as INCOG) convened to develop recommendations for assessment and intervention. Methods: An expert panel met to select appropriate recommendations for assessment and treatment of cognitive-communication disorders based on available literature. To promote implementation, the team developed decision algorithms incorporating the recommendations, based on inclusion and exclusion criteria of published trials, and then prioritized recommendations for implementation and developed audit criteria to evaluate adherence to best practice recommendations. Results: Rehabilitation of individuals with cognitive-communication disorders should consider premorbid communication status; be individualized to the person's needs, goals, and skills; provide training in use of assistive technology where appropriate; include training of communication partners; and occur in context to minimize the need for generalization. Evidence supports treatment of social communication problems in a group format. Conclusion: There is strong evidence for person-centered treatment of cognitive-communication disorders and use of instructional strategies such as errorless learning, metacognitive strategy training, and group treatment. Future studies should include tests of alternative service delivery models and development of participation-level outcome measures.
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Quality of life (QL) can be defined as the individual's perception of their own well-being. Aphasia is the most important potential consequence of stroke and has a profound effect on a patient's life, causing emotional distress, depression, and social isolation, due to loss of language functions. To draw up a QL questionnaire for aphasics (QLQA) focusing particularly on difficulties in interpersonal relationships and on the loss of independence as a result of language disorders. We reported the results of a psychometric evaluation of this measure. Moreover, we experimentally focused on the differences in QLQA between patients affected only by neurological motor impairment and hemiparetic patients with aphasia (PWA) in order to verify the specific role of aphasia on QL. We also explored if the QLQA is sensitive to the severity of aphasia and to the time elapsing from the stroke. A total of 146 consecutive PWA and 37 control subjects were enrolled to evaluate the reliability (internal consistency and test-retest reliability) and validity of the QLQA, using standard psychometric methods. Patients were divided into acute (within 3 months since stroke) and chronic (beyond 3 months) groups, and into mild and severe according to the severity of aphasia. The experimental group of only acute PWA was compared to control subjects, with right hemispherical lesion and without aphasia in QLQA total and partial scores. The QLQA had good internal consistency and test-retest reliability. Acute and chronic PWA and mild and severe ones differed in QLQA total, communication, and autonomy subscales. No differences were found in psychological condition. Between aphasic and control patients, significant differences were found in all QLQA subscales. The QLQA is a valid measure of QL in PWA, contributing to a better distinction between severe and mild aphasia, and it is sensitive also to the variations in QL depending on the time interval from stroke.
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As more postsecondary faculty become engaged in designing online learning environments, research conducted on distance education program quality becomes increasingly important. Measurements in Distance Education is a concise, well-organized guide to some of the many instruments, scales, and methods that have been created to assess distance education environments, learners, and teachers. Entries are organized according to the qualities these measures attempt to gauge—such as engagement and information retention—and provide summaries of each instrument, usage information, the history of its development, and validation, including any reported psychometric properties. Offering more than 50 different surveys, tests, and other metrics, this book is an essential reference for anyone interested in understanding distance education assessment.
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The social model of disability emerged from the work of the Union of the Physically Impaired Against Segregation (UPIAS) who published The Fundamental Principles of Disability in 1976. Central to this were two themes: that it was the experience and expertise of disabled people that was crucial in developing a true understanding of the phenomenon of disability and that the main problems of disabled people were externally located in the disabling barriers and social restrictions that they faced. Building upon these themes and the rigid distinction between impair­ ment and disability that the Fundamental Principles insisted upon, I further developed the social model as the basis of more appropriate professional practice as part of my own work in teaching disability issues to social workers (Oliver, 1983). Subsequently the social model became the accepted vehicle for the promotion and development of disability equality training (Campbell and Gillespie-Sells, 1991) and the basis of the collective self-organization of disabled people into a powerful political movement (Campbell and Oliver, 1996). Outside of social work, the impact of the social model of disability on professional consciousness, let alone practice, has been somewhat limited.
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Purpose: The aim of this study was to adapt the stroke and aphasia quality-of-life scale-39 (SAQoL-39) to the Turkish language and carry out a reliability and validity study of the instrument in a group of patients with aphasia. Method: The study was a descriptive study and contained three phases: adaptation of the SAQoL-39 to the Turkish language, administration of the scale to 30 aphasia patients and reliability and validity studies of the scale. Internal consistency was assessed with Cronbach's alpha and test-re-test reliability was explored (n = 14). The adaptation process was completed based on inter-rater agreement on the translated items and within the scope of final editing by the authors of the study. Result: The SAQoL-39 in Turkish exhibited high test-re-test reliability (ICC =0.97) as well as acceptability with minimal missing data (0-1.4). This instrument exhibited high internal consistency (Cronbach's α = 0.70-0.97), domain-total correlations (r = 0.76-0.85) and inter-domain correlations (r = 0.40-0.68). Conclusion: The analysis shows that the Turkish version of SAQoL-39 is a scale that is highly acceptable, valid and reliable and can be easily used in evaluating the quality-of-life of Turkish people with aphasia.
