Community Integration and Quality of Life in Aphasia after Stroke

Abstract

Purpose: To 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 methods: Thirty 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.

Results: Home 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.

Conclusion: Community 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.

Keywords: Stroke; aphasia; community integration; quality of life.

Fig. 1. Comparison of amount of time spent in performing the Community Integration Questionnaire subunits between aphasia and control groups. Most activities outside home were significantly decreased in the aphasia group (^*p<0.05).

Fig. 2. Mean number of activities performed during a week in aphasia and control groups. Number of social contacts was significantly decreased in the aphasia group (^*p=0.00).

Fig. 3. Correlation between CIQ and multiple factors in the aphasia group. The factors which showed significant correlation are shown in the diagram. FAST score level of PWA, activity of daily living and mobility, depressive mood, and economic status had different influences on CIQ. ^*p<0.05, ^†p<0.01. CIQ, Community Integration Questionnaire; K-FAST, Korean-Frenchay Aphasia Screening Test; MBI, Modified Barthel Index; GDS, Geriatric Depression Scale.