Validation of the Stroke and Aphasia Quality of Life Scale in a multicultural population

Abstract

Purpose: This study aimed to determine the reliability and validity of the Stroke and Aphasia Quality of Life Scale (SAQOL-39 g) and its Mandarin adaptation SAQOL-CSg in Singaporean stroke patients.

Method: First-time stroke survivors were recruited at three months post-stroke and underwent a series of questionnaires in their dominant language (English/Mandarin). This included: SAQOL-39 g/CSg, National University Hospital System (NUHS) Aphasia Screening Test, Barthel Index, Modified Rankin Scale, Mini Mental State Examination, Frontal Assessment Battery, Center for Epidemiologic Studies Depression Scale and the Eurol-Qol Health Questionnaire (EQ-5D). The SAQOL-39 g/SAQOL-CSg was repeated within 1 week (± 6 days).

Results: Ninety-four participants (96.9%) were able to self-report and their results presented here. Both the SAQOL-39 g/SAQOL-CSg showed good internal consistency (α = 0.96/0.97), test–retest reliability (ICC= 0.99/0.98), convergent (r_s=0.64–0.81 and 0.66–0.88, respectively) and discriminant (r_s = 0.35–0.53 and 0.48–0.62, respectively) validity. The correlation between the SAQOL-39 g and the EQ-5D Visual Analogue Scale was 0.27. Further inspection of the EQ-5DVAS scores revealed correlations in different directions for Malay versus Chinese participants.

Conclusions: Both the SAQOL-39 g and SAQOL-CSg demonstrated good reliability and validity. Our results suggested some influence of ethnicity in self-rating of health status in relation to SAQOL-39 g scores. Further research is warranted to examine its use with stroke survivors with greater stroke severity and over time.

Implications for Rehabilitation

• Validation of SAQOL in Singapore:

• Both the SAQOL-39g and the SAQOL-CSg may be used to measure the HRQoL of stroke survivors with and without aphasia in Singapore.

• Further investigation is required to examine use with stroke survivors with greater stroke severity and over time.

Keywords:

• Aphasia
• Aphasia Quality of Life Scale
• health-related quality of life
• multicultural
• Singapore
• stroke outcomes

Acknowledgements

This paper is based on doctoral research being undertaken at The University of Sydney by the first author under the supervision of the second and third authors. Data collection in Singapore was made possible with the support of the fourth author. We thank Ms Angela Cheong, Dr Edimansyah Bin Abdin and Dr Mythily Subramaniam for administrative, material and statistical support.

Disclosure statement

The project is funded in part by the Faculty Postgraduate Funding from The University of Sydney. The first author was supported by the Academic Medicine Development Award from the National University Hospital, Singapore.