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"Construct validation was introduced in order to specify types of research required in developing tests for which the conventional views on validation are inappropriate. Personality tests, and some tests of ability, are interpreted in terms of attributes for which there is no adequate criterion. This paper indicates what sorts of evidence can substantiate such an interpretation, and how such evidence is to be interpreted." 60 references. (PsycINFO Database Record (c) 2006 APA, all rights reserved).
Article
Background : Written material is often inaccessible for people with aphasia. The format of written material needs to be adapted to enable people with aphasia to read with understanding. Aims : This study aimed to further explore some issues raised in Rose, Worrall, and McKenna (2003) concerning the effects of aphasia-friendly formats on the reading comprehension of people with aphasia. It was hypothesised that people with aphasia would comprehend significantly more paragraphs that were formatted in an aphasia-friendly manner than control paragraphs. This study also aimed to investigate if each single aspect of aphasia-friendly formatting (i.e., simplified vocabulary and syntax, large print, increased white space, and pictures) used in isolation would result in increased comprehension compared to control paragraphs. Other aims were to compare the effect of aphasia-friendly formatting with the effect of each single adaptation, and to investigate if the effects of aphasia-friendly formats were related to aphasia severity. Methods & Procedures : Participants with mild to moderately severe aphasia (N = 9) read a battery of 90 paragraphs and selected the best word or phrase from a choice of four to complete each paragraph. A linear mixed model (p < .05) was used to analyse the differences in reading comprehension with each paragraph format across three reading grade levels. Outcomes & Results : People with aphasia comprehended significantly more aphasia-friendly paragraphs than control paragraphs. They also comprehended significantly more paragraphs with each of the following single adaptations: simplified vocabulary and syntax, large print, and increased white space. Although people with aphasia tended to comprehend more paragraphs with pictures added than control paragraphs, this difference was not significant. No significant correlation between aphasia severity and the effect of aphasia-friendly formatting was found. Conclusions : This study supports the idea that aphasia-friendly formats increase the reading comprehension of people with aphasia. It suggests that adding pictures, particularly Clip Art pictures, may not significantly improve the reading comprehension of people with aphasia. These findings have implications for all written communication with people with aphasia, both in the clinical setting and in the wider community. Applying these findings may enable people with aphasia to have equal access to written information and to participation in society.
Article
Analyzed interview data from 9 recovered aphasic Ss (aged 41–69 yrs) and 9 relatives or friends (aged 20–70 yrs) to describe consequences of aphasia as experienced by these Ss. The aphasic Ss' language disabilities were the major cause of handicaps in that they negatively influenced communication, altered relationships, provoked a loss of autonomy, restricted activities, and triggered stigmatization. Relatives and friends also experienced handicaps in terms of communication, interpersonal relationships, work, and leisure activities. Ss reported using various types of coping strategies to deal with disabilities and handicaps. Most of the coping behavior adopted by Ss and their relatives and friends was associated with maintaining communication and relationships, although some behavior served to stifle communication. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Written health information can be better comprehended by people with aphasia if it is provided in an aphasia-friendly format. However, before pursuing research in the area of text-formatting for people with aphasia, it must be determined whether people with aphasia consider it helpful to receive health information in the written media. This study, therefore, aimed to determine the following: whether people with aphasia consider it important to receive written stroke and aphasia information; when people with aphasia prefer to receive this information; and what their preferences are for health information media. Surveys were administered in a face-to-face interview with 40 adults with aphasia. Participants were purposefully selected using maximum variation sampling for a variety of variables including aphasia severity, reading ability, and time post stroke. Participants thought it important to receive written information about both stroke and aphasia. They considered it helpful to receive written information at several stages post stroke, particularly from 1 month onwards. The largest proportion (97%) of participants identified 6 months post stroke as the most helpful time to receive this information. Written information was the most preferred media at participants' present time post stroke (M = 39 months; range, 2-178 months). Videos/DVDs were the most preferred media during the 6 months immediately following the stroke. Despite reading and language difficulties, participants considered written information to be important, hence people with aphasia should receive written information about both stroke and aphasia. This information should be easily accessible throughout the continuum of care.
