Validation of the assessment of living with aphasia in Singapore

ABSTRACT

Background: The Assessment of Living with Aphasia (ALA) is a pictographic, self-report measure of aphasia-related quality of life (QoL). It has yet to be used in the Singapore population or adapted to other languages.

Aims: To examine the reliability and validity of the ALA and develop a Mandarin Chinese adaptation, the ALA-C, in the Singapore context.

Methods & procedures: Linguistic validation of the ALA was conducted to derive the ALA-C. People with aphasia (PWA) who were at least 6 months post-onset underwent the ALA/ALA-C and a series of reference measures in their dominant language (English/Mandarin). Test–retest reliability was evaluated using intra-class correlations and internal consistency using Cronbach’s alpha. Eight reference measures were administered to assess construct validity.

Outcomes & results: Sixty-six PWA were recruited to the study. Both the ALA and ALA-C showed excellent internal consistency (α = 0.97/0.96) and test–retest reliability (intraclass correlation = 0.97/0.98), and acceptable convergent (r = 0.63–0.83 and 0.70–0.83 respectively) and discriminant (r = 0.45–0.60 and 0.39–0.53, respectively) validity.

Conclusions: Both ALA and ALA-C demonstrated excellent reliability and good validity. Further research is warranted to examine use by more practicing clinicians and with more participants of varying degrees of aphasia severity to enable additional investigation of its psychometric properties.

KEYWORDS:

• Aphasia
• quality of life
• outcomes
• assessment
• Singapore

Acknowledgements

This paper is based on doctoral research being undertaken at The University of Sydney by the first author (Y.E. Guo) under the supervision of the second and third authors. The translation and linguistic validation of the ALA was conducted with permission from the Aphasia Institute. We thank Dr Edimansyah Bin Abdin, Mr Brian So, Ms Faith Tan, Ms Siti Khairiyah Binte Mohamed Jamil and Ms Alison Choo for statistical support and all participants for their time in this study.

Disclosure statement

The authors declare no conflict of interest.

Additional information

Funding

The work was supported in part by the Faculty Postgraduate Funding from the University of Sydney. The first author (Y. E. Guo) was supported by the Academic Medicine Development Award from the National University Hospital, Singapore.