Assessing the quality of life among Saudi patients with aphasia after stroke

Abstract

Although there is a growing literature on the impact of aphasia on quality of life (QoL), this has focused on western Christian rather than Arabic cultures. While a few QoL studies have been conducted in Arabic countries, employing translated, culturally unadapted assessment tools, none have considered people with aphasia (PWA). Given the cultural and religious context, this gap needs to be redressed and so this study explored the factors affecting QoL for Saudi PWA, developed a tool to assess QoL, and explored other predictors affecting it. A three-stage qualitative and quantitative approach was used. First, a QoL questionnaire was developed by reviewing existing measures of QoL for aphasia in the light of cross-cultural adaptation, and surveying opinions on QoL and aphasia. Thematic analysis was then employed to produce a questionnaire, which was piloted and then revised. Second, another pilot test was implemented and its properties were examined by factor analysis, producing a shorter version. Third, this version was also piloted and its psychometric properties, accessibility and acceptability were examined. Potential predictors of QoL for demographic and health-related factors for Saudi PWA were then measured. After the review, three main measures were used to develop the questions. Thematic analysis resulted in a developed scale containing 58 items, covering areas such as physical and daily life activities, and communication. This scale was valid and reliable (r 0.992; α=0.896). For the potential predictors, it was found that QoL became worse as factors such as age and severity of aphasia increased. However, gender, post-onset time and employment variables seemed to have no significant effect. The QoL of Saudi PWA centred on mobility, communication, and social participation. Contrary to predictions, religion did not affect QoL despite its importance in Saudi culture, so further research could be conducted on the questionnaire’s psychometric properties, and its clinical implications.