Do social determinants influence post-stroke aphasia outcomes? A scoping review

O’Halloran, Robyn; Renton, Joanne; Harvey, Sam; McSween, Marie-Pier; Wallace, Sarah

doi:10.1080/09638288.2023.2193760

Cited by 15 publications

(9 citation statements)

References 59 publications

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“…Although the authors also reported greater depressive symptoms in individuals with aphasia compared with pre-pandemic scores [26], it appears that the impact on healthy individuals has been higher, and our results might be interpreted as the reflection of the impact of Our study has several limitations. First, the small sample size is a limitation although it is within the typical range of other studies reporting QoL in people with aphasia [22,28]. Secondly, because all the people with aphasia in our study were already recruited in a clinical trial with restrictive inclusion and exclusion criteria, a selection bias cannot be ruled out.…”

Section: Discussionmentioning

confidence: 96%

“…Our study has several limitations. First, the small sample size is a limitation although it is within the typical range of other studies reporting QoL in people with aphasia [22, 28]. Secondly, because all the people with aphasia in our study were already recruited in a clinical trial with restrictive inclusion and exclusion criteria, a selection bias cannot be ruled out.…”

Section: Discussionmentioning

confidence: 96%

“…Fourthly, age and gender differences at baseline may have influenced the results in the tests administered. However, a review of the literature found no supporting evidence of a relationship between gender and language or QoL outcomes in post‐stroke aphasia [28].…”

Section: Discussionmentioning

confidence: 99%

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Impact of post‐stroke aphasia on functional communication, quality of life, perception of health and depression: A case–control study

Bueno‐Guerra,

Provencio,

Tarifa‐Rodríguez

et al. 2023

Euro J of Neurology

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Background and purposePost‐stroke aphasia is associated with a reduced quality of life (QoL) and higher risk of depression. Few studies have addressed the effect of coping with aphasia. Our aim is to evaluate the impact of post‐stroke aphasia on self‐reported QoL and symptoms of depression.MethodsThis was a cross‐sectional prospective case–control study. Cases involved patients with post‐stroke aphasia included in the DULCINEA trial (NCT04289493). Healthy controls were recruited using snowball sampling. All subjects completed the following questionnaires: General Health Questionnaire (GHQ‐12), Stroke Aphasia Quality of Life Scale (SAQOL‐39), Communicative Activity Log (CAL) and Stroke Aphasic Depression Questionnaire (SADQ‐10).ResultsTwenty‐three patients (eight women; mean age 62.9 years) and 73 controls (42 women; mean age 53.7 years) were included. Cases scored lower than controls in perception of health (GHQ‐12: median 3 [IQR 1; 6] vs. 0 [IQR 0; 2]) and perception of QoL (SAQOL‐39: median 3.6 [IQR 3.3; 40] vs. 4.6 [IQR 4.2; 4.8]). Functional communication (CAL: median 135 [IQR 122; 148] vs. 94 [IQR 74; 103]) and SAQOL‐39 communication subscale (median 2.7 [IQR 2.1; 3.2] vs. 4.8 [IQR 4.6; 5.0]) were also significantly lower in the case group. Notably, cases reported fewer depressive symptoms than controls (SADQ‐10: median 11 [IQR 9; 15] vs. 13 [IQR 11; 16]; p = 0.016). A mediational analysis revealed that the relationship between post‐stroke aphasia and depression was not mediated by functional communication.ConclusionsAlthough communication difficulties impact the QoL of patients with post‐stroke aphasia, such patients report fewer depressive symptoms on the SADQ‐10 scale than healthy people, with no differences in scores related to social participation.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

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Impact of post‐stroke aphasia on functional communication, quality of life, perception of health and depression: A case–control study

Bueno‐Guerra,

Provencio,

Tarifa‐Rodríguez

et al. 2023

Euro J of Neurology

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“…These findings suggest very little change in reporting of race from a prior study over a decade earlier (Ellis, 2009). Additionally, this lack of reporting highlights a fundamental aspect of the study of the SDOH in that it is not enough simply to report the sociodemographic characteristics of the participants, but research must also consider how healthcare policy has a differential impact on different groups all attempting to achieve health equity (O'Halloran et al, 2023).…”

Section: Social Determinants Of Health and Aphasia Outcomesmentioning

confidence: 88%

“…Traditional approaches designed to explore aphasia outcomes have primarily focused on neurological measures and a minimum number of sociodemographic characteristics while also utilizing traditional measures of aphasia impairment. O'Halloran et al (2023) proposed that more research should be designed to emphasize the relationship between SDOH and activity, participation, and quality of life rather than the typical approach that simply emphasizes language outcomes (O'Halloran et al, 2023). Some suggest even this approach has been inconsistent thereby resulting in minimum advancement in understanding the complexity of factors that contribute to clinical outcomes (Ellis, 2009;Nguy et al, 2022).…”

Section: Approaches To Explore the Sdoh And Aphasia Outcomesmentioning

confidence: 99%

The Intersection of Social Determinants of Health and Post-stroke Aphasia Outcomes: A Need for Intersectional Analysis

Evans,

Jacobs,

Ellis

2023

Semin Speech Lang

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Aphasia is a disorder that results from damage to portions of the brain that are responsible for language and can vary significantly by type and severity. Differences in aphasia outcomes are influenced by the social determinants of health (SDOH). The SDOH are structural, environmental, and personal determinants that influence health outcomes. Intersectionality, or how one's social and political identities interact to influence individual life outcomes and/or advantage in our society, provides a way to examine the varying levels of the SDOH. However, intersectionality is complex, difficult to measure, and has not yet been explored in post-stroke aphasia outcomes. This article reviews the relationship of race and aphasia outcomes and the SDOH and aphasia outcomes. Additionally, we provide a novel current approach to examine the SDOH and aphasia outcomes. Lastly, we discuss the need for evaluation of intersectionality in aphasia and aim to provide a leveled social–ecological framework to examine aphasia-related outcomes. With notable individual differences among aphasia outcomes, we present a framework to support optimizing research and clinical aphasia care in speech-language pathology.

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Current Topics in Linguistics and Aphasia

Garraffa,

Smith

2024

Linguistic Theory for Aphasia

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Do social determinants influence post-stroke aphasia outcomes? A scoping review

Cited by 15 publications

References 59 publications

Impact of post‐stroke aphasia on functional communication, quality of life, perception of health and depression: A case–control study

Impact of post‐stroke aphasia on functional communication, quality of life, perception of health and depression: A case–control study

The Intersection of Social Determinants of Health and Post-stroke Aphasia Outcomes: A Need for Intersectional Analysis

Current Topics in Linguistics and Aphasia

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