Researchers and clinicians engaged in the study and treatment of aphasia have made substantial progress over the past 30 years. Substantial improvements have been made in the development of models of aphasia that have subsequently resulted in improvements in aphasia treatment outcomes. At the same time, the financial resources available for the treatment of aphasia have dwindled; yet, the expected outcomes have remained the same.
In some countries such as the United States, recent legislation such as the Affordable Care Act has called for a greater emphasis on outcomes that characterise the broader implications of conditions such as aphasia. Such legislation has placed a greater emphasis on the patient’s perception of aphasia. Consequently, aphasiologists are now required to complete treatment research that measures beyond traditional language outcomes and considers a range of diverse outcomes that include measures of the patient’s perspective.
The papers in this special issue explore a range of topics related to aphasia that extend beyond traditional measures of language performance. This collection includes two reviews and three data-based papers that explore life satisfaction, pain and pain assessment, social relationships in aphasia, quality of life and an exploration of aphasia outcomes to determine which are of most importance to clinicians. The papers included here offer evidence of the need to think about measures that describe not only language impairment but the global impact of aphasia on the individual experiencing the condition.
In the first paper, Ellis and Peach (Citation2017) explore the issue of life satisfaction among persons with aphasia (PWA). Although substantial interest has emerged in the study of quality of life, less attention has been given to life satisfaction or the global assessment of one’s quality of life. Measures of life satisfaction in aphasia offer unique judgements based on what the PWA deems to be most important based on their current life circumstances. The second paper by Wallace and colleagues (Citation2017) uses an e-Delphi approach to determine which aphasia treatment outcomes are most important to clinicians and managers. They attempt to address the frustration many clinicians experience with the lack of strong evidence for aphasia treatment approaches and associated outcomes measures. The goal of this work is to establish core outcome sets to address issues of relevancy, transparency and efficiency of treatment.
A third paper by Hilari and Northcott (Citation2017) offers an exploration of the positive contributions social networks and social support can provide to the recovery of aphasia. Both social networks and social support are critical to PWA who continue to experience residual impairments and communication disability. Additionally, they address the issue of social isolation that many PWA experience, particularly those that do not regain the necessary communication ability to return to their pre-aphasia lifestyles. The fourth paper in the collection by de Vries and colleagues (Citation2017) examines the issue of pain and pain assessment among PWA. Little is known about pain-related issues among individuals with aphasia. The paper examines reports of pain among PWA and evaluates the state of pain assessment among PWA who may also be limited in their ability to communicate the impact of pain on their overall recovery. The fifth and final paper by Nicholas, Hunsaker, and Guarino (Citation2017) explores the contributions of non-linguistic impairments to the quality of life of PWA. The identification of non-linguistic cognitive impairments is critical to the overall assessment of PWA as they combine with language impairments to negatively influence quality of life.
It has been my extreme pleasure to serve as the Guest Editor for this special issue titled “Aphasia Outcomes: Beyond Measures of Language Performance”. The substantial changes in health systems and subsequently approaches to aphasia management require that future research emphasise the use of a diverse range of outcome measures that also include patient-reported measures. It is my hope that this special issue will stimulate both discussion and research designed to elicit the broadest descriptions of aphasia-related outcomes.
Disclosure statement
No potential conflict of interest was reported by the author.
Reference
- De Vries, N., Sloot, P., &, Achterberg, W. (2017). Pain and pain assessment in stroke patients with aphasia: A systematic review. Aphasiology, 31, 702–718. doi: 10.1080/02687038.2016.1254150
- Ellis, C., & Peach, R. (2017). Life satisfaction and aphasia: An integrative review with recommendations for future research. Aphasiology, 31, 631–642. doi: 10.1080/02687038.2016.1154500
- Hilari, K., & Northcott, S. (2017). “Struggling to stay connected”: Comparing the social relationships of healthy older people and people with stroke and aphasia. Aphasiology, 31, 674–687. doi: 10.1080/02687038.2016.1218436
- Nicholas, M., Hunsaker, E., & Guarino, A. J. (2017). The relation between language, nonverbal cognition and quality of life in people with aphasia. Aphasiology, 31, 688–701. doi:10.1080/02687038.2015.1076927
- Wallace, S., Worrall, L., Rose, T., & Le Dorze, G. (2017). Which treatment outcomes are most important to aphasia clinicians and managers? An international e-Delphi consensus study. Aphasiology, 31, 643–673. doi:10.1080/02687038.2016.1186265