Background: Although the social approach to managing aphasia is designed to improve the quality of life (QOL) of the aphasic person, the influence of being aphasic on different facets of QOL is unknown. Aims: To delineate socially valid therapy targets, we examined 24 facets of QOL proposed by the World Health Organisation (WHO) to determine which facets differentiate QOL between aphasic and nonaphasic people. Methods & Procedures: A prospective, observational, non-randomised group design was employed. Two measures--the WHO QOL Instrument, Short Form (WHOQOL-BREF) and the Psychosocial Well-Being Index (PWI)--were administered to 18 adults with chronic aphasia and 18 nonaphasic adults. Indices of determination (ID) and degrees of overlap (DO) were calculated to determine which of the 24 facets were best in differentiating between the aphasic and nonaphasic groups. Outcomes & Results: Facets within three domains--level of independence, social relationships, and environment--were best in distinguishing QOL between the aphasic and nonaphasic groups. Conclusion: Therapy that focuses on situation-specific communication and societal participation appears to be most appropriate for enhancing the QOL of people with chronic aphasia.
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Ross et al. (2003) studied this question.