Article
Background: Despite the well-documented benefits of providing people with written health information, there is a growing body of evidence indicating that people who have aphasia are poorly informed about both their stroke and aphasia. Although extensive research has been conducted into stroke education, limited research has specifically investigated the provision of written health information to people with aphasia. Aims: This study aimed to investigate if people with aphasia recalled receiving written information about stroke and aphasia. Subsequent aims were to determine if reported receipt of stroke and aphasia information was related to participant characteristics such as aphasia severity, reading ability, and time post-stroke. This study also aimed to gain insight into where people with aphasia sourced written stroke and aphasia information, and which health professionals provided this information. Methods & Procedures: This article reports on a 10-item verbal questionnaire that was conducted as part of larger project with 40 adults with aphasia following stroke. Participants with a range of aphasia severities, reading abilities, and time post-onsets were recruited from university clinics and seven hospitals in Queensland, Australia. Descriptive statistics have been used to describe participant responses to questionnaire items. The relationship between participant responses and participant characteristics were explored using the Mann Whitney U and Pearson's chi square tests for non-parametric data. Participant's comments have also been categorised. Outcomes & Results: Only 14 participants (36%) indicated that they received written information about both stroke and aphasia. Findings indicated that receipt of stroke information did not equate to receipt of aphasia information with fewer participants reporting that they received written aphasia information (49%) compared to written stroke information (67%). There was no significant relationship between reported receipt of information and time post-stroke, aphasia severity, reading ability, age, years of education, or gender. Participant comments either related to the lack of health information provided by health professionals, or reflected the ineffective provision of written information, with many participants commenting about the inappropriate complexity of written health information received. The rehabilitation group setting was the main location for written stroke and aphasia information provision, with speech pathologists most frequently being identified as the health professional to provide this information. Conclusions: The majority of participants reported receiving no written information about aphasia. Routine provision of appropriately formatted health information and improved access to the health professionals and services that provide information are two strategies for more successful stroke and aphasia education.
Article
This paper describes preliminary studies on a screening test for aphasia which takes 3-10 minutes to complete and which is suitable for use by general practitioners, junior medical staff and other non-specialists. Data are presented to show that it is a reliable, valid assessment. Using cut-off values derived from normal people, the test is sensitive, but its specificity is limited by such associated factors as hemianopia. Using cut-off values derived from patients known to have aphasia, its specificity is improved. An abnormal result needs to be interpreted in the light of all available clinical information. The test should help identify patients with linguistic disturbance.
Article
The purposes of this study were to examine overall and domain-specific quality of life in long-term stroke survivors and to identify variables that predict quality of life after stroke. The study used a cross-sectional, descriptive correlational design. Subjects were 86 stroke survivors who were interviewed 1 to 3 years after stroke. Quality of life was measured with the use of an instrument that assesses satisfaction and importance for four domains (health and functioning, socioeconomic, family, and psychological-spiritual). Independent variables were age, social class, aphasia, functional status, motor impairment, depression, comorbidity, and perceived social support. Multiple regression analysis was used to predict quality of life. Thirty percent of subjects scored in the depressed range. The mean overall quality of life score was relatively high and was comparable to that of a normative population. Quality of life was highest for the family domain and lowest for health and functioning. Depression, perceived social support, and functional status predicted quality of life (adjusted R2 = .38) and contributed to prediction of domain quality of life. Social support and three additional variables, social class, age, and cardiovascular disease, predicted socioeconomic quality of life. The identification of depression, social support, and functional status as predictors of quality of life suggests the need to assist stroke survivors in coping and in maintaining and strengthening their support systems.
Article
To determine lesion locations associated with the various types of aphasic disorders in patients with stroke. The anatomy of aphasia has been challenged by several recent studies. Discrepancies are likely to be due to methodologic issues. We examined 107 patients with a standardized aphasia battery and MRI. Three examiners blinded to the clinical data rated signal abnormalities in 69 predetermined regions of interest. The statistical procedure used classification tree testing, which selected regions associated with each aphasic disorder. 1) Nonfluent aphasia depended on the presence of frontal or putaminal lesions; 2) repetition disorder on insula-external capsule lesions; 3) comprehension disorder on posterior lesions of the temporal gyri; 4) phonemic paraphasia on external capsule lesions extending either to the posterior part of the temporal lobe or to the internal capsule; 5) verbal paraphasia on temporal or caudate lesions; and 6) perseveration on caudate lesions. These analyses correctly classified 67% to 94% of patients. Lesion location is the main determinant of aphasic disorders at the acute stage. Most clinical-radiologic correlations supported the classic anatomy of aphasia.
