Finding a focus for quality of life with aphasia: social and emotional health, and psychological well-being

Cruice, Madeline, Worrall, Linda, Murison, Robert and Hickson, Louise (2003) Finding a focus for quality of life with aphasia: social and emotional health, and psychological well-being. Aphasiology, 17 4: 333-353. doi:10.1080/02687030244000707

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Author Cruice, Madeline
Worrall, Linda
Murison, Robert
Hickson, Louise
Title Finding a focus for quality of life with aphasia: social and emotional health, and psychological well-being
Journal name Aphasiology   Check publisher's open access policy
ISSN 1464-5041
Publication date 2003-04-15
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1080/02687030244000707
Volume 17
Issue 4
Start page 333
End page 353
Total pages 21
Place of publication London
Publisher Psychology Press, Taylor and Francis Group
Collection year 2003
Language eng
Subject 321025 Rehabilitation and Therapy - Hearing and Speech
730303 Occupational, speech and physiotherapy
Formatted abstract
Background:  Speech pathologists infrequently address the quality of aphasic people's lives in a direct manner in rehabilitation, most likely due to the difficulty in grasping the role of communication in quality of life (QOL). Despite considerable research into aphasic language impairments and communication disabilities, there is no clear evidence how aphasia impacts on clients' QOL. This paper reports on a comprehensive evaluation of 30 people with mild to moderate aphasia to determine which aspects of communication predict their QOL. A conceptual model of the relationship between communication and QOL was devised, using the disablement framework of the International Classification of Impairment, Activity and Participation Beta-2 Draft (ICIDH-2) (World Health Organisation, 1998). Communication was conceptualised as language impairment, functional communication ability and activity, and social participation. QOL included both health-related QOL (HRQOL) and psychological well-being concepts.

   The aim of this study was to investigate how measures of impairment, activity and participation, and measures of QOL related to each other for people with aphasia, for the purpose of: (1) determining which specific communication assessments were most predictive of their QOL; and (2) determining whether HRQOL or psychological well-being was represented more in relationships, thus indicating a focus for QOL in aphasia.

Methods & Procedures:  Thirty people aged 57-88 years (mean = 70.7yrs) with predominantly mild to moderate chronic aphasia (mean WAB AQ = 74.4, range 21.9-5.8; mean TPO = 41 mths, range 10-108 mths) participated in this study. In total, 13 standardised and specifically designed measures evaluated the different concepts of the model. Maximal multiple regression analysis illustrated which communication measures were most predictive of participants' HRQOL and psychological well-being.

Outcomes & Results:   Overall, aphasic people's communication predicted their psychological well-being and social health (a subscale of HRQOL). Specifically, the findings demonstrated that functional communication ability, and language functioning to a lesser degree, were implicated in QOL, providing evidence for particular speech pathology interventions in addressing clients' QOL. Finally, emotional health powerfully influenced the relationships among variables, and physiological/physical health was a determinant of social participation.
Keyword Clinical Neurology
Nursing-home Residents
Sensory Impairment
Hearing Impairment
Q-Index Code C1
Additional Notes Special edition: Quality of Life in Aphasia. Guest Editors: Linda Worrall and Audrey Holland

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Excellence in Research Australia (ERA) - Collection
2004 Higher Education Research Data Collection
School of Health and Rehabilitation Sciences Publications
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Citation counts: TR Web of Science Citation Count  Cited 89 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 98 times in Scopus Article | Citations
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Created: Thu, 08 Feb 2007, 10:34:38 EST by Betty Maughan on behalf of Library Corporate Services