What Are the Important Factors in Health-Related Quality of Life for People With Aphasia? A Systematic Review

doi:10.1016/j.apmr.2011.05.028

Archives of Physical Medicine and Rehabilitation

Volume 93, Issue 1, Supplement, January 2012, Pages S86-S95.e4

https://doi.org/10.1016/j.apmr.2011.05.028 Get rights and content

Abstract

Hilari K, Needle JJ, Harrison KL. What are the important factors in health-related quality of life for people with aphasia? A systematic review.

Objective

To determine factors associated with or predictive of poor health-related quality of life (HRQL) in people with aphasia poststroke. Better understanding of these factors can allow better targeting of rehabilitation programs.

Data Sources

Electronic databases, covering medical (eg, Medline, Excerpta Medica Database, Evidence-Based Medicine Reviews, Cumulative Index to Nursing and Allied Health Literature, Ovid, Allied and Complementary Medicine Database) and social sciences (eg, PsycINFO) were searched and key experts were approached.

Study Selection

Studies including specific information on the HRQL of people with aphasia poststroke using validated HRQL measures or established ways of analyzing qualitative data were included. Two reviewers independently screened studies against the eligibility criteria.

Data Extraction

This was undertaken independently by 2 reviewers. Discrepancies were resolved by consensus. Quantitative studies were assessed for quality with Counsell and Dennis' critical appraisal tool for systematic review of prognostic models in acute stroke; qualitative studies with the Critical Appraisal Skills Program tool for qualitative research.

Data Synthesis

Fourteen research reports met the eligibility criteria. Because of their high heterogeneity, the data synthesis was narrative. The evidence is not strong enough to determine the main predictors of HRQL in people with aphasia. Still, emotional distress/depression, severity of aphasia and communication disability, other medical problems, activity limitations, and aspects of social network and support were important factors.

Conclusions

Emotional distress, aphasia severity, communication and activity limitations, other medical problems, and social factors affect HRQL. Stroke HRQL studies need to include people with aphasia and report separately on them, in order to determine the main predictors of their HRQL and to identify what interventions can best address them.

Section snippets

Methods

This review follows well-established methods for conducting and reporting systematic literature reviews.46, 47

Study Selection

Electronic database searches were conducted in September 2010 and resulted in a total of 2254 references. Nineteen references were received from requests for information from subject experts. Study flow in the review and reasons for exclusion are given in figure 1 (only 1 reason is given per excluded study, though in many cases studies could have been excluded for more than 1 reason). After deduplication, 1791 (79%) studies remained. The screening process resulted in the exclusion of 1746

Summary and Implications of Findings

Fourteen reports were found that reported factors associated with or predictive of HRQL in people with aphasia. Emotional distress/depression, extent of aphasic impairment and communication disability, presence of other medical problems, and activity level were the predictors of HRQL emerging from quantitative studies. Social factors also emerged as important. Themes drawn from qualitative studies—looking to the future/having a positive outlook, verbal communication, body functioning, and

Conclusions

Design and quality limitations of the included studies mean that the existing evidence is not strong enough to determine the main predictors of HRQL in people with aphasia poststroke. Factors that have consistently emerged as important are emotional distress/depression, extent of aphasic impairment and communication disability, and, to a lesser extent, presence of other medical problems, activity levels, and aspects of social network and support. There is a need for further research, first to

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Review article (meta-analysis)What Are the Important Factors in Health-Related Quality of Life for People With Aphasia? A Systematic Review

Abstract

Objective

Data Sources

Study Selection

Data Extraction

Data Synthesis

Conclusions

Section snippets

Methods

Study Selection

Summary and Implications of Findings

Conclusions

Trans R Soc Trop Med Hyg

Arch Phys Med Rehabil

J Stroke Cerebrovasc Dis

J Stroke Cerebrovasc Dis

J Fluency Disord

Epidemiology of aphasia attributable to first ischemic stroke: Incidence, severity, fluency, etiology, and thrombolysis

Stroke

Stroke (acute cerebrovascular disease)

Developing and evaluating cross cultural instruments: from minimum requirements to optimal models

Qual Life Res

International use, application and performance of health-related quality of life instruments

Qual Life Res

National clinical guideline for stroke

London: Royal College of Physicians

The relationship of 60 disease diagnoses and 15 conditions to preference-based health-related quality of life in Ontario hospital-based long-term care residents

Med Care

The impact of stroke: are people with aphasia different to those without?

Disabil Rehabil

Quality of life with and without aphasia

Aphasiology

Quality of life after stroke: the importance of a good recovery

Cerebrovasc Dis

Disablement and quality of life after stroke

Stroke

Life before and after strokeLiving conditions and life satisfaction in relation to a general elderly population

Cerebrovasc Dis

Psychosocial function and life satisfaction after stroke

Stroke

Handicap in stroke survivors

Disabil Rehabil

Health status of individuals with mild stroke

Stroke

Quality of life after a first ischemic strokeLong-term developments and correlations with changes in neurological deficit, mood and cognitive impairment

Acta Neurol Scand

Quality of life after stroke

Stroke

A qualitative study of quality of life after stroke: the importance of social relationships

J Rehabil Med

Quality of life 4 years after stroke

Stroke

Longitudinal analysis of quality of life for stroke survivors using latent curve models

Stroke

Life satisfaction in long-term survivors after stroke

Scand J Rehabil Med

Quality of life among stroke survivors evaluated 1 year after stroke: experience of a stroke unit

Stroke

Quality of life after stroke: impact of stroke type and lesion location

Stroke

Health-related quality of life among long-term survivors of stroke: results from the Auckland Stroke Study, 1991-1992

Stroke

Functional recovery and social outcome after cerebral infarction in young adults

Cerebrovasc Dis

Quality of life after stroke: the North East Melbourne Stroke Incidence study (NEMESIS)

Stroke

The influence of depression, social activity, and family stress on functional outcome after stroke

Stroke

The role of cognitive impairment in the quality of life after ischaemic stroke

J Neurol

Clinical determinants of long-term quality of life after stroke

Age Ageing

Longer term quality of life and outcome in stroke patients: is the Barthel Index alone an adequate measure of outcome?

Qual Health Care

What are the consistent predictors of generic and specific post-stroke health-related quality of life?

Cerebrovasc Dis

Perceptions of psychosocial adjustment to aphasia: applications of the Code-Müller Protocols

Semin Speech Lang

Perceptions of psychosocial adjustment to acquired communication disorders: applications of the Code-Müller Protocols

Review article (meta-analysis)
What Are the Important Factors in Health-Related Quality of Life for People With Aphasia? A Systematic Review