Article
This paper argues that higher priority should be given to the development of services which support people with communication disabilities in low income countries and that these services should be different from those in other countries. Present services for this population group have poor coverage levels, tend to be centrally located and are orientated to specialist services. WHO (Health Programme Evaluation, Geneva, WHO, 1981) argue that health services should be based on meeting people's needs. This paper describes an analysis of 'needs related' qualitative data concerning people with communication disabilities and their families in two low income countries and examines the results in relation to service development. The data was collected as part of five different studies concerning people with communication disabilities carried out in Uganda and Nigeria. Using the principles of established theory, these data helped develop, a theoretical model. This model is compared with WHO's classification of Impairment Disability and Handicap ICIDH-2 WHO (International Classification of Impairments Disabilities and Handicaps (ICIDH-2), A manual of classification relating to the consequences of diseases, Geneva, WHO. 1997a; 1999). Suggestions are made as to how this model might inform planning and practice from the perspective of the five major stakeholder groups; government and non-government organizations, people with communication disabilities, their families and professionals. Consideration is also given as to how this theory can be used to strengthen existing services, or encourage a complete paradigm shift, with the creation of different services in new and innovative ways.
Article
This overview of population-based studies of incidence, prevalence, mortality, and case-fatality of stroke was based on studies from 1990. Incidence (first stroke in an individual's lifetime) and prevalence were computed by age, sex, and stroke type. Age-standardised incidence and prevalence with the corresponding 95% CI were plotted for each study to facilitate comparisons. The review shows that the burden of stroke is high and is likely to increase in future decades as a result of demographic and epidemiological transitions in populations. The main features of stroke epidemiology include modest geographical variation in incidence, prevalence, and case-fatality among the--predominantly white--populations studied so far, and a stabilisation or reversal in the declining secular trends in the pre-1990s rates, especially in older people. However, further research that uses the best possible methods to study the incidence, risk factors, and outcome of stroke are urgently needed in other populations of the world, especially in less developed countries where the risk of stroke is high, lifestyles are changing rapidly, and population restructuring is occurring.
Article
The purpose of the present study was to introduce a Swedish version of the Boston Naming Test and to offer normative data based on a sample of native Swedish-speaking healthy adults stratified concerning age, gender, and length of education. The subjects were assessed with other lexical tests and half of the group also performed tests of global cognitive function. A semantic analysis of the responses was performed and the typical Swedish naming of the pictures of BNT was investigated. The results showed that long education, high performance on tests of global cognitive ability (FSIQ), verbal fluency, and other lexical tests had a significant positive association to a good performance on BNT whereas age and gender had a minor influence. The response analysis showed that the more difficult an item was, the more variations in the response pattern. To conclude, the Boston Naming Test is appropriate for use in a Swedish-speaking context and an effective test for assessment of naming ability.
Article
Aphasia, defined as an acquired impairment of linguistic abilities, can be accompanied by a diversity of neuropsychological dysfunction. Accordingly, the necessity to include cognitive testing in the diagnosis of aphasia is increasingly recognized. Here we present the Aphasia Check List (ACL), a new test battery for the assessment of aphasic and associated cognitive disorders. The language part of the battery provides a differentiated profile of important linguistic abilities. In addition, the ACL includes nonverbal screening tests for three neuropsychological domains: memory, attention, and reasoning. Dysfunctions in these domains have been observed in aphasic patients and can have an impact on language function. The ACL is applicable to patients with language disturbances of different etiologies, different stages of disease, and to patients with mild to severe aphasia. As the entire test duration is only about 30 minutes, the ACL is also economically valuable. It thus presents an adequate starting point in aphasia diagnosis for a wide range of patients. Here we describe the construction of the ACL, and the normative study of its original German version with 154 aphasic patients and 106 healthy comparison subjects. The ACL cognition part revealed additional neuropsychological dysfunction in the aphasia group. We present the patterns of these dysfunctions and their correlations with language deficits.
Article
As a result of an increased demand for international cooperation in health care, cross-cultural quality of life (QOL) measures have been developed and tested. At present, a considerable number of QOL instruments are available in various languages, and some have been validated and normed in specific countries. Different approaches highlighting specific tasks have been used, and standards and guidelines for cross-cultural development and testing are now available. However, specific populations, such as persons with disabilities or chronic health conditions as well as minorities, have been neglected in international research. This article presents the current issues confronting cross-cultural instrument development in QOL. It describes the steps of international QOL instrument development and highlights some of the challenges, referring in particular to an ongoing project devoted to children with disabilities and chronic conditions.
Working together for health. The World Health Report
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Uygulamalı çok değişkenli istatistiksel yöntemler. Detay
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Ölçek ve test geliştirme yapısal eşitlik modellemesi ıbm spss ıbm spss amos ve minitab uygulamalı. Nisan Kitabevi
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