Predictors of health-related quality of life (HRQL) in people with chronic aphasia

Background: In recent years, quality of life measures have been used increasingly to evaluate the effectiveness of services or interventions. For people with chronic disabilities, research has focused on identifying the main predictors of their health-related quality of life (HRQL), in order to address the issue of how to meet their needs in rehabilitation in a more holistic way. Aims: This study assessed the main predictors of HRQL in people with chronic aphasia following stroke. We investigated the relationship between HRQL and various demographic and stroke-related variables and other variables that have been associated with HRQL in stroke survivors (e.g., emotional distress, daily activities, social support). Methods: A cross-sectional design was adopted. A cluster sampling framework was used to recruit participants with chronic aphasia (> 1 year) from three different sites. Questionnaires and assessments on the different variables were administered to all participants by a speech and language therapist, in an interview format. Multiple regression analysis was used to assess what were the main predictors of HRQL in people with aphasia. Results: Of 95 participants, 83 (87%) were able to self-report on all the assessments. Emotional distress, involvement in home and outdoors activities, extent of communication disability, and number of comorbid conditions explained 52% of the variance in HRQL (adjusted R 2 = .52). Stroke type (infarct vs haemorrhage), time post-onset, and demographic variables (gender, ethnicity, marital status, employment status, and socioeconomic status) were not significantly associated with HRQL in these participants. Conclusions: Increased distress, reduced involvement in activities, increased communication disability, and comorbidity predict poorer HRQL in people with chronic aphasia after stroke. Service providers need to take these factors into account when designing intervention programmes.