Community Integration and Quality of Life in Aphasia after Stroke

Abstract

PurposeTo examine community integration and contributing factors in people with aphasia (PWA) following stroke and to investigate the relationship between community integration and quality of life (QOL).Materials and MethodsThirty PWA and 42 age-and education-matched control subjects were involved. Main variables were as follows: socioeconomic status, mobility, and activity of daily living (ADL) (Modified Barthel Index), language function [Frenchay Aphasia Screening Test (FAST)], depression [Geriatric Depression Scale (GDS)], Community Integration Questionnaire (CIQ) and Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39). Differences between aphasia and control groups and factors affecting community integration and QOL were analyzed.ResultsHome and social integration and productive activity were significantly decreased in the aphasia group compared to the control group; 8.5 and 18.3 points in total CIQ score, respectively. Amount of time spent outside the home and frequency of social contact were also significantly reduced in the aphasia group. Total mean score on the SAQOL-39 was 2.75±0.80 points and was significantly correlated with economic status, gait performance, ADL, depressive mood, and social domain score on the CIQ. Depression score measured by GDS was the single most important factor for the prediction of QOL, but the FAST score was significantly correlated only with the communication domain of the SAQOL-39.ConclusionCommunity activities of PWA were very limited, and depression was highly associated with decreased community integration and QOL. Enhancing social participation and reducing emotional distress should be emphasized for rehabilitation of PWA.

Social participation in working-age adults with aphasia: an updated systematic review

“…Overall, the studies indicated a greatly reduced productivity level, with few working-age participants returning to paid employment. In a study on a moderate level of evidence, it was found that PWA spent less time on education than individuals without aphasia 20 . The data from an additional study with a low level of evidence indicated that five out of twelve PWA noted moderate or severe limitations in informal education 25 .…”

“…Two studies on a moderate to high level of evidence used the Productivity subscale of the CIQ, with both finding limitations in productivity 20,21 . Attention was given to return to work 13,24,28,29 and the ability to participate in work activities 24,25 .…”

“…In two studies with moderate and high levels of evidence respectively, the Social Integration subscale of the CIQ was used 20,21 , which indicated reduced social integration in working-age PWA, with a decrease in time spent on leisure activities 20 . The remaining two studies on moderate and low levels of evidence respectively, used the ICF to report on their findings 24,29 .…”

Escalas utilizadas para la medición de la calidad de vida en pacientes con enfermedad cerebrovascular

“…A pesar de esto los pacientes con trastorno cognitivo y de la comunicación son excluidos de los estudios, lo que lleva a una carencia de resultados objetivos en esta población, que hace que el enfoque en algunos programas de rehabilitación no sea el adecuado y solamente se trate la alteración del lenguaje y comunicación y no el impacto real de la afasia para lograr una integración a la comunidad que permita mejorar la calidad de vida [38][39][40] .…”

Design principles in housing for people with complex physical and cognitive disability: towards an integrated framework for practice

“…For example, Australian social housing developments have traditionally been located in poorer neighbourhoods and on the outskirts of a community (Jackson, 2008;Wiesel, 2011). With research to suggest that community participation and social integration improves quality of life (Lee et al, 2015;McGarrigle and Layte, 2015), a small number of social housing dwellings have recently been constructed in more central locations. However, being physically located within a community does not necessarily result in community participation, given that "relationships are not always spontaneously formed" (Winkler et al, 2011, p. 161).…”