The relationship between health-related quality of life, perceived social support, and social network size in African Americans with aphasia: a cross-sectional study

ABSTRACT

Stroke significantly impairs health-related quality of life (HRQL). Stroke survivors with aphasia (SWA) experience lower HRQL than stroke survivors without aphasia (SSA) as a result of poorer communication and social functioning. The extent to which aphasia influences HRQL in African-Americans and the components of social functioning that are most important to HRQL warrants further exploration.

There were two main objectives of this paper. The first was to survey HRQL domains of communication, physical, mental/emotional, role, and social functioning in African American SWA and SSA. The second was to examine if social support and social network predicted HRQL in SWA.

A total of 39 African American adults (62.4 ± 11.10) participated in this descriptive cross-sectional case control study. Patient-reported outcome measures were used to assess HRQL, perceived social support, and social network in SWA, SSA, and normal-aging healthy controls (NAH). Data analysis included an ANOVA and moderator regression to determine if social support or social network predicted HRQL in SWA.

SWA reported a significantly lower overall HRQL (p = <.000) than NAH adults. Communication HRQL was the hallmark difference found between SWA and SSA (p = <.000). Social support and social network were relatively similar among all three groups. However, social support and social network did not predict HRQL in SWA.

Findings from this study suggest that social HRQL continues to be significantly lower in SWA; however, social support and social network factors do not drive differences among African-Americans. Moreover, communication HRQL remains the hallmark difference between SWA and SSA.

KEYWORDS:

• Aphasia
• African Americans
• health-related quality of life
• social support
• social network
• patient reported outcomes
• stroke

List of abbreviations

HRQL Health-related quality of life; SWA Stroke survivors with aphasia; SSA Stroke survivors without aphasia, NAH Normal-aging healthy controls; SAQOL-39g Stroke and Aphasia Quality of Life Scale-39g; EQ-5D Euro-Qol 5D; MOS-SSS Medical Outcome Study Social Support Survey; LSNS-6 Lubben Social Network Scale